Coping with cataracts, diabetic retinopathy, glaucoma and macular degeneration

September 17, 2012

More people than ever in the United States suffer from age-related eye diseases. The four most common conditions — cataracts, diabetic retinopathy, glaucoma and age-related macular degeneration — are the leading causes of vision impairment and blindness.

Cataracts

Close to 21 million Americans age 40 and older have cataracts, according to the Centers for Disease Control and Prevention. Cataracts are cloudy areas in an eye’s lens formed by the clumping of proteins as we age. They can lead to hazy, blurry vision and sensitivity to glare.

Detect it. Expect to undergo a comprehensive eye exam, including tests using an ophthalmoscope, a device used to inspect the retina at the back of the eye, and a “slit-lamp” test, which enables doctors to detect cataracts in the lens. Even if a cataract is found, it doesn’t mean you necessarily need to have surgery right away if your ability to read or watch television hasn’t been affected. That’s a decision left to the individual involved.

Treat it. A small incision is made on the side of the cornea, and a tiny probe is inserted that emits ultrasound waves to break up the cataract-containing lens so that it can be suctioned and discarded. A permanent artificial lens is then implanted.

Diabetic retinopathy

The CDC estimates that 5.3 million American adults suffer from diabetic retinopathy, which can damage the blood vessels in the retina at the back of the eye. In some cases, fragile blood vessels swell and leak into the eye, blurring vision. In others, blood vessels grow abnormally on the retina’s surface and leak blood, causing severe vision loss.


Cataracts, diabetic retinopathy, glaucoma and age-related macular degeneration are leading eye diseases. (BigStock/BIGSTOCK)

Detect it. There are often no early warning signs of diabetic retinopathy. The cardinal symptom, blood leaking into the retina, often happens during sleep. But if you have diabetes and notice spots floating in your field of vision, see your eye doctor immediately because you may need treatment before more serious hemorrhaging occurs.

Treat it. Laser surgery to stop blood leakage and stabilize vision can reduce the risk of blindness by 90 percent, according to the National Eye Institute. Cases of severe bleeding may require surgery, called a vitrectomy, to restore sight, in which doctors insert a small instrument through a tiny incision in the eye to drain the bloody fluid and then replace it with a salt solution.

Glaucoma

About 2.2 million Americans age 40 and older have glaucoma, the second-most common cause of blindness worldwide after cataracts. Glaucoma is the name for a group of diseases in which fluid builds up inside one or both eyes, increasing the internal pressure and eventually damaging the optic nerve. If left untreated, people with glaucoma slowly lose their peripheral vision. Over time, central vision can also deteriorate.

Detect it. There are no early warning symptoms of glaucoma. That’s why routine screening at least every two years is so important, especially for people at high risk, such as African Americans older than 40, cigarette smokers, diabetics and everyone over age 60. Tests for glaucoma commonly include measuring eye pressure and checking the corneas’ thickness.

Treat it. There is no cure for glaucoma, and lost vision cannot be restored. But if it’s detected early, medicine and laser or surgical treatments may save your remaining vision. Eyedrops that reduce eye pressure are the mainstay of glaucoma treatment.

Macular degeneration

There are two forms of age-related macular degeneration. In dry AMD, cells in the macula — the part of the eye involved in sharp, central vision — break down, gradually blurring central vision. In wet AMD, the abnormal overgrowth of blood vessels leaks blood and fluid, leading to a loss of central vision.

Detect it. Doctors may dilate the eyes and check behind the retina. Patients may also undergo angiography to check for leaky blood vessels.

Treat it. Nothing has been shown to prevent vision loss from advanced cases of dry AMD. But the National Eye Institute recommends that people with at least moderate dry AMD take supplements that combine high doses of vitamins C and E and beta carotene with copper and zinc to help delay and possibly prevent the disease’s progression.

Wet AMD cannot be cured. Doctors use lasers and other techniques to treat fragile, leaky vessels. Drugs can block the growth of such blood vessels, help slow vision loss and even improve vision.

Copyright 2012. Consumers Union of United States Inc.

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