1. Healthy Vision for Life
Today, I’m here to talk about vision – specifically - how vision changes as you age.

2. Benefits of Regular Eye Exams
Eye problems and even early stages of many systemic diseases can be detected during an in-person, comprehensive eye exam
Early detection is key to preventing irreversible vision loss
There are important benefits to regular eye care, because some eye diseases may not exhibit symptoms until vision is already lost! Eye problems and even early stages of many systemic diseases can be detected during a comprehensive eye exam. Early detection is the key to preventing irreversible vision loss.

3. Vision changes occur naturally with age
We can experience vision changes at any age – even as children and young adults. However, most everyone will have changes occurring in their early to mid-forties.

4. Common Vision Changes
Many adults find that “their arms aren’t long enough”
Loss of clarity when reading, doing close work, or driving
Sensitivity to light
More time required to adjust to different light conditions
One of the most common vision changes that people usually begin to notice in their early to mid-forties is that their arms aren’t long enough. For example, you may have trouble reading a menu in a dimly lit restaurant.
Loss of clarity when reading or doing close work
Sensitivity to light
More time required to adjust to different light conditions
These are all indicators that your vision is changing. And, the official name for the loss of clarity when reading or doing close work is presbyopia.

5. Benjamin Franklin, famous inventor & presbyope
Although not an optometrist, he is credited with inventing bifocals.
We all recognize the man in the drawing. It is, of course, Benjamin Franklin. Mr. Franklin was presbyopic and; although he was not an optometrist – he is credited with inventing bifocals. Bifocals are one form of treatment for presbyopia.

6. Presbyopia Natural age-related eye condition
The eye stops growing during teenage years, but cells in the flexible lens of the eye haven’t stopped growing, and this continued growth makes the lens less flexible
The lens loses the ability to change focus
Presbyopia is a natural age-related vision condition in which the crystalline lens of your eye loses its flexibility, which makes it difficult for you to focus on close objects.
While this condition may seem to occur suddenly, the actual loss of flexibility takes place over a number of years. By the time you reach your teenage years, the eye has stopped growing; however, the cells in the flexible lens of the eye continue to grow. This is what makes the lens less flexible. Because it is less flexible, the lens then loses its ability to change focus. As I mentioned before, presbyopia usually becomes noticeable in the early to mid-40s. It is not a disease, and it cannot be prevented.
Some signs of presbyopia include the tendency to hold reading materials at arm's length, blurred vision at normal reading distance and eye fatigue along with headaches when doing close work.

7. Most changes can be treated by your optometrist
Reading glasses
Bifocals
Trifocals
Progressive addition lenses
Slide #6: Most of these changes can be treated by your optometrist a variety of ways: reading glasses, bifocals, trifocals and progressive addition lenses are the most common forms of treatment.
Let’s take a moment to discuss some common vision conditions:
Photo courtesy of National Eye Institute, National Institutes of Health

8. Astigmatism
Light rays fail to meet in a focal point which results in blurred vision
Astigmatism is a vision condition that causes blurred vision due either to the irregular shape of the cornea, which is the clear front cover of the eye, or sometimes the curvature of the lens inside the eye. This results in light rays failing to meet at a focal point resulting in blurred vision.

9. Hyperopia Also referred to as farsightedness
Ability to see DISTANT objects more clearly than near objects
Hyperopia – also referred to as farsightedness – is a vision condition in which distant objects are usually seen clearly, but close ones do not come into proper focus. Farsightedness occurs if your eyeball is too short or the cornea has too little curvature, so light entering your eye is not focused correctly.

10. Myopia Also referred to as nearsightedness
Ability to see NEAR objects more clearly than distant objects
Myopia – or nearsightedness – is a vision condition in which near objects are seen clearly, but distant objects do not come into proper focus. Nearsightedness occurs if your eyeball is too long or the cornea has too much curvature, so the light entering your eye is not focused correctly.
Photo courtesy of National Eye Institute, National Institutes of Health

11. Spots & Floaters
Harmless protein materials floating in vitreous (gel-like material inside the eye)
Not serious, but if appear larger, or as showers of bright sparks/flashes, may signify presence of serious eye problems such as retinal detachment or complications of high blood pressure or diabetes
Occasionally, you may see spots or floaters in your eyes. In most cases, these are actually shadowy images of particles floating in the fluid that fills the inside of the eye. Although they can be bothersome, spots and floaters are usually harmless and typically do not risk vision. They are another natural part of the eye's aging process. Keep in mind, if you suddenly see more floaters than normal, and they are accompanied by bright, flashing lights, that may be a warning sign of impending retinal detachment—a tear of the retina. This should be treated immediately to prevent serious loss of vision.

12. Age-Related Eye Diseases
Now, let’s turn our attention to age-related eye diseases.

13. Cataracts
Cells in lens swell and cloud lens preventing light from reaching the retina
Glasses and contact lenses can sometimes improve vision temporarily until surgery is required
Surgery removes clouded lens, replaces with artificial lens
Medicare covers surgery and follow- up care
Cataracts occur when cells in the lens swell and cloud the lens which prevents light reaching the retina. It is a cloudy or opaque area in the normally clear lens of the eye. Depending upon its size and location, it can interfere with normal vision. Most cataracts develop in people over age 55, but they occasionally occur in infants and young children. Usually cataracts develop in both eyes, but one may be worse than the other.
The treatment of cataracts is based on the level of visual impairment they cause.
If a cataract affects vision only minimally, or not at all, no treatment may be needed. Patients may be advised to monitor for increased visual symptoms and follow a regular check-up schedule.
In some cases, a change in eyeglass prescription may provide temporary improvement in visual acuity. Increasing the amount of light used when reading may also be beneficial. And, the use of anti-glare coatings on clear lenses can help reduce glare for night driving.
When a cataract progresses to the point that it affects a person's ability to do normal everyday tasks, surgery may be needed. Cataract surgery involves removing the lens of the eye and replacing it with an artificial lens. The artificial lens requires no care and can significantly improve vision. New artificial lens options include those that simulate the natural focusing ability of a young healthy lens.
Photo courtesy of National Eye Institute, National Institutes of Health

14. Diabetic Retinopathy
Can weaken, and cause changes in small blood vessels that nourish retina (delicate, light sensitive lining of back of eye). Blood vessels may begin to leak, swell or develop branches of new, but abnormal vessels that are prone to bleeding inside the retina or eye.
Early stages may cause blurred vision, or may produce no visual symptoms at all. As disease progresses, symptoms may include cloudiness of vision, blind spots, floaters or other vision disturbances.
Diabetic retinopathy is a condition occurring in persons with diabetes, which causes progressive damage to the retina, the light sensitive lining at the back of the eye. It is a serious sight-threatening complication of diabetes.
Diabetic retinopathy is the result of damage to the tiny blood vessels that nourish the retina. They leak blood and other fluids that cause swelling of retinal tissue and clouding of vision. The condition usually affects both eyes.
Early stages may cause blurred vision, or may produce no visual symptoms at all. As the disease progresses, symptoms may include cloudiness of vision, blind spots or floaters.

15. Diabetic Retinopathy
If left untreated, can cause blindness. Once damage has occurred, effects are usually permanent.
For people with diabetes, diabetic retinopathy is controllable by taking prescribed medication as instructed, sticking to a diet, exercising regularly, reducing high blood pressure and avoiding alcohol and smoking.
The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness. Once damage has occurred, the effects are usually permanent. For those with diabetes, diabetic retinopathy is controllable by taking prescribed medications as instructed, sticking to a diet, exercising regularly, reducing high blood pressure and avoiding alcohol and smoking.

16. Glaucoma
Fluid pressure in eye increases or does not drain properly, results in damage to optic nerve and nerve fibers
No early warning signs
Blindness can occur if left untreated
Vision loss from glaucoma cannot be restored
Photo courtesy of National Eye Institute, National Institutes of Health
Glaucoma is a group of eye disorders leading to progressive damage to the optic nerve, and is characterized by loss of nerve tissue resulting in loss of vision. The optic nerve is a bundle of about one million individual nerve fibers and transmits the visual signals from the eye to the brain. The most common form of glaucoma, primary open-angle glaucoma, is associated with an increase in the fluid pressure inside the eye. This increase in pressure may cause progressive damage to the optic nerve and loss of nerve fibers. Vision loss may result. Advanced glaucoma may even cause blindness. Not everyone with high eye pressure will develop glaucoma, and many people with normal eye pressure will develop glaucoma. When the pressure inside an eye is too high for that particular optic nerve, whatever that pressure measurement may be, glaucoma will develop.
Glaucoma is the second leading cause of blindness in the U.S. It most often occurs in people over age 40, although a congenital or infantile form of glaucoma exists. People with a family history of glaucoma, African Americans over the age of 40, and Hispanics over the age of 60 are at an increased risk of developing glaucoma. Other risk factors include thinner corneas, chronic eye inflammation, and using medications that increase the pressure in the eyes.
Photo courtesy of National Eye Institute, National Institutes of Health

17. Ocular Hypertension
Increase in pressure in eyes with no detectable changes in vision or damage to eyes
Term used to distinguish people with elevated pressure from those with glaucoma
Occurs most frequently in those over age 40, African Americans, and those with family histories of ocular hypertension and/or glaucoma as well as in those with diabetes
Ocular hypertension is an increase in the pressure in your eyes that is above the range considered normal with no detectable changes in vision or damage to the structure of your eyes. The term is used to distinguish people with elevated pressure from those with glaucoma.
This vision condition can occur in people of all ages, but it occurs more frequently in African Americans, those over age 40 and those with family histories of ocular hypertension and/or glaucoma. It is also more common in those who are very nearsighted or who have diabetes.

18. Ocular Hypertension No noticeable signs or symptoms
Not all people with ocular hypertension will develop glaucoma. However, there is increased risk of glaucoma among those with ocular hypertension
No cure for ocular hypertension; however, careful monitoring and treatment can decrease risk of damage to eyes
Ocular hypertension has no noticeable signs or symptoms. While not all people with ocular hypertension will develop glaucoma, there is an increased risk of glaucoma.
And, there is no cure. However, careful monitoring and treatment can decrease the risk of damage to the eyes. Your doctor of optometry can check the pressure in your eyes and can examine the inner structures of your eyes to assess your overall eye health

19. Macular Degeneration Leading cause of blindness in U.S.
Affects the macula, area of eye responsible for clear, sharp vision, located at back of eye
Symptoms include: gradual loss of ability to see objects clearly, distorted vision, and gradual loss of color vision
As disease advances, areas of distortion, disruption or even localized vision loss often appear centrally
Macular degeneration is the leading cause of blindness in America. It results from changes to the macula, a portion of the retina that is responsible for clear, sharp vision, and is located at the back of the eye.
Some common symptoms are a gradual loss of ability to see objects clearly, distorted vision, a gradual loss of color vision and a dark or empty area appearing in the center of vision.

20. Macular Degeneration Two kinds:
WET-- swelling of macula, treatable with anti-inflammatory drugs and/or laser therapy
DRY-- age-related degeneration, not treatable, but certain vitamins and minerals may help prevent or slow progression
There are two forms of macular degeneration. Most people with macular degeneration have the dry form, for which there is no known treatment. However, recent research indicates certain vitamins and minerals may help prevent or slow the progression of macular degeneration. The less common wet form may respond to laser procedures, if diagnosed and treated early. Unfortunately, central vision that is lost to macular degeneration cannot be restored. Low vision devices such as telescopic and microscopic lenses can be prescribed to make the most out of remaining vision.
Vision loss cannot be restored
Low vision devices can be prescribed to make the most of remaining vision
Photo courtesy of National Eye Institute, National Institutes of Health

21. IMPORTANT! After age 60 an annual, comprehensive eye examination is an
important way to
maintain eye health.
: It is important to have regular comprehensive eye exams throughout your life. After age 60, the American Optometric Association recommends adults to have a comprehensive eye exam every year. For those who are considered ‘at risk’ for age-related eye diseases, your optometrist may recommend eye exams more frequently.

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