Posterior Vitreous Detachment

Adult Vision: 60 Years and Over

Safeguarding your vision beyond age 60 doesn’t have to be a complicated issue. Mostly you will need to be aware of symptoms and warning signs indicating age-related vision problems that could cause vision loss. Regular eye examinations and your vigilance can significantly improve your chances of maintaining good and healthy adult vision while you age.

Age-Related Eye and Vision Problems

There is the possibility, after turning 60 that a number of eye diseases can develop to affect your vision permanently. You should be aware of the following age-related disorders:

  • Age-related macular degeneration (AMD) is an eye disorder affecting the macula, the center of the retina at the back of the eye, causing loss of central vision. This part of the retina allows us to see fine detail and colors. Reading, watching TV, driving and recognizing faces require good central vision provided by the macula.
  • Retinal detachment tears or separates the retina from underlying tissue and can be caused by head or eye trauma, advanced diabetes and inflammatory eye disorders. It mostly occurs from changes to the vitreous fluid filling the back of the eye and if not treated swiftly can result in permanent loss of vision.
  • Diabetic retinopathy is caused directly by diabetes and comes about through progressive damage to the tiny blood vessels nourishing the retina. These vessels begin to leak blood and other fluids and cause the retina to swell and cloud vision. Usually both eyes are affected and the longer diabetes continues the greater is the risk of developing diabetic retinopathy and possible blindness.
  • Glaucoma results from damage to the optic nerve and produces vision loss. Patients who have a family history of glaucoma, older adults and African Americans are at greater risk for developing the disease.
  • Cataracts are fuzzy, cloudy areas that coat the normally clear lens of the eye. Their size and location suggest how they will affect good vision. They tend to develop in both eyes although one may be worse than the other. Dulling of colors, sensitivity to contrasts and heightened sensitivity to glare are symptoms.
  • Dry eye comes about when tear production begins to diminish and the eye suffers from insufficient lubrication. This condition is usually a chronic problem, particularly in older adults.

Driving after 60

You may begin to experience difficulty driving a car after 60. During this time, vision changes and potential eye conditions can affect driving ability. Some age-related vision changes that commonly affect older adults are:

  • Struggling with near vision when viewing the instrument panel or road maps.
  • Difficulty seeing in twilight or nocturnal conditions.
  • Loss of side vision.
  • Difficulty reading road signs.
  • Color perception changes.
  • Unable to adapt to headlight glare.

Tips for Safe Driving

  • Reduce your usual speed and stick mostly to daytime driving. This will minimize risk and avoid potentially dangerous situations caused by the glare from oncoming traffic.
  • Be extra watchful and cautious at intersections. It’s a known fact that many collisions involving older drivers occur at intersections. Look carefully in both directions when approaching an intersection and turn your head frequently to compensate for possible diminished side vision.
  • Take a seniors’ driving course. This type of course will introduce you to the pitfalls seniors can expect when driving. It will also show you how to compensate for physical changes in your vision while driving.
  • Don’t wear eyeglasses or sunglasses with wide or wraparound frames as these can affect your side vision.
  • Have a yearly comprehensive eye examination to ensure your prescription and eye health are stable.

Some of us will experience unduly bad sight after age 60 but it is important to understand that visual ability alone is not a criterion for the degree of visual difficulty a person may have. Those with reasonable 20/40 vision can have difficulty functioning, while others with bad 20/100 vision may not be suffering any great difficulty at all.

But there are low vision rehabilitative services that can provide people with the aid and resources needed to regain their independence. Your optometrist can assist in planning a rehabilitation program to enable you to live and work more effectively, safely and efficiently. Some of the devices used are:

  • Spectacle-mounted magnifiers – This consists of a magnifying lens mounted in a spectacle or on a headband and frees both hands to perform a near-vision task, such as craft work or letter writing.
  • Hand-held and stand magnifiers – These are convenient for reading small print and doing fine close work. They can also be fitted with lights for additional comfort and effectiveness.
  • Hand-held or spectacle-mounted telescopes – These are miniature telescopes used for seeing long distances, such as watching TV.
  • Video magnification – Table top (closed-circuit television) or head-mounted devices enlarge reading text on a video display. These are portable systems that can be used with a computer or monitor. Brightness, size, contrast and color can be adjusted to suit personal needs.There are many other products to assist vision-handicapped patients, such as large-type books, magazines, self-threading needles, newspapers and many more. Your optometrist can suggest the various options available to you.
Eyecare Over Time

Map Dot Fingerprint Dystrophy

Corneal map-dot-fingerprint dystrophy is the most common corneal dystrophy, and occurs when the epithelium’s basement membrane develops abnormally and the epithelial cells cannot properly adhere to it. This abnormality leads to recurrent epithelial erosions.

Epithelial erosions can be a chronic problem and may alter the normal curvature of the cornea causing blurred vision from time to time. The nerve endings lining the tissue may also be exposed and result in varying degrees of pain that can last a few days. The pain is generally found to be worse on waking in the morning. Symptoms include excessive tearing, feeling of foreign matter in the eye and sensitivity to light.

Map-dot-fingerprint dystrophy usually occurs in both eyes and affects adults between the ages of 40 and 70. The condition is slightly more common in females and usually not found in children.

The name derives from the affected epithelium having a map-like appearance: large, slightly grey outlines that look like a continent on a map. Sometimes concentric lines form in the central cornea that resemble small fingerprints.

The disease usually erupts for a few years and then goes away, with no lasting vision loss. As a rule, patients aren’t aware they have map-dot-fingerprint dystrophy because there is no pain or vision loss. But if treatment is needed, ophthalmologists will focus on controlling the pain associated with the epithelial erosions. An eye patch is often used to immobilize the eye, together with prescription lubricating eye drops and ointments. These erosions can heal within three days although occasional pain may occur for several weeks thereafter.

Other treatments can include anterior corneal punctures and corneal scraping to remove eroded areas of the cornea to allow healthy tissue to regenerate. An excimer laser may be used to remove surface irregularities.

Eyecare for Middle Age

Adult Vision: Age 41 to 60

After the age of 40, you might begin to notice changes in your vision. One of the most common problems is being able to read comfortably and do close work. This normal change in the eye’s ability to focus, called presbyopia, will develop as you continue to age.

At first, you may have to hold reading material farther away to see it clearly. Newspaper text, for example, may appear blurred especially under poor or dim lighting. If you are short-sighted, you might find you have to remove your glasses to see up close. This may require eyeglass prescription bifocal or multifocal lenses. Fortunately, people with presbyopia today have many options to correct their vision.

Eye health problems may also occur during this period, and whether or not a need for prescription lenses is evident, you should see your optometrist every two years for a comprehensive eye examination.

If any of the following conditions exist, those over 40 may be particularly at risk for the development of an eye or vision problem:

  • A family history of glaucoma or macular degeneration.
  • High cholesterol, thyroid problem, anxiety or depression, arthritis, general medications.
  • Diabetes or high blood pressure.
  • Stressful work environment or eye-hazardous occupations.

How Vision Changes as you Age

Your eyes are part of your body and will change over time. Eye changes that take place at this time can result in noticeable differences in how well you see. Although people differ in symptoms and vision problems, the following are common age-related vision changes:

  • Problems with reading and doing close work may be evident. As the lens in your eye becomes less flexible with time, printed material is less clear than before. As a result, the eye has greater difficulty now in focusing on near objects than when you were younger.
  • As you age, the need for more light will become apparent. Brighter lights around your work area or reading chair can make reading and work tasks much easier.
  • During this period, changes in the eye’s lens tend to dissipate light entering the eye causing it not to fall properly on the retina. This leads to experiencing more glare, and the oncoming glare from headlights at night – or from the reflected sun in the day – can make driving difficult.
  • The irritation and dryness you might feel in your eyes at this time is due to diminished tear production as you age. Women after menopause particularly suffer from this condition and tear supplements will become necessary to replenish the supply.

Persons suffering from loss of focusing ability for near vision, due to age, have several options available to regain clear near vision:

Through your 50s and beyond, the condition is likely to worsen. But around age 60, the changes should stop and new prescriptions will be less frequent. Despite this, most individuals should benefit from today’s technology and enjoy comfortable near vision for all their lifestyle needs.

Serious Eye Health Problems

During this period, individuals run the risk of developing serious eye and vision problems. If you experience any of the following, you may have early warning signs of a serious vision disorder problem.

  • Floaters and Flashes – From time to time, you may see spots or floaters in your eyes. These are shadowy images of particles floating in the fluid that fills the inside of the eye. Although a bother, they are usually harmless and do not put vision at risk as they are a natural part of the eye’s aging process. However, should they suddenly increase and be accompanied by bright, flashing lights, they could be a warning sign of retinal detachment. And this should receive immediate treatment to prevent serious loss of vision.
  • Fluctuating Vision – If you experience frequent alternating changes in good and bad vision, it may be a sign of diabetes or hypertension (high blood pressure). These conditions can damage tiny blood vessels in the retina and cause loss of vision that is sometimes permanent.
  • Distorted images – If straight lines become distorted or wavy or a blind spot appears in the center of your vision, you may be exhibiting signs of age-related macular degeneration, also known as AMD. The disorder affects the macula, which is the part of the retina responsible for central vision, hence the blind spot right in the middle of your field of vision.
  • Loss of Side Vision – If you appear to be losing peripheral or side vision, it may be a sign of glaucoma. This disorder results from a damaged optic nerve that no longer transmits all visual images to the brain. Very often there are no symptoms until the damage has started.

It cannot be emphasized enough that regular eye examinations by an optometrist can result in early diagnosis and treatment of eye diseases, which can help you protect and preserve good vision throughout life.

Weekly Eyewear Updates for 2011-06-25

Adult Vision: Age 19 to 40

[dropcap custom_class=”normal”]M[/dropcap]ost adults between the ages of 19 and 40 have good vision. If they do suffer vision problems it is usually due to visual stress and eye injuries.

Whether you’re studying for a college degree, beginning your career, or starting to raise a family, good vision is vital. The following are some things you can do to maintain healthy eyes and good vision:

  • Make sure your diet is rich in antioxidants, like leafy green vegetables and fish. If possible, try to eat five servings of fruit and vegetables each day.
  • Regular exercise is important to improve blood circulation, increase oxygen levels to the eyes and to remove toxins.
  • Preferably do not smoke as it exposes your eyes to high levels of noxious chemicals and increases the risk of developing age-related macular degeneration (AMD) and cataracts.
  • A regular eye examination every two years is one of the best ways to ensure you maintain healthy vision. It can also assist in preventing serious eye conditions from developing. If you are at risk for eye problems due to a family history of eye disease, diabetes, high blood pressure or past vision problems, your eye care practitioner may recommend more frequent examinations. If you notice a change in your vision between eye examinations, contact your eye care practitioner immediately.
  • Wearing sunglasses protects your eyes from harmful ultraviolet rays. Be sure to choose sunglasses with UVA and UVB protection, to guard against both forms of ultraviolet rays.

Visual Stress at College or Work

The pace of today’s world places great stress on our vision, and the typical college student or office worker can spend long hours reading or staring at a computer. During the course of the day, the eyes become fatigued and eyestrain and discomfort develop.

Some key signs and symptoms of eyestrain are:

  • Itching or burning eyes
  • Watery or dry eyes
  • Unable to focus properly
  • Eyes feel sore and tired
  • Eyes are sensitive to light
  • Headaches

Tips for Minimizing Eyestrain

  • If possible, position the top of your computer monitor below eye level so you look slightly down at the screen. This guards against strain to the eyes and neck. Adjust the brightness of the screen and try adjusting the monitor’s position or use a reduction filter to reduce glare coming from outside.
  • Every hour take a short break to give your eyes a chance to rest. Walk around for a few minutes if possible and do something that does not require near focusing. Blink frequently to refresh the eyes and use artificial tear solutions if necessary.
  • Poor lighting can be detrimental to your eyes. Consider switching off overhead lights and using an adjustable lamp to provide controlled lighting as needed.
  • Place your feet flat on the floor when seated at a desk and use a chair that is adjustable and comfortably supports your back.

By implementing these simple requirements you are safeguarding possible damage to your vision, not only in the immediate future but also in the long term. If an eye problem persists despite these corrective efforts, please see your eye care practitioner for a comprehensive eye examination.

Related – Amblyopia: Lazy Eye, Vision Patients: Asking the Right Questions, Ocular Albinism, Medical Reasons for Wearing Sunglasses.

Eye Exam

Herpes Zoster – Shingles

The herpes zoster or shingles infection is caused by the varicella-zoster virus, the virus which causes chickenpox. When the virus first manifests as chickenpox, usually during childhood, it remains inactive within the nerve cells of the central nervous system; but it can recur at a later time in the patient’s life and infect some part of the body causing a blistering rash (shingles), fever, painful inflammations of affected nerve fibers and a general lethargy.

But varicella-zoster can travel to the head and neck, involve an eye, part of the nose, cheek and forehead. It is estimated that the cornea will be affected in about 40% of those with shingles in these areas.

Medication usually consists of oral anti-viral treatment to reduce the risk of the virus infecting cells deep within the tissue and inflaming and scarring the cornea. The disease also can cause decreased corneal sensitivity, which results in foreign matter in the eye not being as keenly felt as before. For many, this decreased sensitivity will be permanent.

Once exposed to the varicella-zoster virus, no one is immune from shingles, but clinical studies have established two risk factors for the disease:

  • Advanced age
  • Weakened immune system

There is a much greater chance of people over 80 contracting shingles than those between the ages of 20 and 40. Unlike the herpes simplex 1 virus, varicella-zoster usually does not break out more than once in adults with normally functioning immune systems.

Corneal problems can arise only months after the disappearance of shingles, and for this reason it is particularly important for those who have had facial shingles to have eye examinations as soon after the disease as possible.

Related – Ocular Histoplasmosis Syndrome, Stevens-Johnson Syndrome, Onchocerciasis: River Blindness, Posterior Vitreous Detachment, Eye Anatomy: Important Definitions, Duane Syndrome.

Hiding Eye

Amblyopia: Lazy Eye

The popular term for amblyopia is lazy eye. It is unrelated to any eye health problem and is the loss or lack of development of central vision in one eye. Lazy eye cannot be corrected with lenses.

It is a condition that usually develops before the age of 6 and can result from an inability to use both eyes together. Lazy eye is frequently associated with crossed-eyes or a big difference in the degree of short-sightedness or far-sightedness between the two eyes.

What are Lazy Eye Symptoms?

Symptoms are not always immediately obvious but may include noticeably favoring one eye or a tendency to bump into objects on one side.

How is Lazy Eye Treated?

Your eye care practitioner may prescribe a combination of prescription lenses, prisms, vision therapy and eye patching. Vision therapy is used to teach the two eyes to work together, which can prevent lazy eye from recurring.

Chances for a complete recovery can occur if the condition is diagnosed early. It is important therefore to ensure that your children have a comprehensive eye examination by age 6 months and again at age 3. Lazy eye is a problem that will remain if not treated and, if not diagnosed until the teen or adult years, takes longer to resolve and can be less effective in responding to treatment.

Related – Vision Patients: Asking the Right Questions, Ocular Albinism, Medical Reasons for Wearing Sunglasses, Stevens-Johnson Syndrome, Glaucoma Information, Onchocerciasis: River Blindness, Presbyopia, Posterior Vitreous Detachment, Eye Anatomy: Important Definitions, Duane Syndrome.

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Holmes-Adie Syndrome

Vision Information - Holmes-Adie Syndrome

Vision Information – Holmes-Adie Syndrome

Holmes-Adie syndrome is a neurological disorder that affects the pupil of the eye and the autonomic nervous system.

Characteristic symptoms are a larger than normal pupil in one eye that constricts slowly in bright light and the absence of deep tendon reflexes, usually occurring in the Achilles tendon.

The cause of Holmes-Adie syndrome is thought to be a viral or bacterial infection which inflames and damages neurons in the ciliary ganglion (the area in the brain controlling eye movement), and the spinal ganglion (the area in the brain involved in the response of the autonomic nervous system.

The disease starts gradually in one eye and often progresses to the other. Initially, the loss of deep tendon reflexes may be felt only on one side of the body, but then it progresses to the other side. The eye and reflex symptoms do not necessarily appear at the same time.

The disorder may cause excessive sweating, sometimes only on one side of the body.

The symptomatic combination of abnormal pupil size, loss of deep tendon reflexes, and excessive sweating usually is called Ross’s syndrome although some doctors may still diagnose the condition as an offshoot of Holmes-Adie syndrome. The HAS symptoms can appear alone or in association with other nervous system diseases, such as Sjogren’s syndrome or migraine. Mostly it appears in young women and is rarely an inherited condition.

How is HAS treated?

Ophthalmologists may prescribe glasses to correct vision in the affected eye and daily application of prescribed drops for the constricting dilated pupil. For the excessive sweating, a thoracic sympathectomy (severing of the particular sympathetic nerve) is the typical treatment.


HAS is not a life-threatening or disabling disorder, although the loss of deep tendon reflexes is permanent. Some symptoms of the disorder can progress but prescribed drops and eyeglasses will, in most cases, improve vision.

Eye Exam

Vision Patients: Asking the Right Questions

Vision Information - Asking the Right Questions

Vision Information – Asking the Right Questions

The National Eye Institute has created a list of appropriate questions that vision patients can put to their eye care practitioners to provide an efficient line of communication and understanding. This will ensure the best possible results are achieved in their consultations.

About My Disease or Disorder

  • What is my diagnosis?
  • What caused my condition?
  • Can my condition be treated?
  • How is my condition likely to affect my vision now and in the future?
  • Are there symptoms I should be aware of and that I should notify you about?
  • Should I make any lifestyle changes?

About My Treatment

  • What is the treatment for my condition?
  • When will the treatment start and how long will it last?
  • What benefits will I gain from this treatment and how successful will it be?
  • Are there risks and side effects associated with this treatment?
  • Should I avoid any foods, drugs or activities while on this treatment?
  • If I have to take medication, what should I do if I miss a dose?
  • Are other treatments available?

About My Tests

  • What kinds of tests must I have?
  • What are the tests likely to prove?
  • When will I know the results?
  • Do I need to prepare for these tests?
  • Do the tests have side effects or risks?
  • Will more tests be needed later?

Getting the Best from a Consultation

  • If you don’t understand your doctor’s responses, ask questions until you do understand.
  • Take notes or ask a friend or family member to take notes for you. An alternative is to tape the conversation for easy recollection.
  • Ask your doctor to write down all instructions for you.
  • Request whatever printed material is available for your condition.
  • If you do not understand your doctor’s answers, ask where more information may be obtained.
  • Talk to nurses and pharmacists as they can be good sources of information also.

Related – Ocular Albinism, Medical Reasons for Wearing Sunglasses, Stevens-Johnson Syndrome, Glaucoma Information, Onchocerciasis: River Blindness, Presbyopia, Posterior Vitreous Detachment, Eye Anatomy: Important Definitions, Duane Syndrome, Helpful Glaucoma Information.

Eye Exam Coming Up - Read On

Ocular Albinism

Vision Information - Ocular Albinism

Vision Information – Ocular Albinism

Ocular albinism is an inherited condition in which the eyes lack melanin pigment, which is essential for normal vision. But the skin and hair show normal or near-normal coloration.

The lack of pigment in the eyes can give rise to several vision problems:

  • Sensitivity to bright light and glare.
  • Nystagmus – involuntary eye movement.
  • Reduced visual acuity from 20/60 to 20/400.
  • Strabismus – crossed eyes.

Impaired vision can result in difficulty at school, such as an inability to read the chalkboard and problems with ball games and sports.

The fovea, a small area of the retina that provides acute vision, has not developed completely in ocular albinism and, as a result, the eye is unable to process sharp light images. This also makes it very difficult to correct vision with eyewear. But some children may do well with ordinary eyeglasses and older children and adults can have small telescopes mounted on the lenses to help with both close and distant vision. Even contact lenses sometimes provide a correction that eyeglasses do not.

Surgery for strabismus may be helpful and can improve the field of vision if the eyes are crossed. This also can improve appearance and the child’s self-image.

Parents concerned about the genetic implications of ocular albinism should consult a genetic counselor, particularly if they wish to have more children. Naturally they also should see an ophthalmologist for a full evaluation of the specific ocular albinism present.

Acceptance of the condition by the parents can lead to emotional and social adjustment in their children that will prevent low self-esteem, relationship difficulties and learning difficulties at school. Children can function well despite their visual disabilities if they are provided with appropriate support and services.

Related – Medical Reasons for Wearing Sunglasses, Stevens-Johnson Syndrome, Glaucoma Information, Onchocerciasis: River Blindness, Presbyopia, Posterior Vitreous Detachment, Eye Anatomy: Important Definitions, Duane Syndrome, Helpful Glaucoma Information.