Golf Guide

Did you hear the one about the woman who refused to wear her reading glasses when she was on a date and ended up setting her menu on fire because she had to hold her arm out to read it and missed seeing the burning candle on the table? Don’t worry. We won’t reveal her name.

It’s a sad testimony. Around the age of 40 we begin the downward slide to reading glasses, bifocals, trifocals and then what? Dr. Tim Elcyzyn of McFarland Eye Centers says seniors are more active now than at any time in history, with many who work, travel, play golf and tennis into their 80s and beyond. “The preservation of good vision is essential in order to maintain independence and enjoy a quality of life.”

Dr. Brian Guice of Kavanaugh Eye Care concurs, saying that baby boomer patients do not realize that age and other risk factors increase the likelihood of ocular disease.

The doctors lay it on the line for us.

Presbyopia

“At around age 40, our eyes begin to lose their ability to focus on near objects,” says Dr. Elcyzyn. “Many of us begin to hold reading materials farther away in order to see clearly and avoid eye strain. This process occurs as our eye muscles gradually weaken and the natural lens within the eye loses the flexibility necessary for focusing. Reading glasses or bifocals become a way of life for thousands. However, for those of us with an active lifestyle who prefer to be free of glasses, there are other options. Contact lenses which are set for distance in one eye and near (or reading) vision in the other work well for many. Others enjoy the newer multi-focal contacts which provide a wide range of vision simultaneously.”

Dry Eye Syndrome

According to Dr. Elcyzyn, tear production normally decreases as we age, often causing a chronic lack of sufficient lubrication to the eye.

“Many notice burning, stinging, scratchiness, irritation, foreign body sensation or general eye discomfort,” he says. “In some cases, patients notice excessive watering due to the eyes over-compensating in an effort to produce enough moisture. Dry eye is often diagnosed based on symptoms alone, but the degree of dryness can be quantified with eye drops that contain a yellow dye. This dye is absorbed by dry or damaged tissue on the surface of the eye.

"The level of tear production can also be identified with filter-paper strips that measure the amount of tear volume produced. Treatment ranges from daily topical lubricants to increase moisture levels to more advanced procedures such as tear-duct plugs designed to prevent constant dehydration and thus avoid uncomfortable surface tissue damage.”

Dr. Guice adds that the hormonal fluctuations of menopause can change the amount and quality of tears on the eye.

“Rheumatoid arthritis is also linked to dry eye disease,” he says.

Strokes

“Aging adults often do not realize that strokes can occur in the eye,” Dr. Guice says. “The outcome is variable but often causes vision loss or blindness. Atherosclerosis and carotid disease, diabetes, hypertension, high cholesterol and smoking are risk factors for stroke.”

Cataracts

“Cataracts are a common age-related change that occurs to the natural lens of the eye,” says Dr. Guice. “Over time, the natural lens in the eye opacifies, causes increasing blurred vision and glare, especially at night, and dulled color vision.  Other risk factors include diabetes, smoking, prolonged corticosteroid use and family history of cataracts.”

In the early stages, Dr. Elcyzyn says a change in glasses prescription may help enough to alleviate some of the blurriness. However, when patients decide that it has become too difficult to perform normal activities such as reading and driving, surgery is available. Typically, this outpatient procedure includes removal of the cataract and implantation of an intraocular lens. The optical power of the implanted lens is customized for each person and often lessens the prescription previously needed in glasses for those who are nearsighted, farsighted or have astigmatism.

“In fact, newer multi-focal implants are often successful in providing such a wide range of vision that glasses are no longer needed for distance or for close-up activities such as reading,” Dr. Elcyzyn says.

Glaucoma

Glaucoma is a condition that damages the optic nerve, which makes our vision possible. Symptoms can include blurry vision, reduced peripheral or side vision, blind spots, and in some cases sudden pain and halos around lights, Dr. Elcyzyn says.

“However, at the point of diagnosis, nearly half of patients are unaware they have the disease as symptoms are subtle or go completely unnoticed in the early stages,” he says. “Without treatment, loss of vision continues with an end result of blindness. There is no cure for glaucoma, but with prompt and proper treatment, vision loss can usually be controlled. Eye drops to lower pressure in the eye are often recommended, with surgical intervention needed in some cases. Early detection is critical. The process is quick and painless and is widely available from most eye-care providers.”

At risk of glaucoma, Dr. Guice says, are those over 60 or those with an immediate family member with glaucoma.  “African-Americans are especially afflicted by glaucoma, having increased risk over the age of 40. African-Americans are five times more likely to get glaucoma than Caucasians. Ocular hypertension, diabetes, cardiovascular disease and prolonged corticosteroid use also increase the chance of glaucoma. There are often no apparent symptoms in glaucoma as it occurs painlessly but does cause progressive peripheral field loss leading to tunnel vision. A less common form of glaucoma occurs suddenly with boring eye pain, nausea, red eye and blurred vision.  Glaucoma is readily treatable with medication that can slow or stop vision loss.”

Age-Related Macular Degeneration (AMD)

Macular Degeneration is a deterioration of the macular tissue, the important area of the retina that provides our central vision. “There are two forms called dry and wet AMD,” says Dr. Elcyzyn. “Dry AMD is most common and typically causes a gradual loss of fine visual ability over years."

Wet AMD is less common. However, the wet fluid that develops within the eye often causes serious vision loss in a very short period of weeks or months. "Both forms of AMD are detectible with a dilated eye exam, and additional testing and specialized treatment are necessary in some cases,” Dr. Elcyzyn says.

Dr. Guice says that AMD mostly occurs in those over 75 but smoking, poor diet, obesity, being Caucasian, female and having an immediate family member with AMD increases risk.  He says AMD classically causes blurred central vision, difficulty seeing fine details, halos around objects, and straight lines appearing crooked.