The 4 Most Common Age-Related Eye Diseases '; BY MARLO SOLLITTO

     

• VISION & EYE DISEASES

The 4 Most Common Age-Related Eye Diseases

BY MARLO SOLLITTO

By age 65, 1-in-3 Americans have some form of vision-impairing eye disease.
There are four major age-related eye diseases (AREDs) — glaucoma, cataracts, age-related macular degeneration and diabetic retinopathy that affect seniors.

Glaucoma

Glaucoma damages the eye's optic nerve and results in vision loss and blindness. Sometimes, there are no initial symptoms, so as many as 1 million people may have glaucoma and do not know they have it. It is one of the main causes of blindness in the United States.

At first, glaucoma has no symptoms. However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing.

There are many different types of medications (in eye drops or pills) that are used to treat glaucoma. In some people, however, medications alone do not control the eye pressure, and surgery needs to be performed. One type of surgery uses a laser -- called trabeculoplasty -- to improve the flow of fluids out of the eye. This can be done in your doctor's office. There is also conventional surgery -- called trabeculectomy -- in which your doctor creates a new drainage path in the eye, under the eyelid.

Risk factors for glaucoma include: age, family history of glaucoma, taking steroid medications and being near-sighted. Learn more about Glaucoma

Cataracts

A cataract is a clouding of the lens within the eye. The lens is composed of water and protein. If the protein clumps together, it starts to cloud over a small area of the lens. This cloudy mass of protein — called a cataract — can grow larger, making it hard to see. If the cataract worsens, surgery may be necessary to remove the cloudy lens and replace it with a new lens.

People with cataracts begin to complain about glare and cloudy/fuzzy vision, double vision in one eye, or glare from lamps and the sun. Surgery is the only way to correct vision loss caused by cataracts.

Getting older is a major risk factor for cataracts. Women are at slightly higher risk than men for cataracts, and people with a family history of cataracts are more likely to have cataracts. Learn more about Cataracts

Macular Degeneration

Macular Degeneration (MD) diminishes sight in a dramatic way: It affects the central vision. Although people with MD rarely go blind because of it, many find it difficult to read, drive and perform other daily functions. The macula is located in the center of the retina, which is the light-sensitive layer of tissue at the back of the eye. Deterioration of the macula results in eye disease. Macular Degeneration affects central vision. People with MD find it difficult to read, drive and perform other daily functions that require central vision.

People with Macular Degeneration can be treated with laser surgery. Anti-angiogenesis drugs and low-vision devices are also useful.

Age is the biggest risk factor for developing MD. After age 75, up to 46% of people may have some form of it. Family history, race (whites appear to have a higher risk than blacks or Hispanics) and smoking are other risk factors. Learn more about Macular Degeneration

Age-Related Macular Degeneration: Information for Caregivers

BY ANNE-MARIE BOTEK

Linda Tedesco knew something was wrong when her mother started asking her to come over to her house to help decipher food labels and thread sewing needles."I noticed my mom having trouble with her eyes when she started to fumble with easy tasks, Tedesco says. "The final straw was when her eye doctor told her there wasn't another prescription for her glasses. That was the best he could do. I knew we were in trouble, then."

So began a quest for answers that would end with a challenging diagnosis: age-related macular degeneration (AMD).

AMD is a progressive eye disorder that damages the macula, the area on the retina that is responsible for clear central vision. Initial symptoms of the condition are mild and include blurry central vision that makes seeing road signs, reading and recognizing faces more challenging, according to Marjan Farid, M.D., Vice-Chair of Ophthalmic Faculty at the Gavin Herbert Eye Institute, University of California, Irvine. The peripheral vision of someone with AMD often remains largely intact, even in the more advanced stages of the condition.

Diagnosing Age-Related Macular Degeneration

"The early and intermediate stages of AMD usually start without symptoms," says Farid. "Only a comprehensive dilated eye exam, usually given by an ophthalmologist, can detect AMD."

There are a number of different tests that doctors administer to determine whether a person has age-related macular degeneration

• Visual acuity test: Uses an eye chart that measures how well you see at different distances.
• Dilated eye exam: An exam that provides a better view of your retina (the back of your eye).
• Amsler grid test: A vision test that checks whether you are seeing unusual wavy lines.
• Fluorescein angiography: A test that makes it possible to identify leaking blood vessels (a sign of wet AMD).
• Optical coherence tomography (OCT): Like an ultrasound, OCT can achieve very high-resolution images of any tissues that can be penetrated by light—such as the eyes.

According to Farid, the first sign that ophthalmologists often see in people with early-stage AMD is the development of drusen—yellow deposits in the macula. As the condition progresses, scarring can occur on the macula, leading to the degeneration and eventual death of cells in that area of the eye.

Treating  Age-Related Macular Degeneration

The type of treatment suggested for a person with age-related macular degeneration depends on which type they have: wet or dry.

Dry AMD is far more common and develops gradually over time. The progression of dry AMD can be further slowed by taking steps to safeguard one's vision such as wearing sunglasses and adhering to a specific dietary regimen known as AREDS2.

The onset of wet AMD is much different; usually heralded by a sudden, dramatic change in vision. Wet AMD occurs when blood vessels inside the eye begin to leak blood into the retina. A person with dry AMD can also develop wet AMD.

Treating wet AMD typically involves the injection of anti-VEGF agents such as Avastin, Eyelea and Lucentis. Laser therapy is also sometimes used for mild and moderate forms of wet AMD, but Farid says "Injections are becoming the standard of care in these patients because it is a small procedure that provides a good benefits as patients retain more vision or even gain a few reading lines again."

For those whose vision is almost completely obscured by wet AMD, there is a surgical treatment option. A doctor implants a tiny telescope into one eye, freeing up the central vision in that eye while allowing the other eye to provide peripheral vision. Farid says the surgery is similar to a cataract-correcting procedure, but warns that it comes with a certain learning curve because patients have to be trained in how to see properly with two eyes that are processing different images.

Living with Age-Related Macular Degeneration

When someone is diagnosed with AMD, the first question they often have is "Am I going blind?"

Tedesco vividly remembers her mother's reaction to AMD. "I will never forget the day my mom came out of the eye doctor exam room. We checked out and got into the car. She looked at me and broke out in tears," she says.

"AMD brings a lot of fear for patients," says Farid. "The answer is that AMD patients never go blind where the world is turning black. Rather, it's usually a diminishment in central vision that makes tasks needing ‘straight ahead' vision more difficult."