The Important Necessity of Eye Exams for Older Adults

Older adults are at higher risk for eye disease and vision problems, so you’ll want to take very seriously any unusual symptoms someone you’re concerned about may be having with his vision. That’s because early detection and treatment can greatly reduce the risk of partial or complete blindness. Routine eye exams are crucial, too, as some eye diseases arrive without any warning.

How often should an older adult’s vision be screened?

For those 65 and older, the American Academy of Ophthalmology recommends complete eye exams every year or two. If a person hasn’t seen an eye doctor recently, it’s important to schedule an appointment. Even if he isn’t having any symptoms or any trouble seeing, it’s possible to have an eye disease. There are often no obvious early symptoms of glaucoma, for example, and the disease progresses slowly. In fact, experts estimate that almost half of those with glaucoma don’t know they have it.

A person may need more frequent exams (perhaps even more often than once a year) if he has certain medical conditions, like diabetes or high blood pressure, which may put him at higher risk for some eye diseases. The eye doctor might want to see him more often, too, if he:    Continue reading

Less Age-Related Vision Loss Linked to Omega-3s

Women who get lots of omega-3 fatty acids are less likely to develop age-related macular degeneration (AMD), an eye disease affecting millions of older adults in the U.S.

That’s the conclusion of a new study, which jibes with earlier research linking fish consumption to slower progression of AMD. Fish rich in omega-3 fatty acids such as DHA and EPA include salmon, trout, sardines, herring and tuna.

AMD is caused by abnormal blood vessel growth behind the retina or breakdown of light-sensitive cells within the retina itself, both of which can cause serious vision impairment. Some 1.7 million Americans have severe vision loss due to the disease, making it the leading cause of blindness in older adults. Continue reading

Silicone Oil May Help Treat Eye Cancer

Silicone oil applied inside the eye can block up to 55 percent of harmful radiation to prevent blindness in patients with eye cancer, a U.S. researcher says.

Dr. Scott Oliver, an assistant professor at the University of Colorado School of Medicine, says eye cancer, a rare but devastating disease, can strike anyone — although fair skin and sun exposure can increase risk — at any time, and treatment often requires radiation that leaves half of all patients partially blind.

Oliver focused on choroidal melanoma of the eye, or uveal cancer, the most common and dangerous form of eye disease, which affects some 2,000 people annually. It can spread quickly to the liver and lungs and often can be fatal.

For treatment, physicians often use plaque brachytherapy in which surgeons attach a gold cap containing radioactive seeds to the white part of the eye.

“Radiation injures blood vessels and nerves in the back of the eye,” Oliver says in a statement. “Half of all patients are legally blind in 3 years in the treated eye.”

Oliver tried several substances to block radiation from striking critical structures while allowing it to hit the tumor.

The study, published in the Archives of Ophthalmology, finds silicone oil — already used to treat retinal detachment — could screen out a majority of harmful radiation.

Eye Disease Affects Nearly One in Three Diabetics

Almost one in three people with diabetes has evidence of the eye disease called diabetic retinopathy, according to new research.

 What’s more, over 4 percent of people with diabetes have diabetic retinopathy that’s so advanced it’s threatening their vision, reports the study published in the Aug. 11 issue of the Journal of the American Medical Association.

 “This was a national population-based study and we found that among Americans with diabetes who were age 40 and older, that 28.5 percent — or 4.2 million people — have diabetic retinopathy. And, 4.4 percent had vision-threatening diabetic retinopathy,” said the study’s lead author, Dr. Xinzhi Zhang, an epidemiologist with the U.S. Centers for Disease Control and Prevention in Atlanta.

 The news wasn’t all bad, however. The findings suggest that good control of blood sugar, blood pressure and cholesterol can go a long way toward preventing or slowing diabetic eye disease. And treatment with laser surgery may be helpful for those with more advanced retinopathy.

 “If you have diabetes, take good care of your diabetes and get your eyes examined regularly,” advised Zhang. “If you find problems early and get treatment, you can delay or prevent the loss of vision.”

 Diabetic retinopathy causes changes in the blood vessels in the eyes. In some cases, new and abnormal blood vessels grow, and in other cases, existing blood vessels swell and leak, according to the U.S. National Eye Institute. Diabetic retinopathy remains the number one cause of vision loss in people aged 20 to 74 in the United States, according to background information in the study.

 The last study that looked at national prevalence of diabetic retinopathy was done between 1988 and 1994. To get an updated estimate of what the prevalence of the eye disease might be now, Zhang and his colleagues reviewed data from the National Health and Nutrition Examination Survey from 2005 to 2008, which included nearly 7,000 people over age 40.

 Of those people, 1,006 reported that they had been diagnosed with diabetes, or they had a hemoglobin A1C reading above 6.5 percent. Hemoglobin A1C is a measure of long-term blood sugar control, and according to the American Diabetes Association, someone who has a level of 6.5 percent or higher has diabetes. The study did not differentiate between type 1 and type 2 diabetes.

 In addition to finding that nearly one in three people with diabetes has some form of diabetic retinopathy, the researchers also found that slightly more men than women have the disease (about 32 percent versus 26 percent), and blacks and Mexican Americans have a higher rate of the disorder than whites (about 39, 34 and 26 percent, respectively).

 Other risk factors for diabetic retinopathy found in the study included a higher A1C level (which indicates poor blood sugar control), higher systolic blood pressure, a longer duration of diabetes and insulin use.

 Zhang said that many of these risk factors, such as a high A1C or the need for insulin (in type 2 diabetics) might indicate more severe diabetes, which is more likely to result in diabetic retinopathy.

 “I was surprised to see that there’s still such a high prevalence of diabetic retinopathy,” said Dr. Richard Bergenstal, president of medicine and science for the American Diabetes Association. “We’ve made a lot of progress in treating diabetes and the hope is always that the complications are going away, but we still have a lot of people who aren’t quite to goal in terms of blood sugar management.”

 Bergenstal said that everyone with type 2 diabetes should have a dilated eye exam soon after they’re diagnosed with diabetes, because they’ve likely had diabetes for a while without knowing it. After the initial exam, he said, a dilated eye exam is needed every year thereafter. People just diagnosed with type 1 diabetes may be able to wait a few years before having their first dilated eye exam, but then should have one every year after as well.

 Bergenstal said that to help prevent retinopathy, people with either type of diabetes need to maintain good blood sugar levels, keep their blood pressure controlled, and lower their cholesterol with medications, if necessary.