Eye diseases in elders: Causes, symptoms and treatment

Health professionals say changes in elders’ vision are normal. However, they may eventually need reading glasses, or it may become increasingly difficult to see well in low light or in the dark. And though such changes are common, but vision loss is not a normal part of ageing.

At the age of 65, about one in three people would have some form of vision reducing eye disease. The most common causes of vision loss in elders include age-related macular degeneration, glaucoma, cataracts, and diabetic retinopathy.

Other health problems, such as diabetes, hypertension, and hyperlipidemia can also contribute to eye problems. Adults with vision problems are at risk of making mistakes, which can contribute to falls and hospitalisations.

Some lifestyle changes that can improve eye health include: stopping smoking, monitoring blood pressure, getting regular exercise, limiting exposure to ultraviolet light, and wearing UV-protective sunglasses in bright sunlight.

Dr. Jane Okparaugo, an optometrist at the Porters House Eye Clinic said: “So many things can cause problems in the eyes, especially when it concerns an aged person. These range from normal ocular pain, which can be a symptom of something going on at the back of the eye. It can also be due to a pathological or refractive condition, depending on what is actually causing it. Normal ocular pain occurs, when the eye is subjected to strain, which occurs, when there are such activities as not being able to sleep well, not being able to rest the eye properly, and so on.

“These can actually cause pain in aged people. And when that occurs, sometimes, medication is not really needed. The person just needs to rest for a while and the eyes would return to normal. But if it exceeds the normal natural pain, it could be due to some pathology going on at the back of the eye. If the eye pressure is high, it can also cause pain, but this can be brought down with oral and topical medication.

“Again, trauma in the eyes can cause pain, but with some treatment, the condition will get better. If there is glaucoma at the back of the eye, it can also triggers pain, in the sense that, when the pressure builds up at the back of the eye, and gets high to a particular point, it will start damaging the nerves that help us to see. That is where the patient starts losing peripheral vision and gradually, glaucoma steps in.

“Just as we have normal blood pressure, so also there is eye pressure. So, if as a glaucoma patient, your eye pressure is very high for a long time, it can trigger severe pain. This is a kind of a pulling sensation in the eye. In such a case, there is need for the eye(s) to be treated with eye pressure drugs that will help to reduce the pressure. Once the pressure comes down, the eye gets back to normal and the pain also tends to reduce.
“But a glaucoma patient should try as much as possible not to let the eye pressure get high. This can be established by going for a test. We do ophthalmoscopy test, check the pressure in eye, and then we do some visual field test, which we call Central Visual Field (CVF) test. If a person is established as a glaucoma patient, what we usually do is to run some tests, after which the patient is now placed on eye drop that works for him/her.
“After establishing the particular drops that work for the patient, he/she would keep using it constantly, so that the pressure in the eye will be maintained. Once it is maintained, the vision that is deteriorating stops and would just remain static. One thing about glaucoma is that once the vision is lost, it can never be recovered. This is what makes it different from other eye diseases.”
She explained that cataract occurs, when the lens in the eye becomes opaque, making it impossible for light transmission from the lens back to the inside of the back of the eye. So, what happens is that the eye won’t be able to see momentarily, because light can’t pass through.
“If that happens, some people would feel pain in eyes once in a while, especially if the cataract is fully matured. The pains come and go often. The only remedy for this is to go for cataract surgery to remove the faulty lens. After this removal, another lens is implanted, which is called intermolecular lens, and with that, the eyes are okay and the patient would start seeing again, while those pains would also be reduced. If a person has cataract and starts noticing the pain, he/she should just go for any steroidal anti-inflammatory drugs and will feel fine again. So, it all depends on what is wrong with a patient that determines the type of treatment to be given,” she said.

“It is advisable to take very good care of the eyes. How do you do that? At least once in a year, just walk into an eye clinic and undertake a routine check, to know the state of the eye. The eye doctor would do some x-ray test and if there is a risk factor, anything that is suspected, the patient is informed on how to go about it.

“Another important thing is that people should avoid self medication. A lot of people do this. Because they have some problem with their eyes, they would visit an eye clinic, where they are probably give an eye drop. If later, the same thing happens, they just go to purchase that same eye drop. But this is drug abuse drug, as firstly, it might be another problem that is showing the same symptom and then you don’t know the side effect of the drugs. That you have this symptom today and it is treated with a particular drug doesn’t mean tomorrow you will treat it with that particular drug.

“So it is recommended that people always visit their eye clinic, and then eat healthy food. Such foods should be rich in calcium, potassium and Vitamin E, among others. They should also take good dietary supplement, eat carrot, fruits and vegetables. Elderly persons should avoid too much sugary things. With all these, the state of the eyes will be very fine.

“For people that are hypertensive or diabetic, it is very important that they visit their eye clinic as often as possible, because such health conditions have a way of affecting the eyes. It is very pathetic to see an individual having issues with their health, especially when this has to do with the eye. And because they don’t have money, they go blind or probably die, and then during their funeral, so much money is spent, which means they had someone after all. But this is some kind of negligence.

“As an elderly person with such an eye issue, which has been brought to your knowledge, have you spoken to your children about it, or people that take care of you? It is not good to abandon oneself to such a terrible fate, when there are people that can help.

“My advice to people is that, in as much as some claim there is nobody out there to help them, they should just open up first. A closed mouth, they say, is a closed destiny. But by telling people your problem, you can never know where help would come from; rather than keeping silent while your sight is gradually fading.

“Again, there is a condition we call presbyopia, which is also age-related. Some elderly ones would tell you, ‘I cannot read tiny prints again. I cannot read the Bible or Qur’an again, or I cannot read newspaper again. Using reading glasses is the solution to this, as it enables the person to see small letters better. Sometimes, people buy all these ready-made glasses, but they are doing more harm than good to themselves. After wearing these glasses, some would tell you they are seeing very well, but it is only after they go to an eye clinic, are tested and given the right glasses, that they would realise they were actually short-changing themselves.

“So, for elderly persons having issues with reading, it is recommended that they visit an eye doctor and know the actual state of their eyes before taking any action or buying reading glasses elsewhere.”