Eye Exams - Eye Conditions

Cataracts and macular degeneration are two common eye conditions that cause vision 
deterioration in older people.
 As we get older many aspects of our vision change. Because of this, it is important to 
make regular visits to your optometrist. This is so your vision can be monitored.
 Cataracts and macular degeneration are two conditions that can affect an aging eye by
 substantially reducing vision. However, both affect your vision very differently. 
This page provides information about cataracts, macular degeneration, their
 possible effects and options available for corrective surgery.

Cataracts: what are they?

Cataracts occur when the lens inside your eye becomes increasingly opaque resulting
in ‘misty’ or ‘foggy’ vision.

What are some effects of cataracts?

Someone with early stages of cataracts may notice a ‘film’ in their everyday vision.
 Often, things that used to look black and white now look grey and colours are perceived as dull. In the early stages of cataracts, new spectacles may improve vision 
but, as the cataract worsens, spectacles often will not provide any significant
 improvement. Your optometrist will be able to advise you further on this.
 You may not be aware of cataracts in your vision. This is because changes can be 
gradual. As cataracts become more advanced, vision becomes ‘foggy’, less detail is
 seen, reading can be slower, television isn’t perfectly clear and driving becomes 
difficult when driving in to the sun. At this stage, new spectacles will not restore 
‘normal’ vision.

Can cataract be helped?

Usually the answer is yes. Corrective surgery removes the cataract (the cloudy lens),
 and an artificial lens (intra-ocular lens) is put in its place.

Can everyone have surgery?

Most people with cataracts will benefit from surgery. Your overall health and any 
other eye conditions you may have will be considered before a decision is made to 
operate. Your optometrist will refer you to an ophthalmologist (eye doctor) to 
confirm that you will benefit from having your cataracts removed.

Macular Degeneration: what is it?

Macular degeneration is also known as age-related maculopathy. As our eyes age, the 
retina (lining the inside of the back of the eyeball) starts to deteriorate, making clear
vision more difficult. This is particularly true of the most sensitive part of the retina, 
the centrally located macula. When this region starts to atrophy, sharpness of vision
 is lost and this can lead to difficulty with reading, and often, the need to give up 

Does macular degeneration cause blindness?

Macular degeneration may cause vision problems, but it rarely ends in total blindness.
 The condition tends to progress slowly with only some aspects of vision being
 affected. Peripheral vision is not affected, but a loss in detail when looking directly at 
an object can be an early sign of macular degeneration. Other early symptoms of 
macular degeneration usually involve an awareness of blurring in the central vision;
 sometimes vision may become distorted. For instance there might appear to be a
 ‘kink’ in an otherwise straight doorframe. This could require urgent assessment.

Who gets macular degeneration?

Many people who are aged seventy and over have some macular degeneration. If 
there is a family history of macular degeneration there may be an increased risk. In
 addition, people with certain medical conditions (e.g. diabetes) may be more likely to 
develop macular degeneration. It is therefore important to make sure you have regular
health check-ups. 
Smoking is a known risk factor for macular degeneration.

What treatment is available?

For many cases of macular degeneration no treatment is currently possible. Your
 optometrist may help with special spectacles or other visual aids to help with reading. 
Laser treatment may be an option for some people with macular degeneration and new 
therapies including micro-surgery and photodynamic therapy are looking promising 
for the future. Your optometrist will be able to advise you on this and provide a 
referral. A healthy diet that includes dark green leafy vegetables is thought to help
 maintain macular health.

Some suggestions:

  • regular eye examinations will help you make the most of your vision

  • continue to enjoy reading and the like – avoiding close work will not ‘save’ your eyes
  • have good lighting when doing close work, preferably with a reflector lamp to 
illuminate your task

  • when outdoors, wear a hat with a brim to reduce unwanted glare from the sky
  • sunglasses may be very helpful in bright conditions
  • ensure you have an adequate diet with plenty of fresh fruit and vegetables

  • regular medical examinations are essential to ensure that your health is normal, 
Remember: age catches up

Both cataracts and macular degeneration are more likely to develop as we get older.
 For many people there is only a mild loss of vision with either of the conditions. 
If you notice any of the symptoms described on this page we recommend that 
you contact your optometrist for an eye evaluation as soon as possible.
 Any sudden loss of vision is unlikely to be due to cataract or macular degeneration and
 such an event requires immediate attention.

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