Age-related sight loss

At 56 years of age, Maureen Nalumansi wears reading glasses while doing her tailoring work. She says her sight was normal until she turned 50. She would see things that were far away but whenever she had to read something, she had to hold the book at a distance.

“At the hospital, the eye specialist said this was a problem that comes with age and I needed reading glasses to ease my work,” she says. 

She bought over the counter glasses at Shs30,000 and these, she says, have eased her work. 

Aging affects every part of the body, including the eyes. While some changes in vision are an indicator of an underlying health condition or an effect of  poor lifestyle choices such as smoking, some of the changes are a normal part of aging. 

Although some may not necessarily have an impact on one’s sight, many affect how we see and oftentimes, lead to vision changes. 

The eye lashes become grey and the skin on the eyes starts to sag causing drooping eyelids; the flexibility of the lens reduces and becomes stiff and unable to change in size and shape depending on the image on focus as it does before one turns 40.  Reduced tear production, clouding, fluid buildup in the eye chambers, damage to the cornea or retina and breakdown of the gel-like fluid in the eyes. Normal age-related changes to the eyes may cause vision trouble as well as other vision-related problems.

Presbyopia

Dr Grace Ssali, a consultant ophthalmologist at Mulago National Referral Hospital, says Nalumansi suffers from presbyopia, an age-related sight problem where one is not able to see near objects as before because of a decline in the focusing ability of the eye due to a reduction in lens elasticity. This problem can appear earlier than 40 years for people who are short sighted. 

“The lens of the eye is flexible before the age of 40 and it is easy for the eyes to focus on objects that are far away or close. The lens becomes less flexible as we age and becomes difficult to focus on objects that are close. Poor lighting makes the problem worse so the person usually holds the reading material at a distance away in order to read properly. This can be corrected by using reading glasses,” she says. 

Cataract

The lens of the eye usually becomes less clear and light cannot easily go through it, causing clouding. This results in diminished or blurry vision due to poor focusing of the light rays. Clouding can be treated by surgery depending on the intensity and the type of work one does according to Dr Ssali. 

“If someone’s work requires clear vision, then cataract surgery should be done as soon as possible but if it does not, then surgery can be delayed but only for a certain period of time,” he says.

Dry eyes

Tears help to keep the eyes clean and comfortable and aid in proper vision. The tear glands secrete lesser tears as one ages and with reduced tear formation, the eyes feel gritty and tired. As a result, the eyes produce fewer tears that are not sufficient to lubricate or keep the eyes moisturised. Dry eyes may cause pain, discharge, redness, and alternating periods of tearing and dryness. The condition may cause heavy eyelids and blurry vision.

Reduced tear production may also increase the risk of eye inflammation and infections but it can be managed using eye drops.

Glaucoma 

Although it is possible to develop glaucoma and cataracts at any age, these common eye diseases happen most often in people who are aging. Glaucoma is a condition where the optic nerve that connects the eye to the brain is damaged due to pressure in the eye.  This damage usually worsens as we age.

“Glaucoma may present as severe eye pain, headache, blurring of vision, increased tearing and seeing coloured rings around light sources. Persistent, increased pressure in the eye can lead to permanent loss of sight due to optic nerve damage but can be treated with medications and surgery,” Dr Ssali says.

Age-related macular degeneration (ARMD)

Aging results in damage of the macula, a part of the retina. ARMD is the leading cause of sight loss among those older than 50.  It causes a blurred central vision, leading to difficulty recognising faces or even reading a clock. However, this degeneration does not lead to complete blindness. There is no specific treatment for AMD.

Floaters 

When the lights are bright, old people usually get to see moving specks in their field of sight and these are referred to as floaters. Occasional floaters are normal, but increased floaters along with flashes of light may indicate a serious underlying condition such as retinal detachment. It is, therefore, important that you contact an ophthalmologist as soon as this happens.

A light-coloured ring around the iris of the eye is made from calcium and cholesterol. The gray-white ring is a common eye problem among people over the age of 60. It does not affect vision, but it may be associated with changes in lipid metabolism.

“There are some diseases that you would not necessarily associate with the eyes but can negatively impact vision and often worsen with age, including diabetes and high blood pressure. These can cause visual impairment and a potential blindness in adults, especially diabetes,” Dr Ssali says.

Other eye conditions that may occur due to aging include diabetic retinopathy, retinal or vitreous detachment, loss of peripheral vision, corneal degeneration and reduced color contrast sensitivity.

How to manage

Regular eye examinations are important to detect early vision changes. They help diagnose eye diseases early and prevent them from worsening through timely treatment. Dr Ssali remarks that the frequency of your eye examination depends on your age and any health conditions you may have.

“Most healthy adults need a comprehensive eye examination every two years. However, after the age of 40, Dr Ssali says, “one should get an annual eye check and more frequently if one has diabetes, glaucoma, and short sightedness or has had an eye surgery to prevent complications.” 

Although some vision changes cannot be prevented, a healthy lifestyle can help slow down the rate of aging in your eyes, according to Dr SSali. 

Nutrients good for eye health include vitamin A, C, vitamin E, omega-3 fatty acids, lutein, and zeaxanthin. Foods rich in these nutrients include leafy greens, oranges, tangerines, fatty fish, and nuts. Eat a variety of colourful fruits and vegetables daily to help protect your eye health.

Maintain normal blood pressure and cholesterol levels

Exercise regularly to maintain a healthy weight

Keep your blood sugar under check

Quit smoking and alcohol consumption