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Vision Loss in the Elderly

UCLA Health
Dr. Grace Chen

Visual changes occur with aging. Some changes lead to significant visual impairment in elderly persons that affects their ability to perform daily functions. This functional decline, in turn, results in decreased independence and increased risk for falls, fractures and depression. Since symptoms may be insidious and slowly progressive, early diagnosis and treatment are vital to prevent blindness and total loss of function.

Leading common causes of visual impairment in the elderly include cataracts, glaucoma, macular degeneration and diabetic retinopathy.

Cataracts are clouding of the eye lens. Common symptoms include cloudy vision, fading colors, glare, poor night vision, multiple images in one eye and frequent prescription eyeglass changes. More than half of all Americans either have a cataract or have had cataract surgery by age 80.

Glaucoma is a group of eye diseases in which the normal pressure inside the eye rises slowly and becomes too high for the retina and optic nerve to function properly. People of African descent have greater risk for vision loss from glaucoma. Initially, there are no symptoms and vision stays normal. As the disease progresses, however, peripheral vision gradually starts to fail and people feel like they are looking through a tunnel. Over time, the entire vision can be impaired.

Age-related macular degeneration (AMD) is deterioration of the macula, which is the central part of the retina that distinguishes fine detail. It causes a gradual loss of central vision, making it difficult to see objects, and is the leading cause of vision loss in Americans age 60 or older. There are two types of AMD: dry and wet. The dry type usually starts with blurred vision, which often goes away in brighter light. The classic early symptom in wet AMD is straight lines that appear crooked.

Diabetes can result in retinopathy or changes in the blood vessels of the retina, the light-sensitive tissue at the back of the eye. The blood vessels may swell and leak fluid and/or new blood vessels grow on the retina surface, disrupting vision. Often there are no initial symptoms.

Speak with your physician about any changes in your vision. People 65 or older should be examined annually by an ophthalmologist, a doctor specializing in eye health. Those with a family history of eye disease or diabetes should receive a dilated pupil eye exam. Early detection may prevent significant visual impairment -- and its accompanying loss of function and independence.

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