Eye Health Articles

The number of people 60 years and older is rapidly increasing compared to birth rates. With an increase in age comes an increase in the prevalence of visual impairments, which can have a negative impact on your quality-of-life. As the eyes are one of the main ways we experience the world, eyesight issues affect the quality of life not only of older adults, but also of their families and society. Therefore, as our population ages, it is important to be mindful of the following four visual conditions associated with age, to better take care of your vision. 1. Skin Elasticity Loss As we age, our skin loses its elasticity and structural support, leading to the drop of eyelids. In addition to eyelid laxity that is seen with age, we also have tear gland atrophy and decreased tear production. This leads to decreased moisture in the eye, which in turn ends in decreased vision due to irritation of the cornea, the transparent outermost membrane of the eye.  2. Corneal Irritation Corneal irritation can be a cause of decreased tear production as less moisture exists to protect the eye, leading to decreased sensitivity to contrast and functional vision. One way to prevent dry eyes is to supplement with Omega 3 and 6 fatty acids and Vitamin C and Vitamin A, as they decrease inflammation and are great antioxidants. Artificial tears can also provide momentary relief from the discomfort experienced with dry eyes.  3. Cataracts Cataracts are clouding of the lens in the eye and can cause visual impairment. Like our skin, our lenses also suffer from decreased elasticity as we age, and changes in the proteins that make up the lens cause us to have a stiffer lens. We also suffer from decreased contractility of the eye muscles, which prevents more accommodation of the eye lens, and thus causes a blurrier image.  As cataracts develop, you may experience blurry vision, double vision, colored halos around light, and even increased frequency of adjusting the prescription on corrective glasses. Age, smoking, and diabetes have been found to be the greatest risk factor in developing age-related cataracts. Finally, as we age, our cells have a much harder time fighting oxidative stress, and thus individuals who supplement with antioxidants and vitamins are shown to have decreased incidence of cataract formation.  4. Age-Related Macular Degeneration Lastly, age-related macular degeneration (AMD) can affect the retina, the area deep in the eye that lines the inside of the eye and holds all the light receptors. Near the center of the retina, the macula is responsible for central and high-resolution color vision. This disease affects nearly 9% of the world’s population, and when it is advanced, individuals will have a hard time looking straight ahead because the disease affects the central vision while sparing peripheral vision.  AMD can present only in one eye and may be without symptoms for many years until it progresses from minimal blurred central vision loss to complete distortion of images. Regular retinal eye exams are recommended. Laser surgery is the primary treatment for wet AMD, while continued monitoring is recommended for dry AMD.  Steps to Take As we age, our bodies’ cells continue to fight the damage from oxidative stress and from normal aging. Eating a healthy balanced meal is a great way of having a diet rich in nutrients and antioxidants. If time is limited, supplementing with a multivitamin and antioxidative supplements can help increase the antioxidants in your diet. Finally, getting a regular eye exam with an eye doctor is essential since an earlier intervention in age-related eye conditions has been shown to help maintain a higher quality of life.  Gabriel Espinoza, MD, has experience in caring for patients in critical care, primary care, and emergency settings. Some of the topics he has focused on in his medical career include public health, pediatrics, wellness, and fitness. He has co-authored a chapter on the utility of point-of-care ultrasound in the diagnoses of eye conditions. The content written by Dr. Espinoza is for information and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition.  References:  Eye care for older people. Community Eye Health. 2008;21(66):21-23.  de Paiva, CS. Effects of Aging in Dry Eye. Int Ophthalmol Clin. 2017;57(2):47-64. doi:10.1097/IIO.0000000000000170  Mathenge, W. Age-related macular degeneration. Community Eye Health. 2014;27(87):49-50.  Michael R, Bron AJ. The ageing lens and cataract: a model of normal and pathological ageing. Philos Trans R Soc Lond B Biol Sci. 2011;366(1568):1278-1292. doi:10.1098/rstb.2010.0300  Nizami, AA, Gulani, AC. Cataract. StatPearls. 2020. https://misuse.ncbi.nlm.nih.gov/error/abuse.shtml

You may think that your eyesight is fine — that the occasional squinting to make things clearer is just a part of getting older or just due to tired eyes. Yet, because we experience a lot of the world through our eyes, we must keep our eyes healthy. Keep your eyes in mind when planning out your yearly health checkups.  Early Diagnosis and Treatment Some eye diseases may have no symptoms at all when developing and can go unnoticed for years, even until irreversible eye damage has been done. So early diagnosis and treatment are extremely critical for common eye diseases associated with age. One of those diseases is cataracts—a clouding of the lens that can lead to vision loss. By eating a healthier diet of leafy greens, fruits, nuts, and fish rich in omega-3 fatty acids, and by limiting sun exposure, you can slow down the progression of the disease. An early diagnosis of cataracts can help you and your doctor plan the best treatment options.  Age-related macular degeneration can also be seen with increasing age. Although this disease has a slow progression, it can lead to a decrease in central vision, and ultimately blindness, if not diagnosed early by an eye doctor.  Comorbidities such as diabetes put patients at a greater risk of developing diabetic retinopathy, damage to the blood vessels that supply the retina in the back of the eye. Regular eye exams are especially important in these cases, since the duration of diabetes is the main factor for the development of diabetic retinopathy. Sugar control is paramount to prevent diabetic retinopathy, and a doctor can help manage this, especially early on.  Glaucoma is another eye condition that benefits from early diagnosis because if it is left unchecked, it can lead to vision loss in the affected eye. Risk factors for glaucoma include having a family history of the disease, being African-American, or being older than 60 years of age.  Eye Exam Frequency The American Optometric Association recommends the following eye examination frequency.  Children up to 2 years of age should have their eyes checked at 6 months and 12 months of age.  Children ages 3 to 5 should have their eyes checked at least once.  Children 6 to 17 should have their eyes checked before they start the first grade and then annually thereafter.  Adults 18 to 65 should have their eyes checked at least every two years. Adults 65 and older should have their eyes checked annually.  Other Steps to Take In addition to getting a regular eye exam, it is also important to know your family’s eye history, since family history may affect the likelihood of the development of eye diseases such as glaucoma, cataracts, and macular degeneration.  Protect your eyes from the sun, and wear sunglasses that block out UV-A and UV-B rays when spending time outside, as UV light has been shown to increase the risk of developing cataracts and conjunctival abnormal growths called pinguecula or a pterygium that may cause visual discomfort.  Finally, protect your eyes if you spend a lot of time focusing on any digital screen. If you work in front of a computer screen the whole day or stare at a cellphone or tablet for prolonged periods of time, take frequent breaks using the 20-20-20 rule, developed by the American Optometric Association and recommended internationally. It recommends taking breaks every 20 minutes, for 20 seconds, to stare at an object 20 feet away to allow your eyes to refocus.  So remember, speak with your loved ones about your eyes, eat a healthy balanced diet, minimize sun exposure, get yearly physical exams, and make sure to get your eyes checked regularly so you can continue experiencing the world to its fullest. Gabriel Espinoza, MD, has experience in caring for patients in critical care, primary care, and emergency settings. Some of the topics he has focused on in his medical career include public health, pediatrics, wellness, and fitness. He has co-authored a chapter on the utility of point-of-care ultrasound in the diagnoses of eye conditions. The content written by Dr. Espinoza is for information and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition.    References: Comprehensive eye exams. AOA.org. https://www.aoa.org/healthy-eyes/caring-for-your-eyes/eye-exams?sso=y. Accessed December 6, 2020.  Keep an Eye on Your Vision Health. Centers for Disease Control and Prevention. https://www.cdc.gov/visionhealth/resources/features/keep-eye-on-vision-health.html. Published October 1, 2020. Accessed December 6, 2020.   Kollias, AN, Ulbig MW. Diabetic retinopathy: Early diagnosis and effective treatment. Dtsch Arztebl Int. 2010;107(5):75-84. doi:10.3238/arztebl.2010.0075    

How Do Our Eyes Work? The eye is a sphere with fluid separated into three parts. The whites of the eyes are called the sclera. The middle outermost part is the cornea, a transparent membrane that allows light rays to pass into the eye. Through the cornea, you can see the iris, which is the colored portion part of the eye. The iris contains muscles that change the size of the pupil, the opening in the center where light passes through and hits the lens.   As light passes through the cornea, it passes through the anterior chamber, which is filled with a clear watery fluid that provides nutrients to the lens and surrounding structures. As the light continues its path from the lens to the back of the eye, the retina, it must travel through a thick gel-like substance called the vitreous humor, which makes up most of the eye’s volume and helps give it its spherical shape.  What Are Floaters? As we age, the vitreous thickens and can sometimes shrink. Sometimes clumps or strands build up in the vitreous since it contains cells that remove some blood and other debris that can interfere with light being transmitted to the retina causing shadows. These are termed floaters, and can look like bubbles, bugs, cobwebs, or dark spots that move with your eye movements.  When the vitreous shrinks and pulls away from the retina in the back of the eye, it is called a posterior vitreous detachment. Floaters are usually the first symptom that you will observe with this condition. Posterior vitreous detachments can occur as we age since the vitreous tends to shrink. Other risk factors include being nearsighted (you need glasses to see far away), having a history of trauma to the eye, having had previous eye surgery (like cataract surgery or LASIK surgery), or having an inflammatory condition in the eye. In some cases, a posterior vitreous detachment can lead to a retinal detachment as well. If left untreated, this can ultimately lead to blindness. Other eye conditions that can cause floaters include posterior uveitis, which is inflammation of the uvea, or the middle part of the eye that contains the iris and retinal tears or detachments. Floaters in your visual field may also be related to other conditions that may not be caused by problems with your eyes alone, like migraine headaches with auras.  Steps to Take If your doctor diagnoses you with a posterior vitreous detachment, you will need to see an eye specialist for a complete dilated eye exam and to carefully examine every aspect of your eye with a special lamp called a slit lamp to rule out a retinal tear or detachment.   With any changes in your vision, it is important to always contact your doctor and get regular eye exams by an optometrist or an ophthalmologist. If you are concerned about any changes in your vision and have posterior vitreous detachment, you will be counseled on the severity of your disease and the best treatment option.  Gabriel Espinoza, MD, has experience in caring for patients in critical care, primary care, and emergency settings. Some of the topics he has focused on in his medical career include public health, pediatrics, wellness, and fitness. He has co-authored a chapter on the utility of point-of-care ultrasound in the diagnoses of eye conditions. The content written by Dr. Espinoza is for information and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition.  References: Ahmed F. Posterior Vitreous Detachment. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK563273/. Published September 27, 2020. Accessed December 6, 2020.   Johnson D, Hollands H. Acute-onset floaters, and flashes. CMAJ. 2012;184(4):431. doi:10.1503/cmaj.110686  Purves D. Anatomy of the Eye. Neuroscience. 2nd edition. https://www.ncbi.nlm.nih.gov/books/NBK11120/. Published January 1, 1970. Accessed December 6, 2020.

When it comes to eye diseases, one that you might hear about often is glaucoma, which is referred to as the silent thief of sight. But what is it, exactly, and what are the causes and symptoms of this condition? We’ve got you covered with info below that can help clear up some of the frequently asked questions about glaucoma.  What Is Glaucoma? It might sound like a single disease, but glaucoma is actually a group of conditions that cause damage to the optic nerve of the eye. When glaucoma develops, it can happen in one or both of the eyes. And vision loss may occur if it isn’t caught and treated in time. In fact, the scary thing about glaucoma is that it’s a leading cause of blindness in individuals who are over 60 years of age, even though it can affect people of all ages.  What Are Some of the Causes and Symptoms of Glaucoma? Often, high pressure inside the eye is what damages the optic nerve. But the tricky thing about glaucoma is that it can occur when eye pressure is normal too!  Wait, what’s this about pressure inside your eyes? Basically, there’s fluid in the front part of the eye. Because it’s produced all the time, it needs to drain properly through what’s known as the drainage angle in order to maintain the right amount of pressure in the eye. If a problem develops and the fluid doesn’t drain like it should, eye pressure goes up, and the risk of glaucoma goes up too. Also, the pressure could go up slowly or quickly.  In terms of what can cause glaucoma, the list includes: Having a thin cornea Being extremely farsighted or nearsighted Trauma or injury to the eye Family history of the condition Certain medical problems, such as high blood pressure  Certain medications  There are several types of glaucoma. Here are three of the main types, along with some of their symptoms: Open-angle glaucoma – This develops when the eye fails to drain the fluid in it properly. As a result, pressure starts to increase, and the optic nerve is damaged. This is a type of glaucoma that likely won’t cause any problems with your vision at the beginning, so you may not know there’s a problem unless you see a doctor and get a diagnosis during a routine exam. Once it gets worse, though, you may start to notice changes in your vision, such as blind spots in your peripheral vision.  Angle-closure glaucoma - This is also known as narrow-angle or closed-angle glaucoma. Put simply, the iris of the eye blocks the drainage angle, and that causes an increase in pressure. This type of glaucoma may develop slowly, so you might not notice any signs until it’s advanced. Or, it can cause the pressure to become elevated quickly, causing an acute attack that leads to symptoms like severe eye pain, headache, nausea, vomiting, blurry vision, halos or rainbows surrounding lights, and redness in the eye. An acute attack is an emergency that, if not treated right away, might cause blindness.    Normal-tension glaucoma - This is also known as normal-pressure or low-tension glaucoma. The pressure in the eye will be within the normal range, yet optic nerve damage will occur. This type of glaucoma might be caused by a problem with optic nerve itself, or by blood flow issues that lead to a reduction in blood flow to the optic nerve. Symptoms might include changes in your vision.    You Might Not Know You Have It! The really unnerving thing about glaucoma: you might not even know that you have it because the changes in your vision may occur slowly over time.  By the time you realize that something is off with your vision, it might be too late, and any vision that you lost might be gone for good. So the goal is to catch it as early on as possible, receive treatment, and hopefully prevent, or at least slow, future vision loss.     Worried About Glaucoma? Your Eye Doctor Can Help! How can you be sure you can tackle glaucoma before it has reached an advanced stage? It’s simple: see an eye doctor on a regular basis, such as once a year! He or she will be able to check your vision and keep track of changes as you get older. In addition to that, an eye care professional can use tools to measure eye pressure and look for other signs to see if glaucoma is present. And, if it is, your doctor can recommend treatment options.  Still have questions about glaucoma and whether or not you are at risk? Find an eye doctor you can trust, and enroll in a high-quality insurance like Spirit so you can save money when it comes to keeping your vision sharp! Sources: https://www.allaboutvision.com/conditions/glaucoma/ https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839 https://www.aao.org/eye-health/diseases/what-is-glaucoma https://www.glaucoma.org/glaucoma/questions-answers-normal-tension-glaucoma.php https://www.webmd.com/eye-health/normal-tension-glaucoma#1 https://www.aao.org/eye-health/diseases/glaucoma-symptoms  

Systemic lupus is an autoimmune disease that leads to pain and inflammation in the body. Any area of the body can be affected by this chronic ailment. Although the joints, skin, and various organs, such as the heart, lungs, or kidneys, are commonly impacted, many people don’t realize that lupus is also capable of damaging the eyes.  Below, we take a look at some of the ways that lupus can cause problems that affect your eyes and vision.  The Various Ways That Lupus Can Impact the Health of Your Eyes There are several ways that lupus can harm the eyes, and you can discuss the risks with your doctor, but we’ve put this list together to give you an idea of the different parts of the eyes that can be affected: Some lupus patients might develop Sjogren’s syndrome, which causes insufficient tear production and dry eye. Also, the inflammation associated with lupus might damage the glands that produce tears. When this happens, the eyes aren’t properly lubricated. If your eyes feel scratchy or irritated, if it feels like something is in your eyes, if they burn, or if your vision becomes blurry, let your doctor know. You might be able to receive treatments, such as eye drops, that may help prevent this condition from getting worse.    Lupus is one of the causes of inflammation in the eyes, so there might be a risk of developing conditions like episcleritis, scleritis, or uveitis. Scleritis and episcleritis might lead to symptoms like tearing, pain, tenderness, sensitivity to light, and blurred vision. Also, the white part of the eye might become swollen or red. It’s important to talk to your doctor if you develop symptoms, as you don’t want to risk vision loss. Symptoms of uveitis might include floaters, blurred or decreased vision, light sensitivity, redness, or pain, so it’s best to tell your doctor right away if you experience these problems as well.    Optic neuritis, which may lead to vision loss, is a condition that develops when there’s inflammation that ends up damaging the eye’s optic nerve. It is yet another eye problem that might occur in some lupus patients.      Some patients with lupus might develop retinal vasculitis, which is inflammation of the retina’s blood vessels. Because this problem might result in mild to severe changes in vision, talking to your doctor as soon as possible is imperative.    If you’ve been diagnosed with lupus, it’s recommended that you see an eye doctor for check-ups and to discuss any symptoms you’re experiencing. Also, if you develop symptoms that are affecting your eyes or vision, let your eye doctor know ASAP so you can receive prompt treatment.  Even the Medication You Take Might Lead to Eye Problems! As if the disease itself wasn’t bad enough, it turns out that some of the medications that are prescribed to treat lupus might also impact your eye health!  One example is hydroxychloroquine, which is also known as Plaquenil. This prescription might result in retinal toxicity. In other words, it might end up damaging the retina of the eye, especially if you need to take a high dose or you need to take it for a long stretch of time.  Having your eyes examined on a consistent basis, such as once a year, while taking medication to treat lupus is wise. If there are any changes, your doctor will notice them sooner rather than later. And the sooner your doctor realizes that there’s a problem, the quicker he or she can act to keep your eyes as healthy as possible.  It’s So Important to Work with Your Eye Doctor Whether or not you’ve been diagnosed with a condition like lupus that can adversely affect your eye health, it’s important to find a doctor you can trust. By doing so, you’ll be able to have your eyes and your vision examined regularly. Plus, you’ll be able to receive treatments right away if you need them.  If you’re worried about being able to afford trips to the eye doctor, or you’re concerned about being able to pay for expensive glasses and contacts that you need to see clearly, don’t fret! With the right vision insurance, such as the plan offered by Spirit, you can get the financial support you need so you won’t have to miss any appointments. Sources: https://www.lupus.org/resources/what-is-lupus https://www.lupus.org/resources/how-lupus-affects-the-eyes# https://www.aao.org/eye-health/ask-ophthalmologist-q/can-lupus-affect-my-vision https://www.webmd.com/eye-health/dry-eyes-immune-system-disorders https://www.aao.org/eye-health/diseases/what-is-scleritis https://www.eyecaretrust.org.uk/view.php?item_id=79 https://www.webmd.com/eye-health/retinitis-types-symptoms-treatment#1 https://www.mayoclinic.org/diseases-conditions/uveitis/symptoms-causes/syc-20378734 https://www.aao.org/eyenet/article/hydroxychloroquine-induced-retinal-toxicity https://www.mayoclinic.org/diseases-conditions/optic-neuritis/symptoms-causes/syc-20354953 https://www.verywellhealth.com/lupus-and-the-eyes-3422110 https://www.medicinenet.com/retinal_vasculitis/definition.htm  

The macula is the central part of your eye’s retina, and it allows you to have clear, sharp vision. Macular degeneration, which is also referred to as age-related macular degeneration, or AMD, is a condition that causes you to lose your central vision. With AMD, even though you’ll still have peripheral vision, your ability to see what is in front of you will be impacted. And this can make everyday tasks like recognizing faces, reading, and driving, pretty much impossible.  Should you take the risk of developing macular degeneration seriously? Absolutely! This condition is a top cause of vision loss, and it affects many older people. Seeing your eye doctor regularly, such as every year, is an important step in diagnosing this condition as early on as possible. But, in addition to that, getting to know the warning signs is also wise. That way, you can more readily recognize changes in your vision and get help right away. The First Thing You Should Know: There Are Two Types of Macular Degeneration Before we dive into the symptoms that are associated with AMD, let’s take a quick look at the two types of macular generation: Dry macular degeneration is the more common type, and it might progress into wet macular degeneration. People with dry AMD might notice that their vision gets progressively worse, but this occurs gradually. Wet macular degeneration is more of a threat to your sight, so people who have this form of AMD might experience more severe vision loss than those who have the dry form, and the loss might occur suddenly as well.   Now, Let’s Cover the Symptoms and Warning Signs of AMD Here’s the scary thing about macular degeneration: in its early stages, you might not even know that you have it if you don’t notice any symptoms. This is just one of the many reasons why it’s best to make appointments with an eye doctor on a regular basis to have your eyes, including your retina, examined by a professional who can spot the signs of AMD.  When symptoms do occur, you will likely begin to notice that your vision isn’t as clear as it should be, and this might happen gradually or suddenly. Also, symptoms of AMD might include the following: Straight lines appear wavy, bent, or distorted When reading, the words appear wavy  Changes in color perception, such as colors appearing paler  Areas in the center part of the visual field appear shadowy, dark, empty, or gray Blurry spots or blind spots in the center of your vision Vision that becomes fuzzy, hazy, or blurry When in low light, experiencing more difficulty seeing details  Objects might appear smaller than they are Note: Macular degeneration might occur in one eye or both eyes. And, when it occurs in both eyes, it might not affect both of them in the same way. Also, it’s important to be aware of the fact that you might not notice any symptoms if the condition develops only in one of your eyes. You can test your vision by closing one eye at a time to ensure you aren’t missing any signs while both eyes are open.  Take Care of Your Eyes by Seeing Your Eye Doctor Regularly! It can’t be stressed enough: seeing an eye doctor regularly is an integral component of keeping your eyes as healthy as possible as you get older. Whether or not you notice any warning signs of macular degeneration, an ophthalmologist can take a look at the interior structures of your eyes to see if there is any evidence that this condition is developing. And, in the event that you do have AMD, your doctor will be able to discuss treatment options.  Also, let’s not forget that seeing an eye care professional will help you see clearly because you can get prescription glasses and contacts that will sharpen your vision. This could help make it easier to notice changes in your eyesight, even if they are minor at first—such an important step when it comes to watching out for signs of AMD!  Final tip: At Spirit, you can easily enroll in vision insurance that will help make it more affordable to see your eye doctor for checkups and prescriptions. With this type of coverage, you won’t have to skip an appointment because you’re worried about how you’ll pay for it. And you can rest assured that you’ll be able to take smart steps to keep your peepers as healthy as possible. Sources: https://www.allaboutvision.com/conditions/amd.htm https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-symptoms https://www.macular.org/symptoms-macular-degeneration https://www.mayoclinic.org/diseases-conditions/wet-macular-degeneration/symptoms-causes/syc-20351107 https://www.mayoclinic.org/diseases-conditions/dry-macular-degeneration/symptoms-causes/syc-20350375 https://www.uofmhealth.org/health-library/hw176039