As hormones wane, so does your eyesight. In recognition of Cataract Awareness Month, find out how to protect your peepers, even if you have decades to go before retirement...
Our joints ache, bones break and faces wrinkle. Now add eye problems to the list of age-related problems women face. The longer we live, the more beating our peepers take.
According to a Duke University study, women are more likely than men to develop vision problems as they get older.
Longevity is a factor, but blame our hormones too, specifically menopause, says James V. Aquavella, M.D., professor of ophthalmology at the University of Rochester Eye Institute in Rochester, N.Y.
That’s right, your eyes are two more body parts affected by fluctuating estrogen and progesterone levels.
Still, you can take steps to save your sight, from eating better to giving up smoking. Here are 6 age-related eye conditions and what you can do about them.
1. Cataracts
What they are: Cataracts, the world’s leading cause of blindness, are the clouding of the eye’s normally clear lens. It’s a big problem for women because they’re living longer, says Ruth D. Williams, an ophthalmologist at the Wheaton (Ill.) Eye Clinic.
Although cataracts can happen at any age, they’re more likely after age 40.
Symptoms: The most common sign is cloudy or blurred vision. You may also experience glare, poor night vision or a sense that what you’re seeing, including colors, is less vivid.
Why we get them: No one really knows. Cataracts result when proteins in the lens clump, interfering with light as it enters the eye.
Treatment: Only surgery can cure a cataract, although sometimes corrective glasses and lighting changes can improve vision.
In a cataract operation, the eye lens is removed and replaced with an intraocular lens (IOL) implant. The surgery improves sight in 95% of patients.
Best preventive steps:
Ditch the cigarettes. Smoking can increase risk – the result of fewer antioxidants in the bloodstream and less blood flow to the retina.
Wear a wide-brimmed hat and good sunglasses. Williams recommends glasses with 100% UV filter, which will “protect the eyes from ultraviolet A and B rays that increase the development of cataracts.”
Lose weight and exercise. Being overweight raises your risk, perhaps because of higher glucose (blood sugar) levels.
Eat fish. A Harvard study found that omega-3 fatty acids may help ward off cataracts and other eye disorders. Women who ate more fatty fish — which contain omega-3s — lowered their risk of cataracts by 12%. Eat fish twice a week or take a 1,000 mg fish oil supplement daily, Aquavella says.
2. Glaucoma
What it is: The second leading cause of blindness in the U.S., glaucoma occurs when pressure in the eye — intraocular pressure or IOP — is too high, damaging the optic nerve.
The most common type, open-angle glaucoma, affects men and women equally. But women are 2-4 times more likely than men to get the more dangerous closed-angle glaucoma, which accounts for 10% of cases, Williams says.
Why? Blame the shape of our eyes.
“The front chamber between the iris and cornea is shallower in women than in men,” she says. That can block fluids from draining out of the eye, which increases pressure.
Symptoms: Open-angle glaucoma is often painless and you may not realize your sight is damaged until about 40% of the optic nerve is destroyed. It first affects peripheral vision, so your tip-off may be black spots in your side vision.
With closed-angle glaucoma, you may feel a sudden sharp pain in your eye, nausea and blurred vision. Because people can lose their vision within three hours after symptoms appear, it’s considered a medical emergency.
Why we get it: Glaucoma can also result from gene mutations or medications that can raise eye pressure, such as corticosteroids. Hispanics and blacks have a higher risk.
Treatment: Prescription eye drops, which you’ll need to use throughout your life, can lower eye pressure, delaying glaucoma’s progression. Surgery to improve fluid drainage is also an option if drops don’t work or if they cause side effects like burning or low blood pressure.
Best preventive steps: Get good eye exams. “The prognosis for glaucoma is excellent if you find it and treat it early,” Williams says.
The American Academy of Ophthalmology recommends a baseline exam at age 40, followed by one every 2-4 years for those 40-65 years old, and every 1-2 years for anyone older than 65.
3. Age-Related Macular Degeneration (AMD)
What it is: This condition gradually destroys your sharp, central vision — the sight that helps you drive and read. It affects the central part of the retina (the macula), which controls fine detail vision.
The most common type, “dry AMD,” occurs when the retina shrinks and small clumps of debris — called “drusen” — accumulate underneath it, blocking sight.
The other, more serious type, neovascular AMD (“wet AMD”), accounts for 10% of cases. It occurs when new blood vessels grow between the retina and eye’s outer layer. When the vessels leak, they cause scarring. Wet AMD starts out as dry AMD.
It's the No. 1 cause of vision loss in people over 40 in the U.S.
“Its incidence increases with every decade of age,” Aquavella says. More women suffer from it because they “tend to live 5-7 years longer than men.”
Symptoms: Most people feel no symptoms initially, but some may experience a blank spot or haziness in their central vision and color perception.
Why we get it: Doctors don’t know what causes AMD, although genetics may play a role. Other factors — age, smoking, a light-colored eye, obesity — may raise risk.
Treatment: If you have dry AMD, your doctor will monitor it to see if it’s progressing to wet AMD. He or she may also suggest special supplements of antioxidants and zinc to slow its progression.
For wet AMD, laser treatments can help destroy new blood vessels; your physician might also recommend medications to block their growth.
Best preventive steps: Many of the same steps that prevent cataracts help with AMD.
Some research suggests a link between AMD, high cholesterol, obesity and heart disease. A study at the University of Sydney, Australia, found that eating fish lowered risk.
So stock up on low-fat meats — including two weekly servings of fish, greens and whole grains — and exercise at least 30 minutes a day, to protect your eyes… and your heart.
4. Dry Eye Syndrome
What it is: This occurs when your eyes produce too few tears or when one of the three tear layers gets weak. Tears have mucous, water and oily outer layers. Each is produced by a different part of the eye. When one goes on the fritz, dry eyes result.
Symptoms: Your eyes may burn, sting or feel gritty. Vision may be blurry or you may blink more. Contrary to the name, you may appear weepy more often — the dryness stimulates more tear production.
Why we get it: As we age, we produce less oil, so the watery layer evaporates more easily. Women are more susceptible.
“In postmenopausal women, the [shift in] balance between estrogen and progesterone is responsible for changes on the surface of the eye,” Aquavella says.
Treatment: Your doctor may prescribe lubricating drops. If your eyes are inflamed, prescription steroidal or cyclosporine eye drops (Restasis) may reduce inflammation. If these don’t work, your physician may place tiny silicone plugs in tear-duct openings to keep them from draining too quickly.
If all else fails, she may recommend surgery to close the ducts.
Best preventive steps: Sunlight and heat can dry out eyes, so shield them with close-fitting, large sunglasses.
Eat fish several times a week, Aquavella says.
“The omega-3 fatty acids in fish are anti-inflammatories and improve the quality of the fat surface on the tear film.”
5. Diabetic Retinopathy
What it is: Diabetes can damage the eye’s blood vessels, which causes vision loss. Called diabetic retinopathy, it’s the most common diabetic eye disease.
Symptoms: There are no early signs. But bleeding in the eye — a symptom that occurs in later stages — will cause spots in sight or even vision loss.
Why we get it: When blood sugar levels are too high, the vessels that feed the retina weaken and eventually leak. The leaks cause the macula to swell. In its most dangerous form, new blood vessels grow, then bleed, causing the retina to detach from the back of the eye. It can lead to blindness.
Treatment: “If you have diabetic retinopathy, check-ups every six months are mandatory,” Aquavilla says. Insulin or other medications can help keep your blood glucose levels under control.
You may also slow the disease’s progress by lowering high blood pressure and cholesterol levels with medications, diet and exercise. The doctor may use laser treatment to close leaking blood vessels as well.
Best preventive steps: Most important, control blood sugar levels and keep blood pressure and cholesterol low. Quit smoking: It may keep the disease at bay — or at least slow its progression.
6. Pregnancy-Related Eye Changes
What they are: Similar to menopause, the hormone shifts that occur in pregnancy can cause several temporary eye conditions, such as dry eye and corneal swelling.
Symptoms: Your eyes may feel scratchy or you may have blurry vision, increased eye pressure or sensitivity to light.
Why we get them: Fluctuating hormone levels affect the eye surface, which may lead to dry eyes. They can also affect the curve of the cornea, Aquavella says.
Treatment: This depends how your eye changes. If you have corneal swelling, your doctor may suggest that you wear glasses because contact lenses can irritate eyes. If your eyes are dry, lubricating drops, safe during pregnancy, may help.
If you already have an eye condition, such as glaucoma or diabetic retinopathy, your obstetrician and ophthalmologist will ask to see you more frequently.
Your doctor will also monitor your blood pressure, because high blood pressure can cause detached retinas.
Best preventive steps: Because eye changes sometimes indicate high blood pressure or gestational diabetes (a form of diabetes pregnant women get), it’s best to have your eyes checked during your pregnancy and to let your doctor know of any vision changes.
Check out our eye-health slideshow, including vision simulators from EyeCare America.
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