Eye Health 101: How To Protect Your Vision From Age-Related Diseases

  • Rana IbrahimMasters of Critical care - Faculty of Medicine, Alexandria University, Egypt
  • Ghufran Al Sayed MBChB, University of Manchester; MPH, University of Manchester

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Importance of eye health

They say ”your eyes are the mirror of your body”, meaning that some general health problems have signs that are reflected in your eyes’ health. Eye problems are widespread and often remain undiagnosed for a long period. This is especially true when they start off without symptoms. In order to avoid several common eye illnesses that can lead to reduced vision or irreversible visual loss, early detection and treatment are essential.

How common are age-related eye diseases?

Over 2 million people in the UK are living with visual loss,, including those whose vision could be partially improved by wearing glasses. Nearly 80% of them are aged 65 or older, and about 60% are above 75 years old. This denotes that age is an important risk factor for visual loss and eye-related diseases. Moreover, half of the people living with visual loss in the UK are women.1

It's common for your vision to change as you grow older. 

Among the typical changes that occur to with age are:

  • Being unable to see closely
  • Having problems differentiating one colour from another, like blue from black
  • Requiring more time to get used to changing light levels

These problems are often simple to fix, usually by wearing glasses, contact lenses, and with improved lighting. However, some eye changes that take place with  ageing might not respond  to these simple measures and may instead require more specialist diagnosis and management.2

How does ageing affect eye health?

The following eye conditions can lead to reduced vision  or total  loss of vision.. They may show little to no symptoms in the beginning. The best protection is through routine eye examinations. In many cases, if your eye care specialist can detect an issue early enough, you may have options to help preserve your vision.

Age related macular degeneration (ARMD)

  • ARMD is a common condition that affects the macula, which is the central part of the retina and is responsible for your central vision - in other words, everything you see straight ahead.. It usually affects people in their mid-50s to 60s.
  • The exact cause is unknown. However, it may be related to smoking, elevated blood pressure, and obesity.3
  • There are two types of ARMD: wet and dry. They differ in their pathology and the rate of deterioration.
  • ARMD can affect one or both eyes. It often starts with blurred central vision. Some people may notice the loss of the central part of their vision entirely.
  • Other symptoms include seeing a bend in straight lines (or seeing wavy lines), seeing things smaller than their normal size, and seeing a more muted version of colours (due to an inability to perceive brightness properly) In some cases, people may report seeing things that are not actually in front of them or do not exist (visual hallucinations).
  • The visual loss that happens with  ARMD is usually painless and develops slowly over months or years. This is especially true for dry ARMD.
  • Your eye care specialist will ask about your family history and check for symptoms of ARMD.
  • There are treatments available, and nutritional supplements may decrease the likelihood of disease progression.

Diabetic retinopathy (DR)

  • Diabetic retinopathy is one of the complications of diabetes that affects the retina as a result  of uncontrolled hyperglycaemia (high levels of sugar in the blood). This can result in visual loss.
  • The higher prevalence of DR in the elderly is related to  the duration of diabetes: the longer you have diabetes, the more likely you are to  get DR, especially if you have poor control of your blood sugar levels.4
  • Normally, ageing affects the anatomy and physiology of the retina, such that it becomes thinner and more fragile. So when this coincides with diabetes, it is more likely to result in DR.
  • All patients living with diabetes should have eye checks every year, and should keep their blood pressure, blood sugar, and cholesterol within normal levels. This may slow down the progression of DR in its early stages, or even prevent it.
  • In the later stages of DR, retinal laser surgeries can be used as part of management..

Glaucoma

  • Glaucoma is a condition in which the eye’s nerve becomes damaged as a result of fluid accumulated in the front part of the eye. This occurs when the eye's drainage passages progressively get blocked over time, leading to a build up in eye pressure.5
  • While it may impact individuals of any age, those in their 70s and 80s seem most affected.
  • Glaucoma does not usually start with symptoms, but with time people may notice:
    • blurred vision, especially provoked in the dark (like when sitting in the cinema)
    • Headache and intense eye pain
    • nausea and vomiting
    • A red eye
    • and seeing halos around light sources
  • There are two main types of glaucoma: open-angle glaucoma and closed-angle glaucoma. Open-angle glaucoma is the most common and develops over many years.
  • Although there is no proven method to prevent glaucoma, routine eye exams can help identify the condition as soon as possible.
  • Routine eye test every 2 years should be enough to detect glaucoma.

Cataracts

  • A cataract is a change in an area of your eye lens from being clear to cloudy or dense, which can limit your vision.
  • It usually appears in both eyes, but not necessarily to the same degree.
  • It is estimated that of people aged 65 years or above are with impaired vision because of cataracts in one or both eyes, 10% of had already undergone cataract surgery.6
  • Risk factors include:
    • A family history of cataracts
    • smoking
    • diabetes
    • trauma to the eye
    • prolonged use of steroid
    • having too much alcohol7
  • Symptoms include: blurred or foggy vision, visual discomfort around dim lighting, and noticing aglare around light sources or hazy vision  (some people describe feeling that the lenses on their glasses aren’t clean even when they are).
  • Cataracts are not painful; however, pain may be a sign of progression or other eye conditions alongside the cataracts.
  • Surgery is the only treatment for cataracts as they progress with time.

How can you prevent age-related eye problems?

Adopting a healthy lifestyle:

  • Healthy eating (enriched with antioxidants and omega 3)

Maintaining the health of your eyes also requires consuming a diet high in fruits and vegetables, especially dark leafy greens like kale, and spinach. Research has also indicated that consuming fish rich in omega-3 fatty acids, such as salmon, tuna, and halibut, has advantages for eye health.8

  • Stopping smoking and alcohol

Smoking has detrimental effects on every part of your body, including your eyes. It increases the risk of developing significant eye disorders that can lead to blindness or visual loss, such as cataracts and ARMD. 9 Similarly, there is evidence linking chronic alcohol use to higher risks of cataracts, age-related macular degeneration, and diabetic retinopathy.10 It is advisable to stop smoking and decrease or limit alcohol use to reduce the risk of developing eye diseases in the future.

  • Weight loss:

Obesity and excess weight can increase the risk of diabetes and other systemic diseases, such as glaucoma or diabetic retinopathy,11 which can cause blindness. Speak with your doctor if you're struggling to keep your weight at a healthy level.

  • Regular exercise:

When examining the associations between physical activity and glaucoma, ARMD, and DR (which are potential causes of visual loss), a great deal of research suggests that regular exercise may have a preventive effect against vision loss.13 Moreover, regular physical activity and exercise over the long-term have been shown to have a positive impact on the onset and progression of cataracts. Walking and high-intensity running are two types of exercise that have been shown to dramatically lower the incidence of cataracts in both men and women, according to some studies.12 

  • Sleep well:

As you may know, your eyes get lubricated when it is closed for quite a long time such as at night therefore, it is advised to have a good sleep pattern at night. Sleep is an essential part of our day, and poor sleep has been linked to developing ARMD and glaucoma. Studies indicate that the regulation of our wake-sleep cycles is mostly dependent on light-sensitive cells in the eyes. With age already contributing to the risk of developing many eye conditions, good sleep is even more essential.  Although it's crucial to shield our eyes from excessive UV light exposure, regular exposure to natural light is also necessary for maintaining a regular sleep-wake cycle.

Eye hygiene practices:

  • Regular checkups:

Getting regular checkups is necessary, especially if you have systemic conditions such as diabetes. Visiting your eye care professional is the best way to be sure your eyes are healthy. Diabetic patients are advised to have yearly eye checks. Moreover, eye problems like ARMD, glaucoma or cataracts benefit from early diagnosis to prevent the condition from worsening or becoming irreversible.

  • Wearing protective glasses: 

You can protect your eyes if you're engaging in activities that may damage your eyes, such as gardening, do-it-yourself activities (DIY) or some sports. Protective eye equipment includes safety glasses and goggles, safety shields, and eye guards. These are made of strong protective materials that are hard to break and, therefore, protect your eyes.

  • Proper contact lens care:

Your contact lenses can become a source of infection if not cleaned properly, so make sure that you disinfect them using special lens cleaning solutions that are widely available in the market and easy to use. In addition, avoid touching your eyes with unclean hands. Rubbing your eyes can also cause friction that might hurt the delicate superficial layer of your eyes.

  • Computer eye strain prevention:

Taking a screen break every hour is important for your eye health to avoid strain and fatigue. You can try the 20-20-20 rule:every 20 minutes take a break for 20 seconds looking at an object 20 feets away.

Summary

Eye health can be an index of general health. A great deal of common eye problems go undiagnosed, making early identification and treatment essential to prevent blindness or irreversible vision loss. Significant risks to vision are associated with age-related eye diseases, including cataracts, glaucoma, diabetic retinopathy (DR), and age-related macular degeneration (ARMD). Regular eye examinations are essential for early diagnosis and management. Age-related vision issues can be avoided by lifestyle changes such as eating a balanced diet high in omega-3 fatty acids and antioxidants, quitting smoking and excessive alcohol use, controlling weight, getting regular exercise, getting enough sleep, and practising good eye hygiene.

References

  1. RNIB [Internet]. [cited 2024 Apr 30]. Key information and statistics on sight loss in the UK. Available from: https://www.rnib.org.uk/professionals/health-social-care-education-professionals/knowledge-and-research-hub/key-information-and-statistics-on-sight-loss-in-the-uk/
  2. National Institute on Aging [Internet]. 2021 [cited 2024 Apr 30]. Aging and your eyes. Available from: https://www.nia.nih.gov/health/vision-and-vision-loss/aging-and-your-eyes
  3. nhs.uk [Internet]. 2017 [cited 2024 Apr 30]. Age-related macular degeneration (Amd). Available from: https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/
  4. Leley SP, Ciulla TA, Bhatwadekar AD. Diabetic retinopathy in the aging population: a perspective of pathogenesis and treatment. Clin Interv Aging [Internet]. 2021 Jul 15 [cited 2024 Apr 30];16:1367–78. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289197/
  5. nhs.uk [Internet]. 2017 [cited 2024 Apr 30]. Glaucoma. Available from: https://www.nhs.uk/conditions/glaucoma/
  6. Cataract statistics & resources | lesh [Internet]. 2017 [cited 2024 May 1]. Available from: https://www.lasereyesurgeryhub.co.uk/data/cataract-statistics/
  7. NICE [Internet]. [cited 2024 May 1]. CKS is only available in the UK. Available from: https://www.nice.org.uk/cks-uk-only
  8. Tips to prevent vision loss | CDC [Internet]. 2023 [cited 2024 May 1]. Available from: https://www.cdc.gov/visionhealth/risk/tips.htm
  9. CDCTobaccoFree. Centers for Disease Control and Prevention. 2023 [cited 2024 May 1]. Vision loss, blindness, and smoking. Available from: https://www.cdc.gov/tobacco/campaign/tips/diseases/vision-loss-blindness.html
  10. Karimi S, Arabi A, Shahraki T. Alcohol and the eye. J Ophthalmic Vis Res. 2021;16(2):260–70.
  11. 1.Cheung N, Wong TY. Obesity and Eye Diseases. Survey of ophthalmology [Internet]. 2007;52(2):180–95. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698026/
  12. Williams PT. Prospective epidemiological cohort study of reduced risk for incident cataract with vigorous physical activity and cardiorespiratory fitness during a 7-year follow-up. Invest Ophthalmol Vis Sci [Internet]. 2009 Jan 1 [cited 2024 May 1];50(1):95. Available from: http://iovs.arvojournals.org/article.aspx?doi=10.1167/iovs.08-1797
  13. Ong SR, Crowston JG, Loprinzi PD, Ramulu PY. Physical activity, visual impairment, and eye disease. Eye (Lond) [Internet]. 2018 Aug [cited 2024 May 1];32(8):1296–303. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085324/

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Rana Ibrahim

Masters of Critical care - Faculty of Medicine, Alexandria University, Egypt

Rana is a qualified medical professional specialising in critical care medicine. She has several years of expertise in the profession and a consistent commitment to clinical excellence and patient care. She has lately been involved in medical writing, driven by her recently discovered passion, using her knowledge and perceptions to teach and educate members of the medical community as well as the society as a whole.

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