Your eyes age first: According to the American Academy of Ophthalmology, the lens in your eye loses flexibility in your late 30s and early 40s. In many cases, little can be done to cure or prevent these losses. That's why Dr. Donald Fletcher, a leading authority on low vision rehabilitation and Medical Director of the Envision Vision Rehabilitation Clinic, says this: “Enjoy the vision you have."
Here's a closer look at two of the most common vision conditions affecting older adults.
Focus on: Macular Degeneration
Macular degeneration is the number one visual condition affecting older adults in the United States, says Karen Kendrick, a Certified Low Vision Therapist (CLVT) who serves as a low-vision occupational therapist (OTR/L) at the Envision Vision Rehabilitation Center in Wichita, Kansas.
Age-related macular degeneration (AMD) is a condition that affects central vision, and there are several stages, says Seema Khanna, an optometrist in York, Pennsylvania. In the early stages (dry AMD), the patient may have some mild blurred vision, decreased contrast, and difficulty adapting from bright light to normal light. In the later stages (wet AMD), there is bleeding in the retina, which can lead to more devastating vision loss. “This can really affect a patient's quality of life because they are no longer able to see fine detail. Their peripheral vision is still normal so patients with AMD will never 'go blind,'" says Khanna.
There is no cure for AMD. “You may hear of people saying they got a shot in the eye (injection) for their macular degeneration," says Kendrick. “This is for the wet form of macular degeneration. The shot is to stop the bleeding in the eye and prevent further growth of the weak blood vessels."
Focus on: Glaucoma
“Everyone will get cataracts if they live long enough," says Khanna. “Whether a patient needs surgery just depends on how severe the cataracts are and how much they are affecting the patient's quality of life," she explains.
What to watch for? Cataracts will often give patients blurry, cloudy vision, problems with glare/nighttime driving, and decreased contrast, Khanna says.
Eye exams are essential as glaucoma can present in various forms, and in many cases, patients have no symptoms, according to Khanna. “In late stages of the disease, patients may develop tunnel vision as their peripheral vision is affected. Certain types of glaucoma can give patients eye pain, halos around lights, but this is not common at all," she says.
Prevention and Next Steps
As your vision changes with age, your eye doctor should become your best friend. Visit often, advises Dr. Fletcher. If you don't already see a vision professional, Dr. Fletcher recommends finding one—and getting a low vision evaluation—when you can no longer read regular-sized newsprint comfortably, or if you can't see clearly anymore.
Many of Kendrick's patients report distortion—or metamorphopsia—as their first symptom of impaired vision, says Kendrick. “They will tell me that the light pole all of a sudden had a bend or curve in it. This is the result of the central blind spot affecting their vision," she explains.
Khanna does nutritional counseling for patients with dry AMD. “Eating leafy green veggies, no smoking, a healthy lifestyle, and lutein/zeaxanthine are important for macular health. Depending on the stage of the dry AMD we may also recommend a vitamin," she says. And while you cannot prevent cataracts completely, Khanna says healthy eating and wearing UV protection may help slow their progression.
For DIY monitoring, Kendrick and Khanna both recommend daily at-home use of the Amsler grid to test for visual changes from macular degeneration or diabetic retinopathy.
Tech Tools That Make the Most of the Vision You Have
“Technology is really where low-vision devices are these days," says Kendrick. “You have simple handheld illuminated magnifiers ranging from 2x magnification all the way up to 14x magnification. But there are also some really great electronic magnifiers that allow a person to change the amount of magnification they need, as well as increase the contrast of the print that they are reading," she explains.
Smartphones and tablets offer a number of helpful low-vision apps with magnifying capabilities and voiceover settings for those who are completely blind. PC users can also download screen-reading or zoom/magnification software. No-glare lenses that help block out the blue wavelength of light emitted from our smart devices and PCs—which has been connected to a increased risk of developing AMD—can ease eye strain, according to Khanna.
Besides the apps, today's larger-sized tablets are a perfect solution for adults with low or impaired vision, particularly the 12-inch iPad Pro and the 18.5-inch Samsung Galaxy View, says Dr. Fletcher. Features like high contrast mode make it easier to see/read text, and Google's Chromecast projects text messages, emails, videos, and anything that comes through your cell phone to your TV.
Home modifications can improve independence in the home for individuals with impaired vision, says Kendrick. “We can tactually mark appliances with little adhesive rubber bump dots," she says. “We mark the buttons on the microwave or the dials on the washer/dryer. This allows for the patients to 'feel' where the buttons are or 'feel' where to turn the dial on the washing machine." Talking clocks, watches, blood-pressure cuffs and thermometers can be useful too, along with telephones featuring large print buttons and talking caller ID. Are you or your parents avid card players? Check out large print or Braille playing cards, adds Kendrick.
Have a large flat screen plasma TV? Turn it into a computer monitor using an HDMI cable, says Dr. Fletcher.
Some things are not always in plain sight. Read 3 Things Your Aging Parent Might Be Hiding.