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Protect and preserve eyes

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If you’ve noticed that it’s getting harder to focus on things up close as you’ve gotten older, you’re not alone.  

With aging comes inevitable changes in vision, a local eye specialist says, but there are steps you can take to protect your eye health and possibly slow deterioration.

The most common vision problem in older adults is “presbyopia” which affects the eye’s ability to focus on near objects, says Dr. Mark Sczepanski, an ophthalmologist at the North Dakota Eye Clinic in Grand Forks. This is because “the lens gets larger and less pliable.”

Next comes the loss of “intermediate vision,” such as the ability to see computer images clearly, he says.  

The second most common problem is “dry eye,” otherwise known as “tear film insufficiency, which affects people especially in this area and especially during the winter,” Sczepanski says.

“We hear over and over from our older patients that at first when they’re reading, everything’s OK. But the longer they read, words get blurry and they have to stop.”

Computers worsen the problem.

“If we’re just sitting and chatting, we blink about 16 times a minute,” he says, “but at a computer, we’re staring at the screen and blink about four times a minute.”  

Another common complaint is seeing “floaters and flashes” in one’s vision, caused by a vitreous membrane detaching from the retina in the back of the eye.   

“It’s more of a nuisance than anything,” Sczepanski says. People with diabetes who experience this should maximize their blood sugar, blood pressure and cholesterol control.      

Those with diabetes are at risk for serious eye diseases, including retinopathy, which can lead to poor vision and even blindness.   

“The longer the time you’ve had diabetes and the older you are, the higher the chance that you’re going to have diabetic retinopathy,” he says.

‘Big three’

Other vision troubles that require medical intervention by an ophthalmologist are cataracts, glaucoma and macular degeneration — conditions Sczepanski calls “the big three.”      

Cataracts cloud the lens in the eye, causing blurry or dim vision, he says.

“Cataracts are like gray hair and wrinkles; they’re inevitable. Chances are you will get them the longer you live.”

Treatment involves replacing the lens with an artificial lens.     

Unlike cataracts, glaucoma is far less common, he says. “About 2 percent of people over 55 years old will develop true glaucoma.”

With glaucoma, pressure on the optic nerve in the eye causes loss of peripheral vision or even blindness.

“It happens so slowly that you don’t realize it,” he says. “Most people are treated with eye drops.” Age-related macular degeneration is often detected in an eye exam, before symptoms are noticeable, according to the American Macular Degeneration Foundation.   

“Prevention is key,” Sczepanski says of this disease.

“Wear sunglasses, don’t smoke, control your blood pressure and take a vitamin supplement (as recommended by your doctor) that slows progression by 25 percent.”

Sunglasses protect the eyes from damaging effects of UVA and UVB rays, he says. “Wear them 100 percent of the time.”

Regular exams  

The American College of Ophthalmology recommends getting an eye exam at age 40, Sczepanski says. “If the exam shows your vision is good, then, after that, get an exam every two to four years.

“Starting in your mid-fifties, you should get an exam every one to three years. When you hit 65, get an exam every year or two.”

Such increased surveillance is needed because the older you get, the higher your risk is for problems to develop, he says.

Diet plays a role in eye health, too. Green leafy vegetables and foods that contain vitamins C and E are good choices, he recommends.  

The old adage that carrots are good for eyesight “is true to some degree, especially for macular degeneration,” Sczepanski says.

“We know that (Americans) don’t get enough omega 3 fatty acids. There’s not enough fish in our diets.   

“A daily multivitamin, like Centrum Silver, is probably all most people need,” he says.  

Symptoms that should send you to an eye doctor include blurred vision, seeing halos around lights, and intermittent eye pain.   

African-Americans are at four times greater risk for developing glaucoma than the general population, he says. Hispanics have a one to two percent higher risk.

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