What Seniors Need To Know About Vision Loss

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The three most common eye conditions that tend to arise later in life are cataracts, macular degeneration and glaucoma. This article from U.S. News and World Report takes a look at each of them and how to care for aging eyes.

For most of us, hitting age 40 signals a time of change with regard to several aspects of our health. One of the most noticeable is a change in how we see close-up objects. Called presbyopia, this condition is different from garden-variety farsightedness and results from a loss of flexibility of the lens in the eye – the lens gets more rigid and it’s simply more difficult to focus on objects near to you. It’s a relatively easy problem to correct – many of us simply reach for a pair of “cheater” reading glasses or a flashlight to help navigate the fine print of restaurant menus and other small type in low-lit areas. Others find it might be time for that first pair of prescription glasses.

But as we continue to age, our eyes continue to change. Those changes may require more than a cheap pair of readers to correct, and changing eye health can also have implications for overall health. Dr. Mona Adeli, an ophthalmologist with the Havener Eye Institute at The Ohio State University’s Wexner Medical Center in Columbus, says “there are certain changes that you can expect as you get older, some of which are kind of universal to most people as they age.” Other conditions, “we’re just more likely to develop with age, but are not necessarily part of a normal aging process.”

The three most common eye conditions that tend to arise later in life are:

  • Cataracts
  • Macular degeneration
  • Glaucoma


Cataracts is the term used to describe when the natural lens inside the eye becomes cloudy. “You have a clear lens in your eye that helps focus light on the back of the eye or the retina,” a patch of light-sensitive cells, Adeli explains. “Once you get older, the lens can get cloudy, and once it becomes cloudy, we call that a cataract.”

Symptoms may include a gradual or progressive decrease in vision. Adeli says many people begin to notice that their glasses are no longer helping to correct their visions. “They also will frequently notice problems from the glare of bright lights, particularly when driving at night.”

Adeli says everyone can expect to eventually “develop cataracts with age if they get old enough. Some people may be more symptomatic from their cataracts and require surgery sooner rather than later, but really everyone can expect to develop cataracts,” given enough time. The American Academy of Ophthalmology reports that “cataracts affect more than 24.2 million Americans age 40 and older. By 75, approximately half of all Americans have cataracts.”

Although not all cataracts cause vision loss severe enough to interfere with your daily activities, for some people, they can cause blindness. Dr. Rishi Singh, staff physician with the Cole Eye Institute at the Cleveland Clinic, says “cataracts are the most common cause of visual blindness across the world.”

However, they are highly treatable, and vision loss caused by cataracts is usually reversible. Using a surgical procedure, your ophthalmologist can remove the clouded lens and replace it with a specially designed artificial lens. “It’s a plastic lens that’s custom fit or measured to be in the eye to help you see better,” Singh says. This procedure is done thousands of times each day across the U.S. “Cataract surgery is the most common outpatient procedure done in the United States across all specialties,” Singh says. “It’s incredibly common – about 2 million adults have cataract surgery each and every year, and it’s a very effective and safe procedure.”

Adeli notes that this area of vision care has improved greatly over the past few decades. Previously, surgery to correct cataracts would remove the cloudy lens, but there wasn’t anything to replace it with, so “after cataract surgery, patients wore very thick Coke-bottle glasses. But now we have artificial lenses that can correct vision and minimize the need for glasses after surgery.” These artificial lenses, which could be thought of as a sort of internal contact lens, can often function nearly as well as your original lens did before the cataract developed.

Macular Degeneration

As the name implies, macular degeneration is a condition in which the macula – a part of the retina – degenerates, or loses function. There are two forms of macular degeneration – dry (non-neovascular or non-exudative) and wet (neovascular or exudative). The AAO reports that nearly 11.2 million Americans aged 50 and older have macular degeneration.

The American Macular Degeneration Foundation reports that about 90 percent of all cases of age-related macular degeneration are the dry form, in which the cells of the macula atrophy, and drusen – small piles of waste from the cells – may buildup on the retina. Singh says the dry form typically results in a slow progression of vision loss.

In some cases, dry macular degeneration can convert into the wet form, which Singh says causes “aggressive vision loss.” This disease, which accounts for about 10 percent of all cases of age-related macular degeneration, can cause blindness faster. With the wet form, new blood vessels grow behind the retina, but they are weak and can leak fluid and blood. This leakage can cause scar tissue to develop that prevents the retina from doing its job.