Seeing through Ages

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One of our greatest fears is becoming dependent. Blindness and vision impairment—which increase with age—directly contribute to dependency, presenting challenges to families and caregivers.

National studies indicate that vision loss is associated with diabetes, heart disease, stroke, death, falls and injuries, depression, and social isolation. It also compromises our quality of life because it diminishes our ability to read, drive, walk, watch entertainment and participate actively in visual art. Eventually vision loss and blindness isolates us from others.

Vision impairment comprises an important public health issue for older adults, affecting one out of six older Americans.  Vision impairments double in persons aged 80 years compared with persons ten years younger. Although more than half of those with impaired vision could improve their eyesight by using prescription lexes, others experience underlying diseases that can result in blindness.

Because eyes are such refined organs in the body, they are prone to damage through increase in blood pressure. Anything that contributes to blood pressure can therefore directly cause blindness—smoking, high cholesterol, being overweight and diabetes. These serious diseases include diabetic retinopathy, cataract, glaucoma, and macular degeneration. Vision problems might start slowly, but they have serious consequences that can lead to blindness. In many cases, blindness can be prevented through early detection and treatment.

Cataracts, the most common eye disease, afflict nearly one in three older adults. A cataract is a clouding of the eye’s lens. More than 15 million Americans aged 65 years or older have a cataract in one or both eyes. By 2020, the estimated number of people aged 40 or older with cataracts is expected to rise to more than 30 million.

Afflicting one in ten older adults, glaucoma and age-related macular degeneration (AMD) are the second most common type of eye diseases among older adults.

Glaucoma is caused by fluid pressure which damages the eye’s optic nerve. Both slow- and fast-developing (painful) glaucoma characterize this disease which is more prevalent among Blacks and Latinos. The number of glaucoma cases specifically among Latinos aged 65 years or older who have diabetes is expected to increase 12-fold by 2050.

On the other hand, AMD affects the central part of the retina (macula), occurring in both wet and dry forms. Wet AMD occurs when blood vessels start leaking under the macula, impairing the senses. While dry AMD—the most common in about 90% of cases—is where the macula thins over time.  AMD is more likely to affect Whites and accounts for half of all blindness among White Americans.  AMD cases are expected to double by 2050, increasing to 17.8 million.

Among older adults who reported moderate or extreme vision loss, one out of four reported that cost prevented them from seeking eye care. In some cases a balanced nutritional supplement can save your eyesight. Older adults should know that Medicare pays for glaucoma screening, cataract removal, and treatment of macular degeneration in some cases. Although Medicare does not pay for routine eye examinations or glasses, numerous agencies offer free or reduced-rate examinations. Your local adult enrichment center should have more details. Eye Care America (http://www.eyecareamerica.org/), run by volunteer ophthalmologists, offers no cost screenings to those who qualify.