By Dr Nicholas Altuneg
Wear and tear – it’s not a phrase we like to think about when it comes to our body as we age. Unfortunately, our eyes are susceptible to changing as we grow older, which aside from being annoying, isn’t always serious.
Over the age of 40, we will increasingly have difficulty adjusting our focus as the lens inside the eye becomes less elastic. For example, we may find fine print harder to read without reading glasses and colour perception could fade making the world appear a little less vibrant.
Furthermore, sometimes our eyes have more difficulty in maintaining lubrication with age. This can leave eyes feeling irritated, sticky, dry, or gritty.
The ability for the eyes to detect contrast also often gradually diminishes, which can pose problems when driving at night.
The good news is that while most of these changes occur normally, they don’t cause significant visual problems and are mostly easily treated. In contrast, cataracts, macular degeneration, glaucoma, and diabetic retinopathy can rob you of your sight.
So, how do you know if an eye problem is nothing more than a nuisance or the start of something serious?
The following symptoms require urgent assessment and possibly treatment. Some of these symptoms may co–exist, for example you may have sudden vision loss and severe headaches at the same time or severe pain in the eyes, redness, and photophobia. Catching serious eye problems early can help preserve your vision.
Sudden loss of vision in at least one eye needs to be investigated immediately and is considered a medical emergency. There are several conditions which could lead to permanent vision loss, and they usually affect either the circulation around the head region or the nerve function directly. The most serious of these conditions is temporal arteritis which is an inflammation of the lining of arteries in and around your head. This condition can cause blindness and in some cases death within days, therefore immediate treatment is essential.
If the vision loss is temporary and recovers, you should still visit your Optometrist or Ophthalmologist as soon as possible. Optical migraines, optic neuritis and strokes are the most common causes of temporary vision loss. If nerve function is lost for long enough, then the damage is usually permanent, so early treatment provides the best chance for maintaining sight.
Sudden, transient blur or the appearance of wavy/crooked lines could be a sign of a break in the retina (e.g., retinal detachment), fluid seeping into the layers of the retina from the retinal vessels (e.g., diabetic retinopathy), or from beneath the retina (e.g., wet macular degeneration). If the retina stays detached or fluid is allowed to remain within the retina, then it can cause scarring in the retina and permanent vision loss. These cases require urgent treatment.
Sudden onset of double vision or abnormal eye movements are often caused by diseases that affect other parts of the body. Causes in and around the brain such as brain tumours, while rare, are potentially lethal. Sudden onset double vision needs to be assessed urgently.
Severe eye pain/headache which persists for a few hours is not normal. The cause could originate within the eye or from the brain or spinal column. Severe eye pain or headache requires urgent assessment to manage the pain and prevent the more serious diseases from causing permanent vision loss.
Photophobia is a strong sensitivity to light. Some people are born with large pupil sizes or with low pigmentation in their eyes (e.g., albinos) and this could be normal. If Photophobia co–exists with other symptoms such as strong pain or very red eyes, then this needs to be investigated as soon as possible.
Sudden appearance of spots in your eyes could be serious or benign. Spots could be neurological in nature, where your brain is creating spots, lines or zigzag lines and there is nothing wrong with the eyes, but a systemic condition may need to be treated. You may be seeing signs of bleeding or retinal detachment at the back of your eyes which needs urgent care, or you could be seeing floaters which are not associated with eye disease. If in doubt, check it out.
Loss of Peripheral Vision is usually not noticed by people if central vision remains intact and is rarely a presenting symptom. The most common causes are glaucoma, retinitis pigmentosa and stroke. If glaucoma is the cause, then you usually don’t know that you have it until your central vision is gone and you are completely blind in the eye. There is no way we can recover the nerve function once it is lost, so an annual eye examination is the only way to detect and preventatively treat glaucoma.
Changes in iris colour are usually benign but could be a sign of a slowly progressive form of glaucoma.
If redness of the eyes is mild and not associated with strong pain or photophobia, then it can be treated as annoying but not urgent. Associated symptoms may be dryness, itching, burning or discharge. In some cases, patients may be unable to open an eye on waking or they may have a lump growing on the eyelid.
Halos are coloured circles observed around lights in low light settings. These are mostly associated with cataracts and are usually slow growing but can grow more quickly in some people. Cataracts need regular monitoring. Halos are sometimes seen by people after laser refractive surgery, especially if they have large pupils.
Change is inevitable in life
It’s likely that your vision will change over time. Understanding what changes form part of the normal aging process, and which symptoms could cause permanent vision loss, could mean the difference between maintaining quality of life as we age or losing it. Don’t neglect your annual check–up with your Optometrist. It could be one of the most important appointments that you ever keep.
This article is intended to promote understanding of and knowledge about general eye health topics. It should not be used as a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your health care professional prior to incorporating this as part of your health regimen.
Dr Nicholas Altuneg is a Behavioural Optometrist who has been working on the Central Coast for almost 30 years. He is the co–founder at Eyes by Design, which is in the Kincumber Centre. Appointments can be made by phone 4369 8169 or online at www.eyesbydesign.com.au