Protect Your Peepers: Eye Problems in Aging Adults

We know what we’re supposed to do. Have a yearly physical. Visit the dentist every six months. After a certain age, get an annual or bi-annual mammogram or a prostate exam. For a variety of reasons, though, some of us have a hard time sticking to that schedule. We’re even worse when it comes to taking care of our eyes and vision. (We’ll save ears and hearing for another article, but sometimes we’re pretty bad at that, too.) However, your eye health is serious stuff and should be given the same care as the rest of your body.
“As we mature, more people have the diagnosis of diabetes or high blood pressure and people can have eye problems related to those conditions, too,” states Dr. Jed Hillmer, an optometrist who owns Hillmer Eye Clinic near downtown Fargo. “I would say that most people don’t know that, though.”
Age-related eye issues will become an increasing burden on our health care system as our current crop of baby boomers continues to get older. By the year 2030, approximately 70 million Americans will be over 65 years old. A report by the U.S. Department of Health and Human Services shows that roughly one in three elderly patients has some form of vision-reducing eye disease by the age of 65.

When Should You Start?
The American Academy of Ophthalmology recommends adults with no signs or risk factors for eye disease should get a baseline screening at age 40, the time when early signs of disease and changes in vision may start to occur. Your screening will determine if you need any follow-up appointments.
An eye exam helps detect eye problems at their earliest, and most treatable, stage. Dr. Steve Bagan, who has had an eye surgical practice in Fargo since 1980 (he currently owns and practices at Bagan Strinden Vision), advises that every adult should have an eye exam every two years, whether or not they wear glasses or contacts.
“Some eye problems or diseases can’t be detected by the patient until they are advanced or beyond treatment that can restore vision,” explains Bagan. “For example, if vision has deteriorated from glaucoma to the point that the patient can notice it, it is quite advanced. If detected earlier, this loss could be prevented.”

What Can You Expect?
Be prepared to discuss your eye health history at your first appointment. Your clinician will want to know if you’ve ever had an eye exam before and why you’re visiting them now. Is this a routine checkup due to age or do you have a primary concern about your eyesight or eye health?
You’ll undergo routine tests which are designed to measure your visual acuity.
“The way I explain visual acuity is to think of it as your quantity of vision,” says Hillmer. “When you hear things like ‘20/20,’ that’s your acuity, the clearness and sharpness when you see.”
You know those eye charts you’ve seen on TV or at your driver’s test? You’ll read from something similar on the wall and from a hand-held sheet both with and without your glasses or contact lenses.
The American Academy of Ophthalmology describes the next portion of your exam as “objective.” This means that your clinician is not looking for your response, but rather they’re examining the form and function of your eye. They’ll check out things like the retina, pupils, eye muscle movements, eye turns, and motility.
Next, your doctor will have you sit in front of a specialized tool called a biomicroscope to determine the health of your eye. The biomicroscope has lenses and very bright lights the doctor looks through to see the front, middle, and back of your eye. Sometimes your doctor will dilate (enlarge) your pupil with eye drops to get a better view.
All of these tests allow your doctor to make a diagnosis (if needed) or at least give them a baseline from which to measure your eye health during routine appointments. If your doctor does find something disturbing (see “What Are Common Ailments?”), he or she will likely discuss a course of treatment with you.

Who Should You See?
Just like medical practitioners, eye doctors have different levels of education and expertise. Your sight depends on who you see, so you need to make sure you’re visiting the right type of eye professional.
Here is a breakdown provided by the American Association of Pediatric Ophthalmology and Strabismus (misaligned eyes):
An Optician is a technician with whom you’ll work after getting a diagnosis or prescription from your doctor. They’ll help you pick out the right glasses and frames and ensure that the fit is ideal for your face. They’ll also help you learn the basics of contact lens use. They do not test your vision and they’re not permitted to diagnose and treat.
An Optometrist is not a medical doctor, but they do hold a four-year doctor of optometry degree (O.D.), along with the requisite bachelor’s degree. They are licensed to perform eye exams and vision tests, prescribe lenses and medications, and detect some eye abnormalities.
An Ophthalmologist (commonly called an eye doctor or Eye M.D.) has a higher level of training and education compared to an optometrist and optician. Ophthalmologists are licensed to not only practice medicine and surgery, but also diagnose and treat all eye disease issues and prescribe medications. Some ophthalmologists also specialize in surgical eye care or a specific eye area or condition like glaucoma, retina, cornea, pediatrics, neurology, and plastic surgery.
Depending on your needs, you might see one or all of these eye professionals during your life. Bagan says many optometrists and ophthalmologists work well together in formulating a patient’s treatment plan.
“While Eye M.D.s can do eye exams and prescribe eyeglasses and contacts, most concentrate on treating eye disease and doing surgery such as cataract surgery, Lasik surgery, and many other kinds of treatments and surgery,” Bagan explains. “Ideally, the two types of eye doctors work in harmony, with the optometrist sometimes referring the patient to the ophthalmologist for consultation and/or surgery of diseases, and the ophthalmologist relying on the O.D. for their expertise in their specialty area.”

What Are Some Warning Signs?
When it comes to our health, it’s easy to ignore symptoms that something is wrong. We may not want to face the truth. We may not think we can afford treatment. Or, we may think the problem will correct itself. That’s a huge risk when it comes to our eyes.
The American Academy of Ophthalmology warns you need to get your eyes checked if you have diabetes mellitus, high blood pressure, thyroid disease, or you experience any of these symptoms:

  • Bulging of one or both eyes
  • Dark curtain or veil that blocks your vision
  • Distorted or double vision
  • Excess tearing
  • Eyelid abnormalities
  • Halos
  • Loss of peripheral vision
  • Misaligned eyes
  • New floaters (black “strings” or specks in the vision) and/or flashes of light
  • Unusual red eye

Because of our brutally cold climate, Dr. Casey Bartz, an optometrist with Moorhead Vision Associates who specializes in macular degenerations and the diagnosis and management of dry eye syndromes, says many people in the Red River Valley are particularly susceptible to eye issues in the winter.
“The eye is covered by the tear layer and when a cold blast of air hits it, the tear layer is disrupted,” explains Bartz. “You feel burning eyes, watery eyes. In general, many people struggle with uncomfortable eyes and, especially, discomfort with contact lenses because of the cool air.”
Tell your doctor if your family has a history of eye disease; it could make you more prone to certain conditions, too.

What Are Common Ailments?
As you age, it’s normal to not see as well. Your eyes are getting older just like the rest of your body. Bartz says you might notice it first around age 40 when you pick up a book and feel your arms aren’t long enough. Or if the numbers on your cell phone get a bit fuzzy.
Most times, this initial loss can be corrected with over-the-counter reading glasses (called “cheaters” among eye professional circles), but there are several eye diseases that can have long-term and profound effects if left untreated as we age.
Glaucoma—This is actually a group of diseases marked by high pressure inside the eye that can damage the nerve fibers that send information to your brain. As the main nerve, called the optic nerve, deteriorates, blind spots form in your visual field. Left untreated, glaucoma can lead to irreversible blindness.
Primary Open-Angle Glaucoma (POAG) is the most common type of glaucoma disease. In 2000, it was estimated that 2.22 million Americans had POAG, a number that will increase to 3.36 million by 2020, according to the American Academy of Ophthalmology.
Cataracts—These are cloudy areas that cover part or the entire lens of your eye. Imagine a healthy lens is clear like a camera lens. If a cataract is present, light can’t filter through the lens and your eye can’t process the image. They often form slowly and don’t cause pain. Cataracts can usually be removed by outpatient surgery, explains Hillmer. “They used to have to do cataract surgery in the hospital and it was really invasive compared to what it is now,” he says. “Overall, it’s a safer procedure.”
Age-Related Macular Degeneration—This disease causes a blind spot to form in the center of your vision. What’s happening behind the scenes is the center part of your retina is deteriorating. You might also experience distorted printed words or a gradual haziness of your overall vision, according to the Mayo Clinic.
Eye Floaters—The Cole Eye Institute at the Cleveland Clinic describes floaters as tiny spots or specks that float across the field of vision. They can look like black or gray specks. Some complicated cases can look like cobwebs. Most floaters are harmless and don’t require treatment. If you experience flashes of light with your floaters, head to the doctor right away: You could have a retinal tear or detachment.

Don’t Delay
Damaging or losing your vision could have a tremendous impact on your quality of life. Many eye problems are treatable and the earlier they are detected, the more likely you are to retain good eyesight. In certain cases, early treatment, medications, or surgery can prevent vision reduction and vision loss—giving you good reason to schedule that eye exam now.
Protect those peepers. They’re the only two you’ve got.
Patricia Carlson is a freelance writer from Dilworth whose work regularly appears in publications across the country. She also crafts strategic website and marketing content for small businesses. Check out her work at

Filed Under: Elder CareWellness

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