According to the CDC, the number of individuals who are blind is predicted to increase to 8.96 million by 2050, due to increasing rates of diabetes, other chronic conditions, and the rapidly aging population of the U.S.  That’s over double the number of blind individuals from just ten years ago.  As we age, the RISK for vision loss increases, but major vision loss is NOT a natural part of the aging process.  What can be done to mitigate the increasing risks?  It starts with understanding, prevention, and routine care.

Several eye problems can affect people of any age but are often more common as we get older.

Glaucoma

Abnormally high pressure in the eye from poor fluid drainage can cause glaucoma.  The pressure damages the optic nerve and can lead to blindness.  Glaucoma often has no warning signs. 

Age-Related Macular Degeneration (AMD)

The small center portion of the retina, called the macula, contains millions of nerve cells.  The macula is responsible for detailed vision – the type of vision used for reading and facial recognition.  AMD is the loss of cells in the macula which causes distorted or blurred central vision.

Cataracts

Cataracts are characterized by cloudy areas in the lens at the front of the eye.  These cloudy areas keep light from passing through to the retina causing blurry vision.  They can develop slowly without pain, redness, or tearing.  At times they stay small enough to not alter eyesight. 

Diabetic Retinopathy

As the name implies, this condition is a complication of diabetes.  Blood vessels in the eye do not feed the retina properly.  In the beginning, you may be symptomless or have blurred vision.  As symptoms progress, there can be floaters, cloudiness, or blind spots.

There are many other common age-related eye problems such as floaters and flashers, presbyopia, dry eyes, tearing, and more.  Reference the Cleveland Clinic Common Age-Related Eye Problems article for more detail.

Associated Conditions with Vision Loss

Studies have shown that diet-related practices that increase your risk for several chronic diseases also increase your risk for vision loss.   In addition to the retinopathy that is often associated with diabetes, studies have shown that higher levels of LDL cholesterol were found in blind older adults as compared to those with normal vision.  Additionally, higher levels of the inflammatory factors associated with heart disease were found in individuals who developed Age-Related Macular Degeneration.  An increase in blood pressure could increase pressure within the eye, potentially leading to an increased risk for glaucoma. 

Adverse impacts of Vision Loss to Health and Well-Being of Older Adults:

Increased risk of falls and fractures–making it more likely the person will be admitted to a hospital or nursing home, become disabled or die prematurely (Centers for Disease Control and Prevention, National Center for Health Statistics, “Trends in Vision and Hearing Among Older Americans,” March 2001).

Increased risk of depression. Among older people with vision impairment, 57.2% are at risk of mild or moderate depression compared to 43.5% of those without vision loss (Journal of Visual Impairment and Blindness, AFB Press 2006, Vol. 100).

Difficulty identifying medications and potential side effects can lead to serious drug-related health impacts. According to a 2003 article in Business Week, medicines taken incorrectly have become the fifth leading cause of death among seniors. Forty percent of seniors take five or more prescription drugs a week, and 12% take more than 10.

Difficulty bathing, dressing, and walking around the house. Approximately 1.8 million U. S. elderly report some difficulty in part because of a visual impairment. Fewer than 2% report using equipment such as telescopic lenses, canes, or computer equipment (Centers for Disease Control and Prevention, National Center for Health Statistics, “Trends in Vision and Hearing Among Older Americans,” March 2001). 

Vision Loss Preventative Tips

Although many of these eye conditions have strong hereditary risk factors, they are also associated with diet and lifestyle practices that we can control.  Incorporating these preventative tips can help to decrease your risk of several chronic conditions and as well as your risk for vision loss.

Protective factors can help to shield cells of the macula from damage.  These include brisk regular physical activity, and a diet rich in green, leafy vegetables – great sources of vitamins A, C, E, and carotenoids.  Smoking has also been associated with an increased risk for AMD. 

Sun exposure has been connected with an increased risk for cataracts and AMD.  Wear sunglasses that protect against UV-A and UV-B wavelengths. 

Be sure to visit an optometrist or ophthalmologist at least once a year.  In addition to a routine vision exam, your provider can examine your eyes to assess the appearance of the optic nerve, measure the pressure, and test the visual field.  Sometimes there is normal pressure in the eye but there is damage present in the optic nerve which can result in glaucoma.  Without this exam, you may not know. Detected early, glaucoma can be treatable.

In addition to your yearly eye exam at your vision provider, routine visits with your primary care practitioner will be the key to early detection.  Insurance, including Medicare, provides for several free preventative screenings.  At your yearly Wellness Visit Medicare covers the following:

  • Measurement of Weight and Height
  • Blood Pressure Check
  • Health Risk Assessment
  • Family History
  • Advice on Disease Prevention
  • Written Checklist of screening tests and other preventative services which could include cholesterol, diabetes, and osteoporosis to name a few.

Knowing your current status as measured through these screenings, can help you to assess your risk for visual problems. 

The most cost-effective and successful treatment to prevent progression will come from visiting your eye doctor and primary care physician and taking advantage of yearly exams and screenings.

Key Points

  • Age-related vision problems may seem inevitable but the two don’t necessarily have to go together.
  • Exercise, a nutrient-dense diet, sun protection, not smoking, and weight management can help to decrease the likelihood of some eye diseases common in older adults.
  • Regular yearly checks by both your primary care physician and an optometrist or ophthalmologist can help to assess your risk for vision loss.  Early detection is key to minimizing the progression of vision loss and obtaining the most cost-effective treatment.

Resources

Aging and Vision | HopkinsMedicine.org (2022).

Berk, Laura E.  Exploring Lifespan Development, Third ed., Pearson, Upper Saddle River, New Jersey, 2014, pp. 402, 451.

Biological Risk of Older Adults with Visual Impairments | PubMed Central. (2012, Dec 19).

Cleveland Clinic Common Age-Related Eye Problems | ClevelandClinic.org (2020, Nov 23).

Fast Facts of Common Eye Disorders | CDC.gov (2020, Jun 9).

Health Effects of Cigarette Smoking | CDC.gov (2021, Oct 29).

By Gretchen Stevenson RN, BSN | August 30, 2022