Picture Courtesy: National Eye Institute, National Institutes of Health

Glaucoma

Glaucoma is a group of eye diseases that damage  the optic nerve.  Someone with glaucoma has increased fluid pressure in their eyes. This pressure in the eye builds, and can damage the optic nerve.

Types of Glaucoma

Normally, fluid leaves the eye chamber at the open angle, where the cornea and iris meet.  The fluid flows like a drain leaving the eye.  However, this is not the case for people with glaucoma.  Along the way, the fluid pressure builds, resulting in increased eye pressure.

Open-angle glaucoma is the most common form of glaucoma.   With Open-angle glaucoma,fluid leaving the eye passes slowly, resulting in increased fluids and pressure that can damage the optic nerve.

Another type of glaucoma is Angle closure glaucoma.  It is not as prevalent among those with the disease, however, people with this type of glaucoma experience eye pressure that rises very quickly.  With this type of the disease, the drainage canals become blocked or covered.  People can experience symptoms that include:

• Blurred vision
• Headaches
• Nausea
• Eye pain

To learn more about the different types of glaucoma visit, National Eye Institute

Glaucoma can steal your vision.  One of the dangers of this disease is that initially there are no symptoms, and vision remains normal.  However, as the disease progresses, more complications can occur.One symptom of Glaucoma is loss of peripheral vision

Risk Factors for Glaucoma increase:

• With a family history of glaucoma the disease
• In people over age 60
• For African Americans over the age of 40

• • African Americans are 5x more likely to have glaucoma than Caucasians
  • African Americans are 4x more likely to be blinded by glaucoma than Caucasians
  • Glaucoma is 15x more likely to cause blindness among African Americans between the ages of 45-64 than Caucasians in that age group

Treatment:

Medications including eye drops and pills, conventional and laser surgeries are used to treat Glaucoma.  To learn more about Glaucoma treatment, click here.

Source:  National Eye Institute and Glaucoma.org

Picture Courtesy: National Eye Institute, National Institutes of Health

Low vision deficits can impact an individual’s ability to age in place.  Low vision can negatively affect daily life activities such as putting on makeup, shaving, doing laundry, reading the newspaper, and watching TV.  February is low vision awareness month and this week, we will be discussing cataracts.

The lens is the part of the eye that helps focus an image or light on the retina.  For the retina to receive a sharp image, the lens should be clear. In the case of cataracts, the lens is clouded, resulting in blurred vision.  With time, cataracts may grow, making it more difficult to see.

There are 3 types of age related Cataracts:

1. Nuclear Sclerotic:  The most common type and is caused by yellowing and hardening of the lens.  This type tends to develop slowly.
2. Cortical:  With this type, cloudy areas develop in the lens.   People with diabetes are at risk for developing this type of cataracts.
3. Posterior Subcapsular:  This type starts off as a cloudy area on the back surface of the lens.  It can develop quickly and symptoms can be noticed in a few months.

Other types of cataracts that are not related to aging include:

• Traumatic cataracts:  These can develop after an eye injury.
• Congenital Cataracts:  Occurs when babies are born with cataracts or when children develop cataracts.
• Radiation Cataracts:  These can occur after someone has been exposed to radiation.
• Secondary Cataracts:  These may occur after surgery following another type of eye problem. They may also develop after steroid usage, and for people with other health problems such as diabetes.

Most cataracts are related to aging.  By age 80, more than 50% of all Americans have a cataract or have had cataract surgery.  However, some people begin to develop cataracts in their 40s and 50s.  These cataracts tend to be small and do not affect vision.  After age 60 however, many cataracts can cause people to have a decline in vision.

Other Risk Factors for Cataracts include:

• Having Diabetes
• Smoking and alcohol use
• Prolonged exposure to sunlight

Symptoms of Cataracts include:

• Blurred vision
• Poor night vision
• Double vision
• Difficulty with depth perception
• Seeing a halo around lights

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. When non invasive treatments don’t help surgery may be needed.  To learn more about cataract surgery and the different types of cataract surgeries, visit:  National Eye Institute

Sources: National Eye Institute and Visionaware.com

Picture Courtesy: National Eye Institute, National Institutes of Health

Age related macular degeneration (AMD) is a chronic, painless, eye disease where there is deterioration of the macula.  The macula, part of the retina, is the part of the eye that has the sharpest central vision and allows us to see precise details.  Someone with AMD has central vision loss.  This vision loss can impact performance of daily activities such as:

• Reading
• Driving
• Cooking
• Watching TV
• Ironing

Symptoms of AMD include:

• Blurred Vision
• A blurred/blind spot in the center of vision
• Straight lines appear wavy during activities like reading

AMD is the leading cause of vision loss and blindness in Americans 65 years old and older.   There are two forms of AMD, the wet and dry forms.

Wet Form: This form of AMD affects approximately 10-15% of individuals with the disease.  It occurs when blood vessels in the retina that have grown beneath the macula, break and leak blood and fluids. This breakage damages the macula, pulling it away from its original location. The leaking results in damage that creates blind spots in the central vision.

Dry Form:  This form affects approximately 85-90% of individuals with AMD.  It occurs when cells in the macula slowly deteriorate resulting in blurred central vision.  As the disease progresses, the individual experiences more blurred vision and gradually loses their central vision.    There are 3 stages of dry form AMD, they are:

1. Early AMD: There are no symptoms and no vision loss, but individuals may have several small, or a few medium sized Drusen – yellow deposits under the retina.
2. Intermediate AMD: Individuals may find that they need more light to complete certain activities like reading.  They may also have blurred spots in the center of their vision.  In this stage, individuals have numerous medium sized drusen or one or more large drusen.
3. Advanced Dry AMD: In this stage blurred spots in the center of vision may get darker and bigger.  Individuals experience more loss of their central vision, which may result in greater difficulty with reading and with recognizing faces.

Risk Factors for AMD include:

• Being 60 years old and older
• Women have higher incidences of the disease
• Obesity
• Smoking
• Having a family history of the disease
• Caucasians have a higher incidence of the disease

Treatment for the Wet form of AMD includes:

• Laser surgery: which is used to destroy leaky blood vessels
• Photodynamic therapy uses drugs and light to destroy blood vessels that may leak
• Injections

Treatment for the Dry form of AMD includes

Taking specific formulas of antioxidants and zinc To find out more about treatments for AMD click here: Visionaware.org

Sources: Visionaware.org, National Institutes of Health, Allaboutvision.com

February is Low Vision Awareness Month.  To help shed light on the subject, throughout the entire month of February, The Aging Suite will be discussing low vision topics.  We’ll also feature low vision devices in our Technology in The Suite.

It is estimated that one in 28 Americans age 40 and older are affected by low vision or blindness.  Low vision deficits are permanent visual impairments that cannot be corrected with the use of contact lenses, glasses, or surgery.

Diseases such as macular degeneration, glaucoma, cataracts, and retinitis pigmentosa can affect an individual’s performance, safety, and independence in their home and community.  An estimated 21.1% of individuals 75 years old or older have low vision.

People with low vision deficits often struggle with functional daily living skills that can impact the quality of their lives in their homes and communities.

Low Vision can impact someone’s ability to:

• Read
• Cook
• Take medications
• Groom themselves including shaving and applying makeup
• Get around safely in their home and community

Research has indicated that older adults with low vision are at increased risk for depression, may be more distressed due to feelings of loss of control, have increased fear of dependency upon others, and may also have a perceived loss of their ability to maintain their social roles.  Studies have also indicated that individuals with visual impairments are less mobile, have higher mortality rates, and are more likely to have accidents and falls.  However, Low vision rehabilitation services can help; they allow people with visual impairments to utilize adaptive devises and techniques to assist them towards independence when performing their daily activities.  Studies have also indicated that patients who have participated in low vision rehabilitation programs have demonstrated an improvement with quality of life; and low vision services helped decrease client’s fears about their deteriorating vision.

To learn more about low vision services, visit The American Occupational Therapy Association ,Lighthouse International ,& The US Department of Veteran Affairs

Sources:  Agency for Healthcare Research and Quality, Psychosocial issues in older adults’ adjustment to vision loss:  Findings from qualitative interviews and focus groups, Quality of life of low-vision patients and outcomes of low-vision rehabilitation

In the early stages of the disease, there are often no symptoms or pain. However, as the disease progresses, individuals can experience blurred vision, specks of blood or spots in their vision, vision loss, and even blindness.

There are four stages of Diabetic Retinopathy, they are:

1. Mild Nonproliferative Retinopathy:  This is the early stage of the disease.  In this stage, swelling occurs in the retina’s blood vessels
2. Moderate Nonproliferative Retinopathy:  In this stage, some blood vessels that supply the retina become blocked.
3. Severe Nonproliferative Retinopathy:  In this stage, more blood vessels supplying the retina become blocked and the eye then starts to grow new blood vessels.
4. Proliferative Retinopathy:  This is the advanced stage of the disease.  The new blood vessels have thin walls and grow along the retina and the gel that fills the inside of the eye.  If these blood vessels break, it can result in vision loss and even blindness.

Populations at Risk for Diabetic Retinopathy

• People with Type I diabetes
• People with  Type II diabetes
• Some pregnant women with diabetes

Controlling blood sugar, blood, pressure, and cholesterol are key in preventing progression of the disease.  In the latter stages of diabetic retinopathy, someone may undergo laser surgery and a virectomy (removal of the blood from the center of the eye).  Check out the National Eye Institute to learn more about treatment for Diabetic Retinopathy.

Source:  National Eye Institute