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Eye Health Through the Ages

When babies are born, their vision isn’t perfect. Instead, vision develops over time. Infants must learn how to focus on objects, track moving images and use both eyes together. Then, the brain needs to learn how to make meaningful sense of the visual information.

Here are some common conditions that can affect visual acuity during childhood: Refractive errors. Refractive errors are focusing problems. In nearsightedness (myopia), patients see close objects more clearly than those that are far away. Farsightedness causes distant objects to be seen more clearly than close ones. Astigmatism is a condition in which the shape of the cornea is irregular (not round), causing images to be blurred because they fall on several areas of the retina.

Amblyopia. Amblyopia (lazy eye) is a condition in which vision doesn’t develop equally between the two eyes, causing one eye to have strong vision and the other to have weak vision. Eventually, the brain may learn to ignore the images coming from the weak eye.

Strabismus. This is a condition in which the eyes are not aligned properly. One eye may point in a different direction from the other. It can cause eye fatigue, double vision, problems with depth perception and difficulty with reading.

As we age, even adults with normal vision can develop problems that affect clarity or eye health. Here are some common problems in aging eyes: Presbyopia. This condition is characterized by a loss of the ability to see up-close images, like newspaper print. It’s believed to occur because the lens of the eye becomes less flexible with age, reducing the ability of the lens to quickly change focus between distant and close images. Presbyopia becomes more common after 40.

Dry eye. Tears lubricate and nourish the eyes. As we age, tear production decreases and the quality of tears diminishes, causing the eyes to become drier. Patients may complain of burning, stinging or eye discomfort. Decreased tear production can also affect the clarity of vision. Women are at higher risk for dry eye after menopause.

Cataracts. A cataract is a cloudiness in the normally clear lens of the eye. The clouding interferes with ability of images to pass through the affected part of the lens, causing blurred or hazy vision. A cataract can also cause an increased sensitivity to glare (especially at night), decrease in contrast sensitivity and dulled color vision. Cataracts can occur at any age (including infancy and childhood), but are most common after 55.

Macular degeneration. Age-related macular degeneration is a condition that affects an area in the center of the retina, called the macula. The macula is responsible for clear, sharp central vision, affecting activities like reading, watching TV and recognizing faces. While images in the center of vision are blurred, side vision (peripheral vision) is unaffected. Macular degeneration is one of the leading causes of blindness among older people in the U.S. Risk increases after 60.

Glaucoma. Glaucoma is characterized by damage to the optic nerve. The most common form is associated with increased pressure of the fluid inside the eye, which damages the nerve fibers that transmit vision signals to the brain. According to the American Optometric Association, glaucoma is the second leading cause of blindness in the U.S. Risk increases after 40.

Diabetic retinopathy. People with diabetes are at increased risk of developing damage to the tiny blood vessels that provide nourishment to the retina. The damaged blood vessels leak blood and fluid, causing the retina to swell and vision to become cloudy. The American Diabetes Association reports diabetic retinopathy is the leading cause of new cases of blindness in Americans 20 to 74. 12,000 to 24,000 cases occur annually.

Getting Eye Exams

According to the National Eye Institute, more than 11 million Americans have vision problems that can be corrected with prescription lenses (glasses and contact lenses). But many people don’t bother getting regular eye exams. A recent study published in the journal, Archives of Ophthalmology, reports only about half of all Americans had an eye exam in the previous 12 months. Among older people who are more at risk for eye health problems, only about 62 percent had received an eye exam.

Regular eye examinations can detect vision problems and enable patients to see clearly. But eye exams go beyond checking visual acuity. For children, eye exams can detect problems that affect their ability to learn and perform well in school. For adults, regular screenings enable doctors to detect eye health problems (like glaucoma and macular degeneration) in early stages, preventing or slowing down vision loss. Suzanne Bellante, O.D., Optometrist with Beth Israel Medical Center in New York City, says examination of the blood vessels of the retina can also show signs of other health problems, like high blood pressure, diabetes or high cholesterol.

People with eye health problems, patients who wear corrective lenses and those who are at risk for vision problems (due to family history, personal history or underlying medical problems) should consult an eye care provider for specific recommendations on eye exam intervals. For those without any risk factors, The American Optometric Association recommends childhood screening at the following intervals: ? Under two. A screening exam is recommended by six months to check for cataracts or early signs of eye health problems. ? Ages 2 to 5. All children should have their first thorough eye exam by three. ? Ages 6 to 18. Screening every two years.

During adulthood, patients should have eye exams every one to two years, depending upon their vision needs and health conditions that may affect their eyes. The American Academy of Ophthalmology recommends a baseline eye screening at 40 to assess a patient’s needs for treatment or follow-up. Generally, patients 65 and older should have annual eye exams.

Bellante is a little more conservative with her exam frequency recommendations. She believes adults in their 20s and 30s need an eye exam every two to three years. Those in their 40s should have an exam every one to two years. Patients 50 and older should have an exam every year.

The exact frequency of eye exams will vary, based on a person's age, family history, personal health history and other risk factors. If you have any questions about how often to have your eyes examined, speak with an eye care professional.