As we age, our eyes change as well as the rest of our body. For most of us, as we approach our 40’s, vision can change significantly and we should be aware of what to do should we experience a change in our vision.
Age-related Macular Degeneration (AMD) is a disorder of the retina. It is the most common cause of vision loss in Americans over 60.
The macula is the central portion of the retina which is necessary for the sharp, “straight ahead” vision needed for tasks such as reading, recognizing people or driving a car. AMD can range from mild changes with no decrease in vision to a severe abnormality resulting in the loss of all “straight ahead” vision. Macular degeneration does not cause total blindness because the unaffected parts of the retina continue to provide “side” vision.
There are two types of macular degeneration “dry” and “wet”. The “dry” form occurs when small deposits called drusen appear under the retina. When a large number of deposits develop, vision may be decreased. The “wet” form is caused by bleeding and a leakage of fluid from an abnormal growth of blood vessels under the retina. This “wet” form can cause severe vision loss and sudden distortion or blurred vision. Although there is no cure for dry macular degeneration, the wet form can sometimes be treated with lasers.
The Amsler Grid is used to screen for macular degeneration. It involves looking at a square grid with a dot in the center. When staring at the dot in the center, all four corners should be visible and the lines of the grid should appear straight and continuous from top to bottom and side to side. If the person notices any blurring, crooked or wavy line or holes, they should contact their eye doctor immediately.
What are flashes and floaters and are they an indication of a serious eye condition?
Floaters are black or gray lines or specks that appear to move as the eye moves. Floaters are caused by bits of material suspended in the jelly-like fluid that fills the back of the eye. Actually, it is the shadow of the floater that you are seeing as it casts
a shadow on the light sensitive retina.
Flashes are when you “see” light when no light is present. Flashes may appear as tiny sparkles or more like lightning flashes. They usually last only a second or so, but it is common to have them repeatedly. Flashes may occur when the “jelly” inside the eye pulls away from or tears the retina. Some people with migraine headaches experience jagged lights that occur in the center of their vision and are present for 15 minutes or longer, followed by a throbbing headache - usually on one side of the head.
While floaters and flashes are not serious in themselves, they may indicate a more serious eye condition. Many people have floaters for years and show little or no change in their vision. If you notice a new floater or suddenly experience flashes, your eyes should be examined promptly by an ophthalmologist. The eye doctor will usually administer eye drops that enlarge the pupils and allow him to look at the “jelly” and retina with special equipment. In this way, damage to the retina can easily be detected. Only about 10% of the cases where flashes or floaters suddenly appear indicate a torn retina.
Flashes and floaters themselves require no treatment and usually go away on their own in a few days or weeks. In the event that there is a retinal detachment, surgery may be required to reposition the separated retina. Retinal tears with little or no detachment may be treated with lasers or freezing techniques.
There are two new treatments for those people who are nearsighted and either cannot or prefer not to wear eyeglasses or contact lenses.
Radial Keratotomy is a surgical procedure in which 4 to 8 radial cuts are made in the cornea of the eye - permanently changing the shape of the cornea. Only an ophthalmologist can perform this type of surgery and it usually requires a one day surgical stay.
In 1995, the FDA approved another form of treatment to correct nearsightedness. It is called PRK or Photorefractive Keratectomy. In PRK, a laser is used to microscopically change the shape of the surface of the eye by “shaving” the lens and correcting the nearsightedness. The laser treatment takes about one minute after which you will be given a prescription for eyedrops.
Regular eye examinations and screenings can detect and arrest serious eye conditions and help to preserve your sight as you age.