Issue 1, March 2007
FEATURE ARTICLE - New Medicaid Regulations Mean Big Changes | HEALTHLINE - Aging and Your Eyes | LIFE CARE PLANNING - What is an Elder Care Coordinator | CAREGIVER HELPLINE - Resources for Caregivers | ONE FAMILY'S STORY - Meet Joseph Buonadonna

HEALTHLINE - Aging And Your Eyes

March is National Save Your Vision Month, a good time to look at your eye health. Age can bring changes that affect your eyesight. Some changes are more serious than others, but no matter what the problem, there are things you can do to protect your vision. The keys are regular eye exams and finding problems early.

Five Steps to protect Your Eyesight

1. If you are over 60, have your eyes checked every year by an opthalmologist or optometrist. He or she should put drops in your eyes to enlarge (dilate) your pupils. This is the only way to find some eye diseases, such as diabetic retinopathy, that have no early signs or symptoms. If you wear glasses, they should be checked too.
2. Find out if you are at high risk for eye disease. Are you over age 65? Are you African American and over age 40? Do you or people in your family have diabetes or eye disease? If so, you need to have a dilated eye exam.
3. Have regular physical exams to check for diseases like diabetes and high blood pressure. These diseases can cause eye problems if not treated.
4. See an eye care professional right away if you suddenly cannot see or everything looks dim or you see flashes of light. Also see an eye care professional if you have eye pain, fluid coming from the eye, double vision, redness or swelling of your eye or eyelid.
5. Wear sunglasses that block ultraviolet (UV) radiation and a hat with a wide brim when outside. This will protect your eyes from too much sunlight, which can raise your risk of getting cataracts.

Eye Problems
Some eye problems do not threaten your eyesight. Others are more serious diseases and can lead to blindness.


Common Eye Problems

The following common eye complaints can be treated easily. Sometimes they can be signs of more serious problems.

Presbyopia (prez-bee-OH-pee-uh) is a slow loss of ability to see close objects or small print. It is a normal process that happens as you get older. Holding the newspaper at arm's length is a sign of presbyopia. You might also get headaches or tired eyes when you read or do other close work. Reading glasses usually fix this problem.

Floaters are tiny specs or "cobwebs" that seem to float across your eyes. You might notice them in well-lit rooms or outdoors on a bright day. Floaters can be a normal part of aging. Sometimes they are a sign of a more serious eye problem such as retinal detachment. If you see many new floaters and/or flashes of light see your eye care professional right away. This is considered a medical emergency.

Tearing (or having too many tears) can come from being sensitive to light, wind or temperature changes. Protecting your eyes, by wearing sunglasses for example, may solve the problem. Sometimes, tearing may mean a more serious eye problem, such as an infection or blocked tear duct. Your eye care professional can treat both of these conditions.

Eyelid Problems can come from different diseases or conditions. Common eyelid problems include red and swollen eyelids, itching, tearing, being sensitive to light and crusting eyelashes during sleep. This condition is called blepharitis (ble-fa-RI-tis) and may be treated with warm compresses. Other less common eyelid problems, such as swelling or growths, can be treated with medicine or surgery.

Eye Diseases and Disorders

The following eye problems can lead to vision loss and blindness. Often they have few or no symptoms. Having regular eye exams is the best way to protect yourself. If your eye care professional finds a problem early there are things you can do to keep your eyesight.

Cataracts are cloudy areas in the eye's lens causing loss of eyesight. Cataracts often form slowly without any symptoms. Some stay small and don't change eyesight very much. Others may become large or dense and harm vision. Cataract surgery can help. Your eye care professional can watch for changes in your cataract over time to see if you need surgery. Cataract surgery is very safe. It is one of the most common surgeries done in the United States.

Corneal diseases and conditions can cause redness, watery eyes, pain, lower vision or a halo effect. The cornea is the clear, dome-shaped "window" at the front of the eye. Disease, infection, injury and other things can hurt the cornea. Some corneal conditions are more common in older people. Treatments for corneal problems can be simple. You may just need to change your eyeglass prescription and use eye drops. In severe cases, corneal transplantation is the treatment. It generally works well and is safe.

Dry eye happens when tear glands don't work well. You may feel itching, burning or have some vision loss. Dry eye is more common as people get older, especially among women. Your eye care professional may tell you to use a home humidifier or special eye drops (artificial tears) or ointments to treat dry eye. In serious cases special contact lenses or surgery can help.

Glaucoma comes from too much fluid pressure inside the eye. Over time, the pressure can hurt the optic nerve. This leads to vision loss and blindness. Most people with Glaucoma have no early symptoms or pain from the extra pressure. You can protect yourself by having regular eye exams through dilated pupils. Treatment may be prescription eye drops, medicines that you take by mouth, laser treatment or surgery.

Retinal disorders are a leading cause of blindness in the United States. The retina is the thin tissue that lines the back of the eye and sends light signals to the brain. Retinal disorders that affect aging eyes include:

Age-related macular degeneration (AMD). AMD affects the part of the retina (the macula) that gives you sharp central vision. Over time, AMD can ruin the sharp vision needed to see objects clearly and to do common tasks like driving and reading. In some cases, AMD can be treated with lasers. Photodynamic therapy uses a drug and< strong light to slow the progress of AMD. Another treatment uses injections. Ask your eye care professional if you have signs of AMD. Also ask if you should be taking special dietary supplements that may lower your chances of it's getting worse.

Diabetic Retinopathy This is a problem that may appear if you have Diabetes. It happens when small blood vessells stop feeding the retina as they should. It develops slowly and there are no early warning signs. Laser surgery and a treatment called vitrectomy can help. Studies show that keeping blood sugar under control can prevent diabetic retinopathy or slow its progress. If you have Diabetes, be sure to have an eye exam through dilated pupils at least once a year.

Retinal Detachment This is when the retina seperates from the back of the eye. When this happens, you may see more floaters or flashes of light in your eye, either all at once or over time. Or it may seem as though there is a curtain in front of your eyes. If you have any of these symptoms, see your eye care professional at once. This is a medical emergency. With surgery or laser treatment, doctors can often bring back all or part of your eyesight.

Low vision affects some people as they age. Low vision means you cannot fix your eyesight with glasses, contact lenses, medicine or surgery. It can get in the way of your normal daily routine. You may have low vision if you:

• have trouble seeing well enough to do everyday tasks like reading, cooking or sewing;
• can't recognize the faces of friends or family;
• have trouble reading street signs; or
• find that lights don't seem as bright as usual.

If you have any of these problems, ask your eye care professional to test you for low vision. There are special tools and aids to help people with low vision read, write and manage daily living tasks. Lighting can be changed to suit your needs. You also can try large-print reading materials, magnifying aids, closed-circuit televisions, audio tapes, electric reading machines and computers that use large print and speech.

Other simple changes also may help:

• Write with bold, black felt-tip markers.
• Use paper with bold lines to help you write in a straight line.
• Put colored tape on the edge of your steps to help you keep from falling.
• Install dark-colored light switches and electrical outlets that you can see easily against light-colored walls.
• Use motion lights that turn on by themselves when you enter a room. These may help you avoid accidents caused by poor lighting.
• Use telephones, clocks, watches with large numbers; put large-print labels on the microwave and stove.

For More Information

To learn more about eye health, contact:

National Eye Institute (NEI)
National Institutes of Health
2020 Vision Place
Bethesda, MD 20892-3655
301-496-5248
www.nei.nih.gov

For more information on health and aging, contact:

National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
800-222-2225 (toll-free)
800-222-4225 (TTY toll-free)

Source: National Institute on Aging
U.S. Department of Health and Human Services

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