Health

Yearly Eye Exams Safeguard Vision in Older Adults

Good vision is a gift many of us take for granted — until a problem develops. And while you probably already know the importance of regular physical exams, you may not realize that all older adults should have a comprehensive eye exam once a year.

“The reason this is so important is that it gives your doctor the opportunity to diagnose eye problems early while they’re still treatable — before irreversible vision impairment occurs,” explains Cynthia Owsley, MD, professor in UAB’s Department of Opthalmology in the School of Medicine. “A comprehensive eye exam includes dilation and can be performed by either an ophthalmologist or optometrist.”

Three eye problems commonly affecting older adults — cataracts, glaucoma, and macular degeneration — can causes severe impairments if left untreated. “We use vision in all aspects of life, so vision impairments can have serious consequences and cause profound disability in the elderly,” says Dr. Owsley. “Many older people may also be living with other diseases of aging, so vision impairment can be especially difficult.”

Here’s what you need to know about the most common eye problems among older adults — so you can take steps today to protect your vision for tomorrow.

Cataracts — Common and Treatable

A cataract is a painless, cloudy area in the lens of the eye that blocks the passage of light to the retina — the nerve layer at the back of the eye. “Everyone gets some degree of cataracts as they age, but there’s great variability in the severity of cases,” explains Dr. Owsley. “The condition can be debilitating in many people. It can cause cloudy or unclear vision and can also cause significant glare problems.”

The good news is that cataracts are highly treatable. “We can treat the vast majority of cases in an outpatient procedure covered by Medicare or Medicaid,” Dr. Owsley explains. “After the procedure, most patients need reading glasses.”

Glaucoma — Dangerous and Silent

“Glaucoma is a common vision problem typically associated with aging,” explains Dr. Owsley. “The condition is often accompanied by high pressure inside the eye, although people with normal fluid pressure can also have glaucoma.”

The increased fluid pressure inside the eye can damage the optic nerve. “If the condition progresses to the point that the optic nerve is destroyed, permanent vision loss results,” says Dr. Owsley. “But it’s important to know that progression of this disease can often be minimized with early intervention.”

Dr. Owsley explains that early treatment for glaucoma often involves eye drops to relieve the pressure inside the eye and help preserve peripheral vision – which is typically affected in early stages of the disease.

“The big problem with glaucoma is that it’s a silent disease with no obvious symptoms in its early phases,” observes Dr. Owsley. “In Alabama, glaucoma is the leading cause of irreversible vision impairment among older African Americans. That’s why yearly comprehensive eye exams are so important for diagnosing and treating dangerous eye problems such as glaucoma.”

Macular Degeneration — Serious and Potentially Debilitating

Macular degeneration — also known as AMD — is the leading cause of severe vision loss in people over age 60. This age-related eye disease occurs when the small central portion of the retina, called the macula, slowly deteriorates.

“Many new treatments have become available in the past few years that can slow or prevent further progression of AMD,” Dr. Owsley explains. “If you’re not plugged in to comprehensive eye care, you could miss the chance for early intervention and treatment of AMD – which can cause serious visual disability.”

Two Groups That May Be Missing Eye Care

While yearly comprehensive eye exams are important for all older adults, Dr. Owsley points out that two groups in particular don’t seem to be getting the care they need – nursing home residents and older African Americans, particularly in rural areas.

“Vision impairments and rates of eye disease are much higher among nursing home residents,” observes Dr. Owsley. “Because the most common eye conditions among this group are cataracts and the need for reading glasses, much of the impairment is reversible. The important message here is that if you have a loved one in a nursing home, make certain they’re receiving regular eye exams.”

Dr. Owsley says that — like many nursing home residents — many older African Americans aren’t plugged in to regular, comprehensive eye care. “This group is less likely to receive care, even though Medicare and Medicaid would pay for eye exams,” explains Dr. Owsley. “There are many reasons that underlie this situation, including the cost of eyeglasses and trust and communication issues with the doctor. Eye health education programs are needed in order to remove the barriers to care for this population.”

Dr. Owsley points out that lack of transportation can also be a barrier to care for this group — as well as many other older Americans. “We’re currently conducting an eye health education program targeted to older African Americans in Alabama, stressing the importance of eye care and making them aware of transportation services in their cities and counties,” she adds. “For all older adults, the importance of regular eye exams in helping to prevent visual disability can’t be overstated.”