Senior Eye Health

As we age, our eyes change just like the rest of our body. Many people mistakenly believe that vision problems in older adults are unavoidable and cannot be treated, which leads to a lack of proper eye care. However, advancements in eye care have introduced ways to prevent and treat many common eye diseases.
 

• Cataract
  A cataract is when the lens of the eye becomes cloudy, blocking light and affecting vision. People with cataracts often feel like they are looking through dirty glasses. The most common cause is age-related lens degeneration, but there are other factors as well. Common symptoms include: 

  • Blurry vision, especially at night
  • Sensitivity to light, seeing shadows or halos
  • Frequent changes in glasses prescriptions with no improvement in vision
  • Colours appearing less vivid, looking greyer and duller 

  Cataracts can be treated with surgery to remove the cloudy lens and replace it with a permanent artificial lens. A common question is, "When do I need cataract surgery?" The answer is that you should consider surgery when your vision starts to affect your daily life. You don't have to wait for the cataract to become severe. Modern cataract surgery has a very high success rate and can also improve other vision problems like nearsightedness, farsightedness, astigmatism, and presbyopia. Your ophthalmologist can provide more details during your eye examination. 

   

• Glaucoma
  In Hong Kong, glaucoma is a common cause of blindness, with elderly people at a higher risk. Glaucoma is classified into acute, chronic, congenital, and secondary types. Chronic glaucoma is the most common type among all glaucoma cases. In the early stages, it often goes unnoticed by patients because there is no pain or any effect on vision at this stage. However, the increase in eye pressure gradually damages the optic nerve and reduces the visual field, ultimately leading to blindness. 
  
  Therefore, it is strongly recommended that seniors, especially those with a family history of glaucoma, undergo regular eye check-ups. There are several methods to treat glaucoma, including medication, laser treatment, and surgery. Although glaucoma can potentially cause blindness, it can be controlled if discovered and treated appropriately in its early stages. 

   

• Age-Related Macular Degeneration
  The macula is a special area in the central retina, made up of many small and delicate nerve cells. A healthy macula is essential for seeing details, reading, and perceiving colours. When the macula is affected by disease, central vision is reduced, and images may become distorted. 
  
  Macular degeneration is mostly age-related. In Asia, there has been an increasing incidence of macular degeneration in recent years. High nearsightedness is also a major cause of macular degeneration. Much research has been devoted to discovering safe and effective treatments for these diseases. Some cases are best treated with laser therapy or intraocular injections of special medication, while others may require special magnifying devices.

   

• Diabetic Retinal Diseases
  Diabetic retinal diseases result from small blood vessel abnormalities caused by diabetes, leading to a series of complications in the eye, including macular bleeding, swelling, lipid leakage, abnormal new blood vessel growth, vitreous bleeding, retinal detachment, and glaucoma. These retinal diseases can cause blindness if not treated promptly. In the early stages, you may not notice any visual changes, diabetic retinopathy can only be discovered through an eye examination. Therefore, patients with diabetes should have regular eye examinations by an ophthalmologist. Diabetic retinal diseases can be treated with laser therapy or special medications to prevent serious complications, such as retinal bleeding, macular oedema, and neovascular glaucoma, which can lead to blindness.

   

• Floaters
  Floaters are a very common symptom among the elderly, mostly caused by degeneration of the vitreous gel inside the eyes. They usually come and go without affecting vision. As long as retinal problems are ruled out during eye check-ups, no treatment is required. However, serious retinal or vitreous diseases, such as vitreous hemorrhage, retinal tears, or detachment, can also cause an acute onset of floaters. Therefore, it is important to consult an ophthalmologist as soon as possible for a detailed examination if you start seeing floaters. 

   

• Dry Eye Disease
  Dry eye disease is common in seniors and is marked by inadequate lubrication on the eye's surface, causing discomfort and vision issues. As tear production decreases with age, older adults may experience irritation, redness, and a gritty sensation. Factors like medications and environmental conditions can worsen symptoms. Management often includes lifestyle changes, artificial tears, and sometimes prescription treatments to boost tear production. Regular eye examinations are essential for early detection and effective care. 

   

• Presbyopia (Difficulty in Reading or Seeing Near Objects)
  The normal human eye can adjust its focus due to the elasticity of the lens and the function of the ciliary muscle, which decline with age. Presbyopia usually appears after the age of 40. If you are nearsighted, you may notice that it is easier to read without glasses. However, those with farsightedness may find reading increasingly difficult. Presbyopia can be corrected with glasses or presbyopic contact lenses. Another option is to have your presbyopia improved through cataract surgery. 

   

• Eyelid and Facial Aging
  Changes in facial bones and soft tissues occur with ageing, leading to wrinkles and sagging. While these changes may be cosmetic at first, some, particularly around the eyes, can affect vision and/or cause discomfort. For example, excess upper eyelid skin and drooping eyelids can block vision, and if the blockage is significant, oculofacial plastic surgery to remove excess eyelid skin and/or eyelid lifting surgery may be considered. Eyelid malposition can also be surgically repaired. Please consult an ophthalmologist for further assessment and treatment.