many options are now available for vision correction

“Hey, Doc, I don’t see as well as I used to.”

Yes, I get to hear this familiar statement every day. Truth is, there are countless reasons why this complaint occurs. I don’t have enough space to go through everything, but I can give you an overview of the most common causes of vision loss in different adult age groups.

Starting in our 40s, many people begin to realize that their vision is not the same. When the eye is younger, small amounts of nearsightedness, farsightedness and astigmatism (warping on the surface of the eye) might not cause many problems. As we age, the whole optical system is aging as well, and small amounts of refractive error cause more visual blurring. Another common problem is decreased near vision or presbyopia.

This is due to the loss of the ability of the lens (inside our eye) to change shape, and we lose our range of focus at near. Some of the more common ways to treat these conditions are glasses and contact lenses. For people who are motivated not to wear glasses/contacts, LASIK and Advanced Surface Ablation (LASIK without cutting a flap) can also be solid options.

As patients enter their 50s, other issues become more prominent. By this point, most patients are used to needing some sort of vision correction (glasses, contacts, readers, etc.).

However, many patients may still complain of decreasing vision. A common culprit is dry eye. This occurs when your tears are inadequate for effective lubrication of the ocular surface. This can be because you do not produce enough tears or the quality of your tears is poor. Some common causes of dry eye are: diabetes, rheumatoid arthritis, lupus, scleroderma, Sjogren’s syndrome, thyroid disorders and vitamin A deficiency. Most patients do not realize that certain medicines including antihistamines, decongestants, hormone replacement therapy (menopause), antidepressants and blood pressure medicines can also cause dry eye. Fortunately, there are many treatment options for eye-care professionals to help these patients.

Another issue that we begin to see in the 50s is cataract development. As our techniques for removing cataracts and the technology of lens implants has improved, my criteria for removing cataracts has broadened. As a result, cataract surgery has evolved into more of a refractive procedure like LASIK. Not only are we trying to improve patients’ vision, but we are also getting people out of glasses. It is truly an exciting time to be a cataract surgeon because we can tailor your surgical plan like never before. Whether you are nearsighted, farsighted or have astigmatism; we have options to correct your vision.

For our patients that are 60 and above, both cataracts and dry eye become even more prominent. Because of this, these patients are not good candidates for LASIK. That is the bad news, but the good news is that they can still take advantage of all the advancements in cataract removal and lens implantation. Laser cataract surgery is great at controlling small amounts of astigmatism and for larger amounts we have toric lens implants (my personal favorite).

Are you interested in not having to wear glasses for driving or reading? Well, we even have multifocal implants that can correct both far and near vision.

Other ocular conditions that are more prevalent in patients that are over 60 are glaucoma and macular degeneration. Glaucoma is a condition that damages the optic nerve (the nerve that transfers vision from the eye to the brain).

Typically, there is rise in the pressure inside the eye, which causes injury to the head of the optic nerve. Often, there are no symptoms, but a complete eye exam can detect glaucoma. If you have an immediate family member with glaucoma, you are at higher risk for developing this disease. Although there is no cure, we have medicines (eye drops), laser surgery and conventional surgery to blunt the progression of this disease process.

Macular degeneration is another disease that happens in the older age group. This correlation with age is so close that it is often called age-related macular degeneration or AMD. AMD affects the macula, which gives us our sharp central vision and can decrease a patient’s ability to read, drive and watch TV. There are two types of AMD: wet and dry. Dry AMD is a thinning and atrophy of the macula, which causes visual loss. It is typically a slower process than wet AMD. Wet AMD occurs when abnormal blood vessels grow underneath the macula causing bleeding and scarring. In general, we treat dry AMD with vitamins and antioxidants to slow the progression, and wet AMD can be treated with lasers and injections into the eye.

So there it is, a brief overview of some of the most common problems I see in my ophthalmic practice. I hope that this article gives you a better understanding of these conditions as well as their treatments. Don’t fall into the trap of trusting Dr. Google. Your eye-care professional is just a phone call away, and a good ophthalmic exam is the first step toward better vision.

Russ Van Norman, MD, is board-certified by the American Academy of Ophthalmology and is a member of the American Society of Cataract and Refractive Surgery. He is also a member of the Cornea Society and currently serves as president of Shreveport Medical Society.