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SALEM COMMUNITY HOSPITAL...With aging comes changes in vision

June 3, 2012
Salem News

Eyesight is often one of the first senses affected by aging, and almost everyone's vision deteriorates to some degree.

If you're over 40, you've probably noticed some differences in how well you see. Just like your body, your eyes and vision can change over time.


"Beginning in the early to mid-forties, most adults start to experience problems in seeing clearly at close distances, especially when reading," explained Ophthalmologist Bart Brine, M.D. "This normal aging of the eye's ability to focus, called presbyopia, will progress as the lens loses elasticity and makes it difficult to focus on close-up objects."

Along with presbyopia, other vision problems become more common over 40, including:

Changes in Color Perception: The eye's lens is normally clear and may start to discolor, making it harder to distinguish between certain shades of colors. "The yellowing lens tends to absorb and scatter blue light, making it more difficult to see differences in shades of blue, green, and violet," he added. "Colors may seem duller, and contrasts between colors will be less noticeable. It also may become more difficult to tell where an object ends and its background begins, making it harder to see curbs or steps. Eventually, the underlying process that causes lens yellowing may lead to cataracts."

Pupil Changes: "The most significant age-related changes seem to occur in the lens and the pupil, as the pupil becomes smaller and less responsive to changes in light," Dr. Brine continued. "The pupil controls the amount of light that reaches the retina. As the pupil decreases in diameter, it becomes harder to see well in dim light. The less able the pupil is to adjust to varying light conditions, including glare, the more difficult it is for a person to adapt to darkness or bright light."

Proper illumination can help compensate for many of the changes to the aging pupil. Studies show that for specific tasks, the average 60-year-old needs at least three times the amount of light compared to the average 20-year-old. To reduce glare from the use of brighter lighting, avoid bare bulbs and lights without shades; and cover shiny, polished surfaces in the home or work area. In addition, more time may be needed to adjust to changing levels of illumination, such as going from sunshine into a dimly lit room.

Reduced Tear Production: With age, the tear glands in the eyes produce fewer tears and the eyes may feel dry and irritated. This is particularly true for women after menopause.

Other Vision Problems

Cataracts: By age 65, about half of all Americans have developed some degree of lens clouding, although it may not impair their vision. "As a person ages, the eye's lens becomes less flexible and less transparent," said Dr. Brine. "A cataract occurs when the lens becomes cloudy and light rays cannot easily pass through it. At first, the cloudiness may affect only a small part of the lens and the person may be unaware of any vision loss. As the cataract grows denser, it clouds more of the lens and vision is blurred. Surgical procedures are available for people whose degree of vision impairment due to cataracts is severe enough to interfere with their safety or quality of life."

Glaucoma: "There are various types of glaucoma, which can be caused by high pressure within the eye and damage to the optic nerve," Dr. Brine advised. "Glaucoma is one of the main causes of sight loss and usually affects people over the age of 40."

Macular Degeneration: "The macula is the central part of the retina used for detailed vision," Dr. Brine stated. "As a person's eyes age, the macula can gradually degenerate. Eventually, a 'blind spot' can develop in a person's center of vision, while his or her peripheral or side vision is normally unaffected."

Protect Your Eyes

"Fortunately, there are several ways to lessen the impact of age-related eye changes," Dr. Brine added. "One of the first steps in protecting your eyes is to distinguish between vision changes that are due to normal aging processes and vision changes that may be signs of disease. The internal and external structures of the eyes, which work together to help people see clearly at various distances and under different lighting conditions, begin to wear down as people get older."

Studies show that certain lifestyle habits and dietary choices may help protect the lens of the eye and reduce the risk of certain lens conditions that diminish sight. According to a study published in the American Journal of Nutrition, a diet rich in vitamin C and foods containing plant pigments or carotenoids, may help protect the lens of the eye and reduce the risk of cataracts. A lack of these nutrients appears to speed cross-linking, a process in which proteins in the lens form unwanted links or bonds, making the lens thicker, more rigid, and scattering even more light than it would otherwise. Carotenoid-rich foods include sweet potatoes, cantaloupe, spinach, tomatoes, kale, and mangoes.

In addition to nutritional deficits, other lifestyle choices may speed up cross-linking and put lens' health at risk, such as smoking and excessive exposure to UV rays from the sun.

What's Not a Normal Part of Aging

"As you get older, it is very important to have regular eye examinations," Dr. Brine concluded. "A regular eye test every one to two years is a vital health check and this is especially true once a person reaches 40. Age increases the risk of cataracts, glaucoma and macular degeneration; but a thorough eye test can help detect these conditions early on. Don't rely on a substitute eye exam like a driver's license vision test or a vision screening to determine if you have a vision problem. Many eye diseases do not have warning symptoms and could be minimized or slowed with proper treatment."

Bart Brine, M.D., is a board certified ophthalmologist, affiliated with Salem Community Hospital's medical staff. His office is located at 1059 East State Street in Salem, 330-332-9991, and 32 East Broadway in Alliance, 330-821-0314.



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