A quarter of a million Kiwis have now celebrated their 60th birthday and most are fully intent on living longer and healthier lives.  New Zealanders in growing numbers are seeking an active retirement.

An active lifestyle is a healthy lifestyle but how does that work if you cannot see?  

People who do not see well are less likely to cope with living independently.  They rate their quality of life lower than people who do see well.  

People with poor vision also have higher rates of depression, more falls and fractures, increased need for community and/or family support and need institutionalized care at an earlier age.

Put bluntly, poor eyesight is bad for you.  

The trouble is that permanent loss of vision can occur before you notice it.  First there is the 40+ phenomenon. Around the age of 40, most people will notice a change in vision known as presbyopia. This condition is a natural part of the aging process and for many, reading glasses may clear the blurry vision.  Once we get over that it is back to full-time careers, exercise, travel, and active grandparenting filling our time and energy.  Sixty just becomes the new forty, with a new lease of life.

Today’s 60-year-olds are more health conscious than 60-year-olds 20 years ago, but being better informed about health risks, improved technology, and treatment options has not necessarily translated into including regular eye examinations into their health care routine.

Healthy people need healthy eyes but unfortunately, for many; age-related eye diseases are being robbing them of many years life enjoyment.

To maintain the active lifestyle that most Kiwis are accustomed to, we need to get into the habit of regular comprehensive eye exams from an early age.

Here are a few sobering facts about eye health and advancing age:

  • Age-related vision problems, like macular degeneration and glaucoma, strike often without warning or symptoms.
  • Most vision loss is permanent and irreversible.
  • Blindness and vision loss treble for each decade over the age of 40 years.  
  • By age 90 half of the population has some form of visual impairment and 1 in every 8 are blind.
  • Blindness and vision loss may be preventable.

Age Related Macular Degeneration

Many people who are aged 70 and over have some macular degeneration. If there is a family history there may be an increased risk and in addition, people with certain medical conditions such as diabetes or other micro-vascular diseases may be more likely to develop macular degeneration. Again it’s important to make sure you have regular check ups with your optometrist.

There are steps people can take to prevent ARMD

  • Avoid smoking
  • Eat fish and green leafy vegetables.
  • Take dietary supplements and anti-oxidants if your doctor advises you to do so
  • And, especially if there is a family history, have a regular eye examination with your optometrist.

For many cases of ‘dry’ ARMD there is no treatment currently possible. Some cases of ‘wet’ ARMD are amenable for treatment by an ophthalmologist such as photodynamic therapy (PDT) or an injection of a particular drug, such as Lucentis or Avastin which is designed to block abnormal blood vessel growth and leakage.

If your condition is not treatable or the treatment is not working, your optometrist may be able to help with special low vision aids to help with reading and close work tasks.

Glaucoma

Glaucoma is an eye condition that can result in too much pressure from eye fluid in the eye and another cause of low vision, particularly in older people. This high pressure can damage the optic nerve and if the pressure persists, glaucoma will worsen your sight.

When left untreated, glaucoma can cause loss of sight in just a few years. Glaucoma NZ reports that 10 percent of people over 70 years will have glaucoma.

People at risk are:

  • Having a parent, brother or sister with glaucoma
  • Being over 60 years old
  • Having certain medical conditions: high blood pressure, diabetes, thyroid disease, or a history of migraine.
  • Taking steroids over a prolonged period
  • A history of eye injury
  • Injuries that have involved sudden blood loss
  • Being myopic (short sighted) in primary open angle glaucoma; and being hyperopic (long sighted) in angle closure glaucoma.

Usually there are no symptoms except vision loss, in advanced cases, which is why it is so important people visit their optometrist for a regular check up – at least every two years.

In a few cases, glaucoma will develop rapidly with blurred vision, loss of side vision, seeing coloured halos around lights, redness of the eye, nausea or vomiting and pain in the eye. This is serious and should be treated as a medical emergency.

While glaucoma can’t be prevented, it can be detected before vision loss occurs. If detected and treated early the disease can be controlled.

Diabetes

People with diabetes are also at risk of low vision. Reduced vision is one of the most distressing and difficult complications of diabetes. More than 200,000 people in New Zealand have diabetes.

Diabetes may cause damage to the eye’s light sensitive lining, the retina, and produce changes called diabetic retinopathy where the walls of the blood vessels are weakened.

These tiny blood vessels at the back of the eye begin to bulge and leak, oozing blood into the eye. Cellular changes can also cause fats and fluids to leak into surrounding tissue. Resulting damage to the eye can lead to permanent loss of vision.

As the disease progresses, you will notice rapid changes in vision. There will be difficulty in achieving stable vision, sensitivity to glare and reduced night vision.

With regular examinations any threats to your sight can be detected and treated promptly, minimising the risk of permanent loss of vision.

Research shows people with low vision are negatively affected in terms of independent living, quality of life, self-ranking of health, depression, falls and fractures. They are also likely to have increased need for community and/or family support and earlier institutionalised care.

Optometrists are the primary care providers to people with a wide range of eye conditions which require long term management as functional vision is reduced.

Low vision care is a core part of optometry training and optometrists around New Zealand are daily providing care to patients trapped in the long, arduous progression from normal vision to legally blind.

For many of these people, the transition to low vision status is accompanied by the need for a range of low vision aids to maintain both health and safety.

Most commonly, low vision patients are assisted by the use of a magnifier to enable them to read. Safety issues addressed include reading names and directions on medicines, reading key bills for payment such as electricity bills to avoid disconnection, reading safety instructions on appliances and checking oven settings and temperature to avoid stove fires.

The optometrist is able to prescribe the most suitable low vision aid based on clinical findings, but most low vision patients will need to ‘test drive’ a few magnifiers to settle on the best one for their needs and abilities.

To find your nearest NZAO member optometrist, check the Yellow Pages ® of your phone book or contact: New Zealand Association of Optometrists -  email: info@nzao.co.nz,  phone: 0800 439 322 or visit our website: www.nzao.co.nz/locate-an-optometrist

Vision and Age