Vision problems are a normal part of aging
Eating healthy and not smoking can help
Even if you are a fortysomething who can pass for 30, your vision can't keep up the same charade.
Changes in vision are an inescapable part of aging. By 45, nearly everyone has noticed those natural but annoying differences in their eyesight: presbyopia, or difficulty focusing close; floaters; cataracts; dry eyes; glare sensitivity; and just the overall sense that you don't see as well as you used to.
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Smoking is one of the worst things you can do to your eyes. It can accelerate the normal degeneration of the eye, increase the risk of cataracts and aggravate dry eyes.
But other than eating a balanced diet, including a vitamin and mineral supplement, protecting your eyes from ultraviolet light and staying healthy, there's nothing you can do to prevent these vision changes.
Most of these inexorable changes are gradual. Any sudden changes in vision require a dilated-pupil eye exam, Noon said.
Here are some changes that happen to eyes as we age. The information is from Noon and www.agingeye.net, an informative Web site produced by AgingEye Times; the American Foundation for the Blind; and the American Academy of Ophthalmology.
Presbyopia
If you compare the eye to a camera, in people younger than 40, the camera is on autofocus, with the lens adjusting to accommodate near and far vision simultaneously. After age 40, the lens becomes less flexible, like a "fixed focus" that's able to see clearly at only one distance. This is why up-close reading becomes more difficult.
Presbyopia is treated with glasses or contact lenses, including a technique called "monovision," in which one eye is corrected for distance and the other is corrected for seeing nearby.
Floaters
The vitreous, or gel inside the eyeball, starts to shrink as we age. This causes the fibers in the vitreous to become denser and to move around more. That causes shadows on the retina, which are seen as spots that float in the field of vision.
People who are nearsighted tend to get more floaters.
Floaters are painless and harmless. Your brain learns to ignore them, so they seem less bothersome and eventually settle to the bottom of the vitreous.
If floaters are extremely bothersome, they can be treated with laser surgery or even by draining and replacing the vitreous, but few doctors recommend these procedures, which can have serious complications.
If you suddenly get a large floater or a large number of dark spots, see an eye doctor immediately to rule out a retinal tear or detachment.
Cataracts
In addition to becoming less flexible, the lens of a middle-age person also becomes yellow and cloudy. This is a cataract. The condition is painless.
"Everyone gets cataracts if they live long enough," Noon said. "It's kind of like wrinkles. You don't get there without it."
Some people with cataracts see well and never need treatment. But when a lens with a cataract becomes a problem -- causing blurred or foggy vision or difficulties with glare -- it must be surgically removed. The surgery, very safe for most people, removes the cloudy lens and inserts an artificial lens.
Dry eyes
The eyes are moistened by tears, which coat the eye as we blink. Aging can reduce the amount of tears we produce, leading to dry eye syndrome, which can create an irritating, burning, gritty or itchy feeling in the eyes.
More women than men are affected because of changes that occur after menopause, Noon said.
Dry eye syndrome can be aggravated by oral contraceptives, antihistamines, anti-depressants and some hypertension or Parkinson's medications. Climate can also affect dry eyes.
Dry eye syndrome is chronic and has no cure, but it can be treated with lubricating eyedrops or ointments. Eating foods high in omega-3 fatty acids, such as salmon or flaxseed oil, also can help, as can some supplements. For severe cases, silicone or gel plugs can be inserted into the tear ducts to prevent tears from leaving the eye.
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