Illustration by Alicia Tatone
En español | It should have been a run-of-the-mill appointment. “My vision was getting blurrier, and it was becoming more difficult to focus,” says Patrick Thompson, 55, an engineer from Huntsville, Alabama. “It was quite aggravating.”
After giving Thompson a comprehensive dilated eye exam, his optometrist, Barbara Horn, adjusted his glasses prescription. She also found something else: “He had pigment-dispersion syndrome, in which the pigment from the iris flakes off and floats around in the eye.” PDS is a precursor for glaucoma, a leading causes of blindness in people 60 and older. “Thank goodness for his blurry vision, or we would never have known,” she adds.
Most of us assume it’s natural for our eyesight to go as we age — and that notion can be dangerous. “No one’s eyes just get ‘bad with age,’ and you don’t just lose vision without a reason for it,” says Douglas Wisner, M.D., an ophthalmologist at Wills Eye Hospital in Philadelphia. Meaning: Don’t accept blurriness, spots, flashes or floater s— get yourself checked out. “I urge anyone over 50 to get an annual checkup,” notes Charlotte Yeh, M.D., chief medical officer of AARP Services. “An annual dilated eye exam can help diagnose conditions like glaucoma and age-related macular degeneration before they are severe.” Here are nine reasons to make eye checkups a priority.
1. There’s more to your eye than meets the eye
With dilation, drops added to the eye widen the pupil, allowing your doctor to view the inside of the eye — including the retina, lens and optic nerve — and look for age-related macular degeneration, glaucoma and melanomas. “Examining an undilated eye is like looking through a keyhole into a room. Dilation opens the door completely, so you can see all the corners of the room,” says optometrist Laura Di Meglio, an instructor at the Wilmer Eye Institute at Johns Hopkins Medicine in Baltimore.
2. Eyes are a window into your health
“The eye is the only place in the body where you can directly visualize nerves and blood vessels,” Wisner explains. Eye doctors scan your eye for signs of hypertension, high cholesterol and diabetes — and can sometimes be the first to detect a problem. “Heart disease still remains one of the biggest causes of morbidity and mortality in our country, and if we pick up on it early enough, we can get on top of it and prevent damage,” he says.
3. Try a new alternative to dilation
Dilation is included in the price of your eye exam. For an extra fee, though, some private practices offer testing on Optos retinal-imaging devices. “These machines capture a wide view of the retina, even with undilated eyes,” Di Meglio says.
4. You can stop switching glasses to read the paper
Around age 40, people naturally begin to develop presbyopia, a condition in which the lens of the eye loses its ability to change shape and accommodate for different distances. “You can’t read things up close anymore, so you hold materials at an arm’s distance. But by age 55, most can’t struggle through it — their arm just isn’t long enough anymore,” Di Meglio notes. Drugstore readers might suffice, but talk to your doctor about prescription readers or progressive lenses, which can improve depth perception. (Progressives take some getting used to, so inform your doctor if you’re at risk for falls.)
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5. The latest contacts could change the way you see
New materials can improve comfort and let contact lenses solve more than one vision issue at a time. For example, Acuvue Oasys with Transitions, the first light-adaptive contact lens, also has UV-blocking qualities. Bausch + Lomb Ultra Multifocal corrects both astigmatism and presbyopia. Alcon Dailies Total 1, a one-day comfort lens, uses technology to provide a moisture cushion.
6. You may be able to ditch wearing glasses forever
Cataracts — a clouding of the lens of the eye — can develop so slowly that you may not notice the difference initially. For some, cataracts begin to grow in their 50s; by age 80, more than half of Americans have had one. But cataract surgery can liberate some people from glasses altogether, Wisner says. The procedure is quick (one hour), downtime is short (no more than a few days), and new techniques mean that some people won’t need post-op eye drops.
7. You don’t need to drive with glare
If night driving is becoming increasingly challenging, ask about antireflective lenses for your glasses, Horn suggests. “If your eyes are healthy with no or minimal cataracts, antireflective lenses are the most common solution,” she says.
8. Those floaters could signal something bigger
With aging, the gel-like substance in the eyes, called the vitreous, begins to shrink; it may even separate from the retina, explains Elena Roth, M.D., an ophthalmologist with the University of Miami Health System. One symptom of this might be seeing floaters and flashes in your vision. Most of the time you won’t need to be treated for floaters, but you will need to be closely followed by your doctor to watch for a retinal tear, a complication that can lead to vision loss. The good news is that those floaters usually stop bothering you eventually. “After three to six months, the brain learns to adjust and accommodate them,” Roth says.
9. If you have diabetes, see your eye doc — it’s critical
Nearly 60 percent of people with diabetes skip their yearly eye exam, according to research from the Wills Eye Hospital. “Diabetes is a disease of blood vessels. In the eye, it causes bleeding and leakage of fluid in the retina, which can cause loss of vision,” Wisner says. If detected early, some of this loss can be reversed, but the more profound the damage, the harder it is to correct. That’s why an annual dilated exam is crucial. What’s going on in your eyes is a direct reflection of what’s happening in your kidneys, he adds; if an exam shows diabetes is not well controlled, you have an opportunity to take steps to preserve your eyesight — and the rest of your body.
Great Stuff We Can See Coming
These advances in eye care are here or may be just around the bend
Eye drops as good as glasses. Israeli company Orasis Pharmaceuticals currently has an eye drop, CSF-1, in phase 2 clinical trials that channels light to improve or correct near vision, for those with presbyopia.
Headsets that boost low vision. IrisVision, a Wi-Fi-capable headset, is available now for people who have low vision. It costs nearly $3,000 but can be paid for over time.
Contacts that treat allergies. In clinical trials, an antihistamine-releasing contact lens was found to control itchy, watery eyes due to allergies, as well as simultaneously correct vision.