As our bodies age, it is normal to notice that there are decreases in our ability to complete certain functions that may have been natural for us in our youth. Just like our physical strength, the strength of your eyes can also weaken over time.

Several different factors influence how each of us will experience aging. Your genetics can play a pivotal role. Understanding your family history and making sure to communicate this can help Dr. Kubota to monitor changes and spot early signs and symptoms. Exposure to certain chemicals or harsh environments or experiencing trauma to our eyes can also have an impact on how our eyes function and age. While the eyes can often recover from traumatic injury or exposure, they may still have acquired a detrimental injury or effect that can manifest as problems immediately or as you age.

Here are some of the most common ailments that people experience when they age:
 

Presbyopia

Once you are over 40 years old you may experience a loss in vision at close range. Presbyopia is a normal condition that occurs due to the hardening of the lenses in your eyes (natural cataract formation). In the early stages, you can often compensate for small changes to your vision, but as the condition progresses, you will likely need bifocal lenses, separate single vision glasses for distance and near, multifocal or monovision (one eye focused for distance and the other focused for near) contact lenses or choose a surgical procedure such as refractive lens exchange, for example.
 

Cataracts

Cataracts are a natural aging change of the lens in the eye. While the lenses age and cataracts slowly form over the decades of a person's life, the lens becomes less and less flexible, but increasingly more discolored and cloudy.  Basically cataracts turn the clear, flexible lens from our teen years into a cloudy, dark, inflexible one that is difficult to see out of.  The majority of the population over 65 have at least the early or middle stage signs of visually compromising cataract formation. While it can be frightening to begin losing your vision, cataract surgery is extremely successful and can restore up to 100% of the lost vision. If you notice even small changes to your vision, it is smart to talk to Dr. Kubota right away. Cataract surgery is best performed when the cataracts are in the less-dense middle stage and can be more easily removed.

Macular Degeneration

Age Related Macular degeneration (AMD) is a completely painless disorder that affects the central area of the retina, which is the light-sensitive tissue lining the inside of the eye. Within the retina, the area responsible for sharp central vision (called the macula) deteriorates, causing blurred vision. This can cause a blind spot in the central area of vision, which leads to legal blindness and low vision.  There are two types of macular degeneration – non-exudative (dry form) and exudative (wet form). The dry form usually progresses slowly, while the wet form causes more rapid and severe vision loss due to abnormal blood vessels developing under the macula and leaking fluid and blood. The biggest risk factor for macular degeneration is age. Other risk factors include genetics, race, smoking, and high blood pressure.

Glaucoma

Glaucoma is a completely painless disease that has no symptoms or warning signs so it is often called the "silent thief of sight." Because there are no outward symptoms, it is important to get a COMPREHENSIVE eye HEALTH exam annually to check for any signs of glaucoma.  Glaucoma falls into four main types:

1) Open Angle Glaucoma: Open Angle Glaucoma happens when the eye does not drain fluid as well as it should, the eye pressure rises and starts to damage the optic nerve and nerve fiber layer of the retina. 

2) Normal Tension Glaucoma:  This type of glaucoma occurs when a patient with "normal" eye pressure has sensitive optic nerves and still develops glaucoma damage over time.  

3) Narrow Angle/Chronic Angle Closure Glaucoma: This type of glaucoma occurs when a person's "angle" (the area where the fluid drains) is narrow so the fluid does not have much room to drain, the eye pressure rises and starts to damage the optic nerve and nerve fiber layer of the retina.  Again because there are few or no outward symptoms, it is important to get a COMPREHENSIVE eye HEALTH exam annually to check for any signs of glaucoma. 

4) Secondary Glaucomas:  Secondary glaucoma is the name used to describe glaucomas that occur as a side effect or “secondary” to another underlying medical condition or trauma.

• Pigmentary Glaucoma: This secondary glaucoma results from Pigmentary Dispersion Syndrome and occurs when the pigment rubs off of the iris and subsequently raises eye pressure causing damage to the optic nerve and nerve fiber layer of the retina. 

• Pseudoexfoliation Glaucoma: Pseudoexfoliation occurs when the edge of the lens starts to flake away like dandruff, they clog up the trabecular meshwork and stop the aqueous fluid from draining efficiently raising eye pressure and damage the optic nerve and nerve fiber layer of the retina. This condition tends to be more common in older people and in people of Scandinavian and Southern Mediterranean origin.

• Uveitic Glaucoma: Uveitis occurs when a part of the eye called the uvea becomes swollen and inflamed. If uveitis leads to increased pressure, we get uveitic glaucoma.

• Neovascular Glaucoma: Neovascular (“new blood vessels”) glaucoma occurs when poor blood supply within the eye causes new blood vessels to grow on the surface of the eye and into the drainage channel. The new blood vessels can cause eye pressure to rise by blocking the outflow of aqueous fluid. This type of glaucoma is usually associated with other eye conditions like diabetic retinopathy.

• Steroid-Induced Glaucoma: Medicine-related secondary glaucoma is the result of inflammation caused by medication, typically steroids. Steroids are used for a variety of medical conditions and can be inhaled (inhalers), taken orally as tablets, injected or applied directly to the skin or eye. They are an important type of medicine, but a possible side effect is increased eye pressure. This effect is called "steroid response."

• Trauma Induced Glaucoma: Trauma can mean either a blow to the eye, a penetrating injury (when something pierces the eye) or a chemical injury (such as an alkali burn). It can happen immediately after the injury or develop over time. Blunt trauma (such as a blow to the eye) can affect the shape of the eye and the pressure builds up over several years. People affected will need to be monitored to limit the chance of developing glaucoma in the future.

• Iatrogenic Glaucoma: Iatrogenic literally means "caused by a doctor." The main iatrogenic cause is following retinal surgery. During retinal surgery, the surgeon may need to put gas or silicone oil in the eye. These substances can have the side effect of raising the eye pressure. 

Most of the time, glaucoma develops very slowly which means that many people don’t realize that they are affected until some damage to their vision has already occurred. However, occasionally a person can have an Angle Closure Glaucoma "attack," their already narrow angles close, the fluid can no longer drain and the pressure in the eyes can rise drastically causing sudden and severe or complete vision loss.  An Angle Closure Glaucoma attack can develop quickly, and symptoms do occur, especially when going from a dark environment into light. These can include:  

• Red eyes
• Intense headaches
• Tenderness around the eyes
• Eye pain
• Seeing rings/halos around lights
• Blurred vision
• Nausea and vomiting

**If you notice any of these symptoms, it’s important to CALL DR. KUBOTA'S OFFICE RIGHT AWAY so that you can be examined as soon as possible. If the office is closed, please go IMMEDIATELY to the nearest emergency room and ask to see the ophthalmologist on call.**

Retinal Detachment

• A sudden change or increase in floaters
• Prolonged flashing lights that repeat on an off for over an hour
• A sheer, cloudy film in front of your vision
• A black curtain going up over your vision

Diabetic Retinopathy

Individuals who have diabetes may be affected by diabetic retinopathy. This disease occurs when blood sugar levels are elevated for an extended period that causes damage to the eye. This damage may lead to permanent vision loss. Americans with diabetes over the age of 40 are at an increased risk, with about 40 percent of people with diabetes over this age displaying some degree of diabetic retinopathy.
 

Other Aging-Related Issues

The previous examples are what we normally imagine when we think about age-related issues and our eyes, but there are other changes that also occur. Some of these can be treated with over the counter medications or eye drops, while others are a natural part of the aging process.
 

Dry eyes

Our bodies naturally decrease tear production and quality as we age. This reduction can leave your eyes feeling dry. Fortunately, you can use eye drops or artificial tears in order to keep your eyes moist and free from discomfort.  If these fail to alleviate dry eye symptoms then prescription medications and other procedures can help.
 

Peripheral vision loss

Our peripheral field of vision gradually decreases as we age. Researchers suggest that the rate of loss is between 1-3 percent of our field of vision per decade of our life. This means that by the time you reach your 70’s, or 80’s that your peripheral vision could be reduced by as much as 20 to 30 degrees.
 

Seek Help

It’s important to know that you should not attempt to self-diagnose any changes to your eyes. If you experience a change in your vision, it is important to see Dr. Kubota immediately to prevent additional or unwarranted damage to your eyes and vision.