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The ageing eye and its problems ARE YOU finding difficulty reading small print and do you increasingly find yourself avoiding driving at night because of the glare of lights? If so, you may be facing problems commonly caused by ageing eyes. As people age, many will inevitably encounter some changes in their vision. With a growing elderly population, age-related eye diseases are becoming the leading cause of vision impairment in the developed world. Changes in vision Associate Professor Lee Shu Yen, Ophthalmologist at the Singapore National Eye Centre identifies some changes in vision that an ageing adult may face. "The eyes begin to have reduced sensitivity to light, and will require brighter lighting for reading and other near-work. In some cases, colours will appear dim and a glare forms when light is shone directly at the person. This often deters some older adults from driving at night. Also, as the lens in the eyes become less elastic and lose ability to focus, reading small print becomes more difficult and reading glasses are needed." In addition to these vision changes, ageing also makes one more prone to developing eye conditions that can result in poor vision. Some common eye conditions include presbyopia, floaters and flashes, cataracts, glaucoma and age-related macular degeneration. Proper annual check-ups and treatment are essential in preventing and slowing the progression of these ageing eye conditions. Presbyopia Presbyopia (long-sightedness) is the most common eye problem associated with ageing. Associate Professor Lee said that everyone will develop presbyopia, and this usually occurs in the 40s. However, some individuals can develop the condition at a younger age in their 30s or at a later stage in their 50s. "Presbyopia is an inevitable consequence of ageing and can easily be corrected with prescription glasses or reading glasses. Some pharmacies sell reading glasses that can help those with minimal or no refractive error. But such glasses do not cater to people with astigmatism or myopia," added Associate Professor Lee. Floaters and flashes Floaters and flashes are frequently experienced by short-sighted people or those who have undergone cataract operations. The flying flies or dots that one sometimes see moving in the field of vision is caused by tiny clumps of gel inside the vitreous (a jelly-like fluid), that fills the inner cavity of the eye. As one ages, the vitreous gel shrinks and degenerates to form clumps within the eye. To deal with floaters and flashes, Associate Professor Lee advises: "This condition is seldom serious and they usually disappear on their own. There is no cure for it. However a sudden onset of many new floaters or flashes of light could be an indication of a torn retina, and prompt medical attention is needed." Cataracts Cataracts, a condition where the lens in the eye becomes cloudy, causing blurred vision, affects mostly older people and is easily treated. An earlier onset of cataract may be caused by prolonged ultraviolet light exposure, long-term usage of drugs such as steroids and certain illnesses, such as diabetes. An individual with cataracts may find it harder to see at night, experience sensitivity to light and glare, see halos around lights, and experience fading or yellowing of colours. A frequent need to change glasses may be another sign an individual has cataracts. "When cataracts impair your vision to the point where it affects your daily activities, it is time to have them removed. Cataract surgery is simple and one of the safest surgeries. At the Singapore National Eye Centre, 10,000 cataract surgeries are performed each year and many people find their vision improves significantly after undergoing the surgery," said Associate Professor Lee. Glaucoma Glaucoma is not just one disease but a group of conditions resulting in optic nerve damage, which affects vision. It is usually caused by abnormal pressure inside the eye which causes optic nerve damage. Glaucoma is often known as the silent thief of sight, as it damages one's vision gradually without any obvious signs and symptoms, until the disease is at an advanced stage. Those with a family history of glaucoma and the elderly aged above 60 years old, are at a higher risk of developing the condition. The most common type of glaucoma is the primary open-angle glaucoma. It has no noticeable signs or symptoms except gradual vision loss. Some symptoms of acute angle-closure glaucoma include severe eye pain, nausea and vomiting accompanied by severe eye pain, reddening of the eye, headaches, blurred vision and vision of halos around lights. On prevention and treatment for glaucoma, Associate Professor Lee explains: "One should visit an ophthalmologist (eye specialist) immediately, if any of the these symptoms are experienced. Even if you don't have any of these symptoms, it is advisable to go for an annual eye check-up, especially if you are over 40 years old. There is no cure for glaucoma, but early treatment in the form of eye drops, laser treatment or surgery can help to halt and control the progress of the condition." Age-related macular degeneration Age-related macular degeneration (AMD) is a deterioration of the tissue in the part of the eye responsible for central vision. The condition does not cause total blindness, but can worsen the quality of life by blurring or causing a blind spot in the central vision, which affects daily activities such as reading, driving, doing detail work and recognising faces. Macular degeneration tends to affect adults aged 50 years and above. There are two forms of related AMD - wet and dry. Dry AMD, which is experienced by the majority of AMD patients marks an early stage of the disease while wet AMD usually leads to serious vision loss, due to damaged retinal cells caused by new blood vessels that grow beneath the retina. In about ten per cent of cases, AMD patients first suffer from dry AMD which then progresses to wet AMD. Some signs and symptoms for AMD are - the need for increasing bright light when reading or doing near-work, appearance of distorted or increasingly blurred printed words when reading, colours appearing washed out or dull, and a gradual haziness of overall vision. "Smoking and ageing are high on the list of risk factors for macular degeneration. Though the condition usually cannot be reversed, early detection can help to reduce the extent of vision loss. Studies have also shown that certain nutrients such as vitamins A, C and E, and zinc may help prevent or slow the progression of dry AMD," said Associate Professor Lee. Sidebar Singapore National Eye Centre is an institution of SingHealth, the largest integrated healthcare group in Singapore. [Non-text portions of this message have been removed]
