You use your eyes all of the time, yet you probably don’t think much about them unless they’re bothering you or you’re having vision problems. Nonetheless, it’s important to get your eyes checked on a regular basis as you get older, since many eye problems aren't accompanied by obvious symptoms. The good news is that by making your eyes a priority, many common eye and health issues can be discovered before they cause serious problems.
Eye Exam Guidelines
"Without any history of problems, a baseline comprehensive eye screening exam is recommended at age 40," says Ravi Menghani, MD, MBA, an ophthalmologist with Long Beach (Calif.) Memorial Medical Center who is also on the MemorialCare Physician Society Board of Directors.
For such routine screenings, he says an exam with an optometrist is typically appropriate. An optometrist is a health professional with a doctor of optometry (OD) degree who is licensed to evaluate eyes, and diagnose and treat a variety of general eye conditions. An optometrist can check your vision to make sure you don’t need any correction, or if you do, he or she can prescribe glasses or contact lenses. An optometrist will also be able to diagnose most major eye conditions. Generally, you don’t need a referral for an optometrist. (Just check with your insurer, since every health plan is different.)
If you’ve got hypertension, diabetes, or cardiovascular (heart and blood vessel) disease, you’ll likely need to be screened by an ophthalmologist, Menghani says. An ophthalmologist is an MD who specializes in eye health and can evaluate, diagnose, treat, and also perform surgery on eyes. The services of an ophthalmologist are often covered under health insurance policies. Again, just be sure you select a provider who is considered in-network with your plan, if applicable. (You may need a referral from your primary care physician if you are under an HMO plan.) Your ophthalmologist will determine the appropriate screening frequency, which will depend on your specific risk factors and health status.
4 Common Conditions
"According to the National Eye Institute, the most common eye diagnoses over age 40 are cataract, diabetic retinopathy, glaucoma, and age-related macular degeneration, in that order," Menghani says.
To understand more about each of these diagnoses, here is what you need to know:
- "Cataracts (a clouding of the eye lens) occur gradually and result in a decrease in contrast sensitivity. In other words, things may look a bit hazy or smoky," Menghani says. Cataracts can also cause halos and glare at nighttime. Cataracts are very common; the University of Michigan's Kellog Eye Center estimates that more than 90 percent of people have a cataract by age 65, and cataracts cause vision loss in half of people ages 75-85. Treatment includes prescription eyeglasses, or, in some cases, surgery to replace the damaged eye lens.
- Diabetic retinopathy, which occurs in people with diabetes, causes damage to the retina (the lining in the back of the eyes). It's the result of too-high blood sugar levels, and usually affects both eyes at the same time. The American Diabetes Association says at 4.2 million people over 40 have diabetic retinopathy. In order to prevent this problem, which can impair vision, it’s important to keep your blood sugar levels well controlled.
- Glaucoma causes fluid to build up in the front of the eye, causing pressure that damages the optic nerve and leads to loss of peripheral vision (also referred to as "side vision"). "The most common daily activity that this affects is driving," Menghani says. The Glaucoma Research Foundation reports that more than three million people have glaucoma, though only half of them are aware that they have it. Glaucoma is often treated with special eye drops or surgery.
- Macular degeneration causes the macula (the center portion of the retina that helps you to see) to deteriorate. This condition is the leading cause of vision loss, and it affects more than 10 million Americans, according to the American Macular Degeneration Foundation. Treatments vary depending on the type of macular degeneration and the cause, but may involve taking vitamins and supplements, medications, and laser therapy.
Protecting Your Eyes
"Like most diseases, eye disease becomes more common as we age. The natural aging process can change the cellular structure of our lens and retina, which can produce disease," says Charles Eifrig, MD, FACS, Vitreoretinal Surgeon, Saddleback Memorial Medical Center in Laguna Hills, Calif., and Adjunct Clinical Assistant Professor of Ophthalmology at the University of Southern California Roski Eye Institute at the Keck School of Medicine.
"Risk factors for many retinal diseases are age, cardiovascular disease, hypertension [high blood pressure], diabetes, genetics [family history of same disease], and other conditions," he adds. Other factors that can affect your eyes as you age include smoking, fair skin, and excess exposure to sunlight.
Making Healthy Lifestyle Choices
While regular eye exams provide a valuable opportunity for your eye professional to look for these and other eye-related diseases, it’s also important to incorporate some key lifestyle steps to protect your eye health.
Here are several healthy choices you can make to protect your vision:
- Eat your greens. Consume lots of green leafy vegetables like spinach and kale, which contain antioxidants that are good for your vision and protect your retina from being damaged by harmful light. It’s also important to eat a balanced diet and get plenty of exercise to maintain healthy eyes.
- Protect your peepers. Wear sunglasses that filter out the sun's harmful ultraviolet light, and use safety glasses for sports and when doing home improvement projects, Eifrig suggests.
- Get comfortable. When your eyes are tired, irritated, or dry, "Keeping the eyes lubricated with over-the-counter tears and warm compresses atop the closed eyelids will help maintain comfort," Menghani says.
Charles Eifrig, MD, FACS, and Ravi Menghani, MD, MBA, reviewed this article.
Sources
Eifrig, Charles, MD, FACS. Email interview July 1, 2016.
Menghani, Ravi, MD, MBA. Email interview July 1, 2016.
"Cataract." University of Michigan Kellogg Eye Center. Page accessed July 14, 2016.
"Glaucoma Facts and Stats." Glaucoma Research Foundation. Last reviewed May 5, 2015.
"Statistics About Diabetes." American Diabetes Association. Page last edited April 1, 2016.
"What Is Macular Degeneration?" American Macular Degeneration Foundation. Accessed online July 1, 2016.
