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Eye problems in the age

Many older folk have no problems at all with their eyes and vision, with most maintaining good eyesight into their 80s.

However, natural physical changes can cause some problems with age, and disorders such as cataracts and glaucoma are more likely to occur. Older people generally need brighter light for everyday tasks such as reading, cooking, mending and driving a car.

Common eye complaints

Presbyopia

This is a common disorder first noticed after the age of 40 (usually 45 years onwards) when a change in the eye muscles and lens caused by loss of elasticity makes reading more difficult. You can read only by holding the material at arm's length. This applies to small print as in telephone books and street directories. It is a focusing problem, which is easily corrected by having reading glasses with a convex lens.

Every few years you will need slightly stronger spectacles to allow for decreasing ability to focus. Bifocal lenses may be needed if you have another eye problem.

Floaters

A common complaint is of seeing tiny spots or specks that float across the eye, especially in bright light. They are normal and usually harmless but may be a warning of impending eye problems. If they become more noticeable or cause flashes of light, report to your doctor.

Excessive tears

Excessive tears are usually a sign of increased sensitivity of the eyes to wind, light or temperature changes. This complaint is very common in a cold wind. It can be minimised by wearing glasses, especially sunglasses, in those conditions. However, it may indicate blocked tear ducts (lacrimal ducts) or an eye infection, and so an eye check is recommended.

Dry eyes

This is caused by a reduced production of tears by the tear glands. It can cause many problems, such as blurred vision, itching or burning. It is easily corrected by using artificial tears.

Common eye diseases

Glaucoma

Glaucoma is caused by too much fluid pressure in the eye, which can lead to blindness. It comes in two forms: the rarer acute form (which causes sudden pain and visual problems) and the common chronic form (which slowly develops without any early symptoms). It is important to have any unusual eye symptoms checked, and all elderly patients should have eye tests (including eyeball pressure) every 2 years. When detected, it can be treated and blindness prevented.

Cataracts .. also (cataract pdf - 3/2002)

Normally the lens within the eye is clear and allows light to pass through it. A cataract is where the clear lens becomes cloudy or opaque and cuts down the light entering the back of the eye. Apart from deterioration of vision, there are no other symptoms. They can occur in anyone but are more common in diabetics and those taking cortisone tablets. Cataracts can also run in families. They are diagnosed during an eye examination. A modern lens implant (an artificial lens placed in the space left by the cataract lens) can give excellent results.

Retinal disorders

Disorders of the retina (the photosensitive area of the eye) can lead to varying degrees of blindness. Diabetes and other diseases can cause retinal problems. Sometimes the retina can become detached and seriously affect your eyesight. Retinal detachment can be treated successfully if detected early.

Tips

• Light bulbs are better than fluorescent lights.
• Have regular checks for blood pressure and diabetes.
• Have an eye examination every 2 years.
• Eye problems tend to run in families.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia