The Eyes Have It

By Robert F. Bornstein, PhD and Mary A. Languirand, PhD

As one ages vision problems become more common. In fact, we've both had challenges in this area in recent years, with one of us undergoing a laser procedure to relieve pressure in one eye, and the other experiencing ocular migraines (yes-there really is such a thing) with accompanying changes in vision. We're hardly alone: More than 3 million older adults in America today have significant vision loss. For some, vision difficulties can make independent living challenging; many Activities of Daily Living (for example, paying bills) become difficult when vision is impaired.

As with many health-related issues, being proactive is crucial in maintaining good vision. A periodic visit to the ophthalmologist is well worth your time; your ophthalmologist can not only spot early signs of vision impairment and take steps to correct the problem, but eye exams are among the best ways of detecting certain diseases (like diabetes) that have wide-ranging negative effects.

There are four leading causes of vision impairment among older adults today. Here are the most important characteristics of each:

  • Macular degeneration is a condition wherein leaking blood vessels in the back of the eye interfere with central vision (peripheral vision is less strongly affected). Laser therapy to destroy leaking blood vessels is currently the treatment of choice, but studies suggest that a combination of zinc, beta-carotene, and vitamins C and E may also be effective in slowing progression of the disease.
  • Cataract is a clouding of the lens in the front of the eye; risk factors include diabetes, smoking, and prolonged exposure to direct sunlight (so wear sunglasses). More than half of us develop cataracts by age 80, and though the condition is now surgically treatable, costs may be prohibitive for those without excellent insurance.
  • Diabetic retinopathy is a condition in which blood vessels in the eye break down, leak, or become blocked, gradually leading to vision loss. Laser surgery or a vitrectomy procedure (removal of vitreous humor-the jellylike substance that fills the eyeball) are currently the treatments of choice for diabetic retinopathy; research into pharmaceutical treatment options is ongoing.
  • Glaucoma results from damage to the optic nerve connecting eye and brain, and unfortunately the symptoms of glaucoma are rarely detected until nerve damage has become substantial. Timely diagnosis is key because the earlier glaucoma is diagnosed, the greater the amount of vision that can be preserved.

Robert Bornstein and Mary Languirand are the authors of When Someone You Love Needs Nursing Home, Assisted Living, or In Home Care, which is available at, or may be purchased directly from HarperCollins Publishers.

Our latest book is entitled How to Age in Place: Planning for a Happy, Independent, and Financially Secure Retirement, published by Ten Speed Press, a division of Random House.