Ageing eyes: What to Expect and how to slow it down

Signs of ageing eyes

Your eyes age along with the rest of your body. One of the first symptoms of our eyesight starting to fail is the loss of our ability to focus on near objects. You sudddenly find you have to increase the distance between your eyes and your reading material, which commonly occurs during your 40s. This condition, which occurs when the lenses of your eyes become less flexible, is known as presbyopia. Unfortunately, this is not the only change in the health of your eyes as you age.

You shouldn’t regard declining vision as a ‘normal’ part of ageing. In fact, “20/20” vision is considered the normal vision of a healthy 80 year old eye! However, development of new eye diseases or the worsening of existing problems can cause your vision to deteriorate. Some of these happen gradually and subtly. Others happen suddenly and can rapidly cause blindness.

Vision loss in ageing eyes

Vision loss among everybody, but particularly older people, is a major health care problem. Approximately one person in three elderly persons has some form of vision-reducing eye disease by the age of 65. The most common causes of vision loss among the elderly are age-related macular degeneration, glaucoma, cataract and diabetic retinopathy.

If you suffer vision loss, it can severely compromise your lifestyle and independence. Unfortunately, many older Australians are forced to withdraw from their pasions and hobbies due to vision loss, which can lead to isolation and depression. So looking after your eyes is really important. Fortunately, many of these age-related eye diseases can be slowed down, or even prevented, through appropriate medical care – as well as generally taking  care of your overall health: food food and not too much, no smoking, exercise, no alcohol and good sleep. Yes, you’ve heard it all before. But it really pays dividends as you get older.

Another action that is important is having your eyes examined regularly by an eye specialist. This is very important so that early signs of eye problsems can be identified and treated. With the right guidance you can take steps to lower your risk of developing age-related vision problems. Or, if you have changes, you can slow their rate of progression.

These are the common eye problems in ageing eyes:

Macular degeneration

If your central vision has become distorted and blurred, you may be suffering from age-related macular degeneration.

Glaucoma

Glaucoma occurs when the pressure inside the eye causes damage to the optic nerve (the nerve of sight). This results in progressive and irreversible visual field loss. Glaucoma usually affects the peripheral vision first and is therefore asymptomic in its early stages. Substantial amounts of vision can be lost before the individual realises that there is a problem. This is why it’s so important to get your eyes checked regularly!

Cataract

Cataract is a common cause of vision impairment among the elderly. Fortunately vision can be effectively restored with surgery. During cataract surgery, your old lens is replaced is with a new one, especially formulated for your sight. You will be amazed by the difference in clarity, and how bright colours suddenly seem to be.

Diabetic retinopathy

Diabetic retinopathy can be most easily understood if you think of the retinal blood vessels like pipes – elevated blood sugar “rusts” these pipes. The resultant leakage of fluid, blood, and lipid into the retina causes blurring of vision. Diabetic patients should undergo an eye examination at diagnosis and then at least annually thereafter.

Dry eyes

Dry eye becomes more common with age for two reasons: the oil glands that line your eyelids become obstructed, and your production of watery tears may also decrease. Paradoxically, dry eye can cause excessive ‘reflex’ tearing when you’re in a cold windy environment. This is not a condition that affects only older people these days, as excessive peering at screens can also cause anybody to develop dry eye.

Above: Comparison of a healthy lens (left image) and a cataract (right image).

Above: Comparison of a healthy retina (left image) and a retina affected by diabetic retinopathy (right image).

Numerous other changes occur to your eyes as you age:

• Yellowing or browning, if your eyes have been overexposed during your life to ultraviolet light (sunlight), wind and dust.
• Patchy pigmentation.
• Thinning of the conjunctiva (the mucous membrane covering of the eye);
• Increased transparency of the sclera (the white outer layer of the eyeball), which can take on a bluish-grey tint.
• A grey-white ring at the edge of the cornea known as ‘arcus senilis’, which is a deposit of cholesterol and calcium salts.
• The accumulation of ‘floaters’ in your vision. These are harmless for the most part, but if you ever notice a sudden increase in floaters then you should get your eyes checked immediately.
• Your pupils become smaller and no longer dilate well in dim lighting.
• Muscles weaken with age, and the muscles that move the eyeball are no exception. This can cause older individuals to see double when they look in the far distance, or when they try to focus up close. Although this can be a normal ageing change, if you ever notice double vision have your eyes checked immediately.
• Laxity of the eyelid tissues. Your lower eyelid can start to sag outwards (known as ectropion), or it can turn inwards and cause the eyelashes to rub agains the eyeball (known as entropion). Your upper eyelid can also droop (a condition known as ptosis).
• Orbital fat can start to bulge forward into the upper eyelid, which appears as a soft lump in the inner corner of the upper lid.

Improving eye care as you age

Some ways in which you can protect your eyes and generally slow the decline in potential vision problems are quite sensible and straightforward. For example, it is important to maintain good physical health and well-being. Eating a healthy diet which is nourishing and contains the necessary vitamins and mineral to support eye health is very important. It should not surprise you that the foods that are good for your eyes are also good for the rest of you! These include:

• Green leafy vegetables (for example, spinach, broccoli and kale)
• Oily fish (for example, sardines, salmon, mackerel, tuna, anchovies)
• Citrus fruits and green peppers (for Vitamin C)
• Nuts (in particular, walnuts, lentils, cashews, peanuts and Brazil nuts)
• Seeds (like chia, flax and hemp)
• Yellow vegetables, like sweet potatoes, pumpkins and carrots
• Beef, pork, and oysters
• Eggs
• Milk
• Oats
• Olive oil
• Lots of water.

Food is better than vitamin pills

Eating these foods is better than taking pills, and a varied diet containing these foodstuffs will ensure that you get the vitamins that are important for eye health, like the following:
Vitamin A helps keep your cornea clear. Reduces risk of age-related macular degeneration
Vitamin B1 (Thiamine). This vitamin helps convert food to energy and ensures that cells function correctly, and so may reduce the risk of cataracts.
Vitamin B, especially B6, B9 and B12. These vitamins lower levels of homocysteine, a protein that is inflammatory and can increase your risk of developing age-related macular degeneration.
Vitamin B2 (Riboflavin). This is an antioxidant that supports general eye health.
Vitamin B3 (Niacin). This is an antioxidant, and it also helps convert food to energy. It may help prevent glaucoma (when your optic nerve becomes damaged).
Vitamin C is a powerful antioxidant. It also helps make collagen, which is a protein that provides structure to you eye, in particular the cornea and sclera. So, it may help lower the risk of developing cataracts.
Vitamin E is also an antioxidant, which helps protect your cells. This may help prevent age-related macular cataracts.
Lutein and Zeaxanthin. These are carotenoids which are found in high concentrations in the central retina (the macula). They help protect your eyes from harmful violet and blue light, which is emitted by the sun as well as video screens.
Omega-3 fatty acids. The cell membranes of your retina are found to have a high concentration of DHA, which is a particular type of this polyunsaturated fat. It is also anti-inflammatory. It can also help with dry eye disease and may be of benefit for age-related macular degeneration.

Exercise is important for good vision

In addition to eating properly nourishing food, getting enough exercise (to ensure increased oxygen in your system) and hydration (drinking water) are also important. And don’t forget physical protection, too, like wearing good sunglasses that filter out ultra-violet light, and safety goggles when working with dust or chemicals.

Your eyesight is one of the most important things you possess. Taking good care of your eyes is crucial for eye health and may help you avoid vision loss and even surgery. And don’t forget regular checkups with your ophthalmologist or optometrist, who can detect early signs of cataract, glaucoma or macular degeneration and take early preventative action.

Maintaining clear vision as you age reduces your risk of falls. It also allows you to maintain your independence and to live an active, social life.

Happy living and happy seeing!