About Eye Diseases Senior Eye Health

Common Eye Diseases of Seniors
Like the rest of our body, our eyes undergo changes as we grow older. Many people are under the misconception that deterioration of eyesight in seniors is inevitable and untreatable, resulting in the neglect of due eye care. The fact is, modern advances in the eye care field have brought methods of prevention and cure to many common eye diseases. This pamphlet aims to provide you with some general information on common eye diseases as well as their prevention and cure.

Cataract
Cataract is the clouding of our crystalline lens. It obstructs the passage of light into the eye, which affects vision. Patients feel as though they are seeing through very dirty glasses. Cataract can be caused by many reasons, the most common of which is age-related lens degeneration. Common symptoms are as follows:

The treatment for cataract is surgical removal of the cloudy lens and replacement by a permanent artificial lens implant. A frequently asked question from patients is “When do I need cataract surgery?”. The answer is: when you feel that your daily life is affected by your unsatisfactory vision, you should consider cataract surgery. You do not need to wait until the cataract progresses into an advanced stage. The success rate of modern cataract surgery is extremely high and brings with it the additional benefits of improving your preexisting nearsightedness, farsightedness, astigmatism and presbyopia. Your ophthalmologist can further explain in detail when you undergo an eye examination.

Glaucoma
In Hong Kong, glaucoma is a common cause of blindness, with elderly people at a higher risk. Glaucoma is classified into acute, chronic, congenital and secondary. Chronic glaucoma is the most common type, accounting for 60-70% of all glaucoma cases. Early stage often goes unnoticed by patients because there would be no pain or any effect on vision at this stage. But the increase in eye pressure will gradually damage retinal nerve cells and reduce the visual field, ultimately leading to blindness. Therefore, it is strongly recommended that senior people, especially those with a family history of glaucoma, should undergo regular eye check-ups.

There are several methods to treat glaucoma, namely medicine, laser and surgery. Although glaucoma can potentially cause blindness, it can be controlled if discovered and treated accordingly in its early stage.

Age-Related Macular Degeneration
Macula is a special area in the central retina, made up of many small and delicate nerve cells. We need a healthy macula to see details, read and see colours. When the macula is affected by disease, central vision will be reduced and images will be distorted.

Macular degeneration is mostly age-related. In Asia, there has been an increasing incidence of macular degeneration in recent years. High nearsightedness is also a major cause of macular degeneration. Much research has been devoted to discovering safe and effective treatments for these diseases. Some are best treated with laser or intraocular injection of special medicine, while others may need special magnifying devices.

Diabetic Retinal Diseases
Diabetic retinal diseases are due to small blood vessel abnormalities caused by diabetes, resulting in a series of complications in the eye, including macular bleeding, swelling, lipid leakage, abnormal new blood vessel growth, vitreous bleeding, retinal detachment, glaucoma, etc. Such retinal diseases can cause blindness if they are not treated promptly. In the early stage, you may not notice any visual changes; the retinopathy can only be discovered through eye examination. Therefore, patients with diabetes should have regular eye examinations by an ophthalmologist.

Diabetic retinal diseases can be treated with laser or special medication to prevent serious complications such as retinal bleeding, macular edema and neovasular glaucoma, which can cause blindness.

Floaters
Floaters is a very common symptom among the elderly, mostly caused by degeneration of the vitreous gel inside the eyes. They usually come and go without affecting vision. As long as the retinal problems are ruled out during eye check-ups, no treatment is required. However, serious retinal or vitreous diseases, such as vitreous haemorrhage, retinal tears or detachment can also cause acute onset of floaters. Therefore, it is important that you consult an ophthalmologist at the earliest appointment for a detailed examination if you start seeing floaters.

Dry Eyes
Human eyes have tear glands which produce tears for our eyes. There are two kinds of tear glands: the small glands which constantly produce small amount of tears that lubricate eyes to keep them healthy and comfortable; and the bigger glands that make a large amount of tears when we cry or experience discomfort in our eyes, and in the case of dry eye condition.

Many middle-aged or elderly people (especially women) suffer from dry eye condition due to the dysfunction of small tear glands. Therefore, the big glands will overcompensate and produce more tears than usually needed. With the use of lubricating eye drops, the big tear glands will reduce excessive tear production, and dry eye symptom will be relieved. Other conditions, such as tear duct blockage, can also cause tearing eyes. You will need to consult an ophthalmologist for proper treatment.

  • Presbyopia (Difficulty in reading or seeing near objects)
    The normal human eye is capable of adjusting its focus due to the elasticity of the lens and the function of small intraocular eye muscle which will decline with age. Presbyopia usually appears after 40 years of age, and the eye would be like a camera which is not equipped with auto-focus. If you are nearsighted, you may notice that it is easier to read without glasses. However, those with farsightedness may find reading increasingly difficult. Presbyopia can be corrected by glasses or presbyopic contact lenses. Another option is to have your presbyopia treated with cataract surgery.

    Eyelid and Facial Aging
    Changes in facial bones and soft tissues come with aging, leading to wrinkles and sagging tissues. While cosmetic at first, some of these changes, if around the eyes, can affect vision and/or cause discomfort. For example, excess upper eyelid skin and drooping eyelids can block vision, and if the blockage is significant, oculofacial plastic surgery to remove excess eyelid skin and/or eyelid lifting surgery could be considered. Eyelid malposition, such as an in-turned eyelid, can be surgically repaired. Please consult an ophthalmologist for further assessment and treatment.


    Details of Annual Comprehensive Eye Examination for Senior Citizens (60 years old or above)

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