Around the time I turned 50 an ophthalmologist told me I’d never need distance glasses and I’d be able to get by with drugstore readers. If I hadn’t eventually developed cataracts he might have been right. Alas, ten years after that appointment a local optometrist casually asked if anyone had told me I had mild cataracts. Since cataracts are one of the leading causes of vision loss, I researched what might help and found N-acetyl-carnosine (NAC) drops. Twelve years later my cataracts are still mild. NAC drops, which should be used twice daily, can be found on Amazon and through Clarity Vision. And I now know that without preventive measures, my vision impairments can easily worsen.
Age Associated Vision Problems
Globally, around 2.2 billion people suffer from vision impairment or blindness. In most cases, age associated vision loss is preventable. The National Eye Institute (NEI) division of the National Institutes of Health recommends that older individuals have complete eye exams with dilation every two years or sooner if new symptoms occur or problems are detected. Common problems encountered as we age include difficulty seeing close up objects clearly; declining sensitivity; inability to distinguish colors accurately, particularly distinguishing between black and blue; and the need for more light to see well. This is especially important because falls are responsible for 70 percent of accidental deaths in older people, and poor lighting conditions are frequently responsible.
Age Related Eye Diseases
Aging increases risk for certain eye diseases including age-related macular degeneration (AMD), cataract, diabetic retinopathy, glaucoma, low vision, and dry eye. The leading causes of vision loss include:
uncorrected refractive errors (such as myopia, hyperopia, and astigmatism), which can lead to low vision. When low vision develops it can no longer be corrected with glasses, contact lenses, medications or surgery. Vision rehabilitation can help patients with low vision adjust to this disorder.
cataracts are cloudings of the eye lens associated with low eye levels of the antioxidant glutathione. By age 80 half of all people either have cataracts or have had cataract surgery.
macular degeneration, a low vision disorder, gradually destroys the macula, which is essential for the sharp, clear central vision needed to read or drive. AMD develops slowly and can affect one or both eyes, and today excellent treatments are available.
AMD may run in families and has two types: dry and the more serious wet form. Early on, it doesn’t cause symptoms but is easily detected with eye exams. Early treatment can halt disease progression. Blue-light blocking glasses won’t help in AMD but increasing the contrast on electronic devices or the projection of light on any screen can help. Bumping up one’s glasses prescription or even using a magnifier can help patients see better. Dry AMD is often treated with the dietary supplement Age-Related-Eye-Disease-Study (AREDS), which contains vitamins C and E, zinc, copper, lutein and zeaxanthin, which may keep low vision from progressing. Wet AMD may require more aggressive types of treatment including eye injections.
glaucoma refers to a group of diseases that lead to a buildup of fluid and pressure that damages the optic nerve. It first affects the side or peripheral vision but can lead to total vision loss if left uncontrolled. Many forms of glaucoma develop without causing any warning signs until the condition is advanced. Left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15 percent of patients become blind in at least one eye within 20 years. Treatments which are used lifelong include eyedrops, cannabis, CBD, and other marijuana derivatives, and surgery. UK scientists have found that the spice turmeric benefits people with early signs of glaucoma. A form of eye drops with turmeric has been developed that could help prevent vision loss in patients with glaucoma.
diabetic retinopathy is a complication of diabetes that damages the blood vessels in the retina, which is the light sensitive tissue at the back of the eye. The NEI reports that early detection and treatment of diabetic retinopathy can reduce the risk of vision loss by 95 percent.
Preventing Vision Loss
The NEI reports that half of all sight loss is avoidable. While genetics plays a role, lifestyle factors carry a greater weight when it comes to disease development and disease prevention. The NEI recommends eating a balanced, nutrient-rich diet that includes dark, leafy greens, blueberries and an assortment of bright colored fruits and vegetables, along with fish high in omega-3 fatty acids such as sardines and salmon; not smoking; maintaining a healthy weight and blood pressure; keeping conditions of diabetes well controlled; avoiding sun exposure by wearing tinted glasses and a brimmed hat while outdoors; wearing protective eyewear during sports; and discussing the eye disease history of relatives with healthcare professionals.
Dietary Supplements
Dietary supplements are also important, particularly lutein and carotenoids. The macular pigment of the eye is composed of lutein, zeaxanthin, and meso-zeaxanthin. The density of the macula is essential for proper vision. With age, macular density naturally decreases, leading to macular degeneration. In addition, while young people convert lutein into meso-zeaxanthin, some aging people lose their ability to convert lutein into meso-zeaxanthin causing a marked deficiency of this nutrient.
Another carotenoid, astaxanthin, helps protect against free radical induced DNA damage while repairing UVA-irradiated cells and inhibiting inflammatory cell infiltration. There are many eye supplements with multiple ingredients. Find one containing at least 20-40 mg lutein, 3.75 mg of zeaxanthin and meso-zeaxanthin blend, and 6 mg of astaxanthin. An excellent product that relieved my eyestrain is Dr. Steven Sinatra’s Vision Gold. Other supplements known to promote eye health include cyanadin-3-glucoside, beta carotene, alpha carotene (which helps increase macular density), vitamins A, C, D and E, saffron, zinc, copper, N-acetyl-L-cysteine (which increases levels of the antioxidant glutathione), and taurine. Foods with high amounts of lutein include, carrots, spinach, kale, eggs, and squash.
Risk Factors for age related eye disease include staring at a fixed-distance object, such as a computer screen or electronic device, for extended periods of time, which can cause the the muscles that focus the eyes to tire or spasm. This can lead to headaches, sensitivity to glare, sore and tired eyes, dryness, and blurred vision. It’s important to take 20 second computer breaks in which one looks away from the computer screen to an object at least 20 feet away every 20 minutes. A higher risk for eye disease is seen in children born to older parents and in children born prematurely.
Other Age Related Eye Problems
Presbyopia is a condition of farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age. Presbyopia can be corrected with the use of corrective lenses. Natural ways to keep presbyopia from progressing include following a nutrient-rich diet, protecting eyes from the sun, taking breaks from looking at things that are close-up, eye exercises, dietary supplements, and avoiding eye strain.
Dry Eye is a condition affected 30 percent of adult Americans which adversely affects the tear film, which is the essential coating that protects the surface of the eye. Symptoms include discomfort, irritation, pain, and potential blurring. People especially prone to dry eye include contact lens wearers, people with allergies, perimenopausal women, people who have had laser or cosmetic eye surgery, and people with Sjogren’s syndrome or autoimmune thyroid disorders, especially Graves’ disease. Dry eye can also be a cosmetic concern as it can cause lines, wrinkles, redness and bags beneath the eyes.
When associated with allergies, the problem is often complicated by allergy medications known to cause eye dryness. In his book, The Dry Eye Remedy, Robert Latkany, MD, founder and director of the Dry Eye Clinic at the New York Eye & Ear Infirmary reports that other medications known to cause dry eye include diuretics, urinary bladder control medicines, systemic retinoids including Accutane, beta blockers, over the counter eye drops used to reduce redness, oral contraceptives, hormone treatments, antidepressants, anti-psychotics, and sleeping pills. Decreased androgen production, a common effect of treatment for prostate cancer, can cause inflammation of the tear-secreting meibomian glands, leading to eye dryness. Androgens are being studied as a treatment for dry eye in patients with Sjogren’s syndrome. Common treatments include punctal plug implants, cautery, the Boston scleral lens, and surgical intervention.
Temporal arteritis, which is also called giant cell arteritis (GCA) is an autoimmune inflammatory condition that affects the blood vessels that supply the head, eyes, and optic nerves. GCA typically affects people over age 60, causing the vessels in the teple and scalp to become painfully tender and swollen. Women are four times more likely to be affected than men. The major concern in GCA is vision loss, which occurs when inflammation in the arteries obstructs blood flow to the eyes and optic nerves. If untreated, vision loss can become permanent due to oxygen deprivation to the retina and optic nerve. While at first one eye is affected, if untreated the other eye soon becomes affected. A simple blood test, the erythrocyte sedimentation rate (ESR) is markedly elevated in GCA and can be used to confirm diagnosis. Oral corticosteroids are used to reduce inflammation in this condition. Natural treatments include avoidance of wind, protective coverings in sunshine, adequate hydration, a nutrient rich diet, dietary supplements that benefit the eye including flaxseed oil, which is known to increase eye moisture, using 1000 mg twice daily.
Age Related Cosmetic Concerns
While eye dryness can certainly affect appearance, most concerns are related to the wrinkles, under-eye bags, and discolorations that become more evident with age. Like problems seen in aging skin, these are often related to inadequate sleep, dehydration and nutrient deficiencies. Today, there are improved eye creams and serums that can help, particularly those containing hyaluronic acid, and LED treatments, particularly red light treatments, which may reduce these signs of aging. Collagen peptides used orally have also been reported to improve the appearance of skin in the eye area.
Red light therapy (RLT), which is also called low level light therapy (LLT), photobiomodulation (PBM), biostimulation, and low-power laser therapy (LPLT) was first used to increase cellular energy in muscle wasting disorders. RLT is thought to strengthen the mitochondria in cells, which allows cells to make more adenosine triphosphate (ATP). Unlike intense pulsed light (IPL) RLT doesn’t damage the skin surface and promotes wound healing and tissue repair. While RLT devices are widely available online, it’s best to do your homework before buying one or instead first consider a RLT treatment at a salon. There is a potential risk of eye damage although RLT is considered safer than traditional lasers. For use near the eyes proper eye protection is essential.