Aging Eyes: What’s Normal, What’s Not

Like every other body part, our eyes change as we age. Mostly, the changes are unwelcome, but some are more annoying than threatening. But some changes, as explained in Healthbeat, a publication from the Harvard Medical School, are serious and require immediate attention.

Normal age-related changes include increasing difficulty focusing on close objects — many people need to use reading glasses sometime in their 40s to address their eyes’ diminishing elasticity in switching from far to near vision.

Other aspects of getting older include thinning eyelashes, and less lubrication. The former might be aesthetically objectionable, but the latter can leave your eyes feeling dry, sticky or gritty. Your vision often is less acute when you get older, and can make driving more difficult.

More serious vision problems primarily related to age are cataracts, macular degeneration and diabetic retinopathy.  All can make you blind, or partly blind.

Cataracts are cloudy areas in the eye’s lens that cause blurred or hazy vision. According to the National Institutes of Health  (NIH), some remain small and don’t much affect eyesight. Others become large and reduce vision, and can be corrected by replacing your clouded lens with an artificial one during outpatient surgery.

Macular degeneration (or age-related macular degeneration, AMD), says the NIH, is a disease that destroys your sharp, central vision, which is necessary to see objects clearly, to read and to drive. AMD does not hurt, but it causes cells in the macula, which enables you to see fine detail, to die.

There are two types, wet and dry. Wet AMD is characterized by abnormal blood vessel growth, which leak blood and fluid and damages the macula quickly. Blurred vision is a common early symptom. In dry AMD, light-sensitive cells in the macula slowly break down, and central vision is gradually lost. A common early symptom is that straight lines appear crooked. Treatment can slow vision loss.

Last week, the NIH released the results of a study showing that women with a genetic predisposition for AMD significantly increased their odds of developing the disorder if they also were heavy smokers and didn’t regularly exercise or eat sufficient fruits and vegetables.

Diabetic retinopathy, according to the NIH, is the most common diabetic eye disease and a leading cause of blindness in American adults. It’s caused by changes in the blood vessels of the retina. Sometimes, the blood vessels swell and leak fluid; sometimes, abnormal new blood vessels grow on the surface of the retina (the light-sensitive tissue at the back of the eye).

If you have diabetic retinopathy, you might not notice changes to your vision initially. But diabetic retinopathy can get worse and cause vision loss, and usually affects both eyes.

So some serious eye issues can arise before you even know you’re at risk; other problems might seem dire, but aren’t. How do you know when to seek care, and when to just curse the aging process?

An annual visit to the ophthalmologist can help you cope with normal eye aging. But detecting significant problems early is key to preserving your vision. As Healthbeat advises, contact your doctor if you experience these signs and symptoms:

  • change in iris color
  • crossed eyes
  • dark spot in the center of your field of vision
  • difficulty focusing on near or distant objects
  • double vision
  • dry eyes with itching or burning
  • episodes of cloudy vision
  • excess discharge or tearing
  • eye pain
  • floaters or flashers
  • growing bump on the eyelid
  • halos (colored circles around lights) or glare
  • hazy or blurred vision
  • inability to close an eyelid
  • loss of peripheral vision
  • redness around the eye
  • spots in your field of vision
  • sudden loss of vision
  • trouble adjusting to dark rooms
  • unusual sensitivity to light or glare
  • veil obstructing vision
  • wavy or crooked appearance to straight lines

For more information about your eyes, see our backgrounder on ophthalmology.

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