Health measures no longer help and vision loss begins to interfere with activities such as driving, watching TV or reading, surgical removal of the cataract is indicated with the insertion of an artificial lens. Such surgery is more than 90% effective in improving eyesight and is one of the most common of all surgical procedures. In Canada, each province or territory will have full coverage for such surgery including the basic artificial lens, but more recently developed enhanced lenses may require individual payment. The choices may be difficult for the patient to understand and, while the recommendation of the ophthalmologist is important, the patient can make much more of an informed decision by referring to the Canadian Ophthalmological Society’s website and reading “Which lenses are right for you?” Macular Degeneration: Ten to 13 per cent of people over the age of 65 are affected by Age-related Macular Degeneration (AMD). It is estimated, because of our rapidly aging population, that there will be a 50% increase in the number of cases in the next 20 years. Macular degeneration is caused by deterioration in the central portion of the retina called the macula, resulting in loss of central vision impairing one’s ability to drive, read, recognize colours or faces and see things in detail. It is a progressive disease which may result in becoming legally blind. There are two types of macular degeneration. Dry AMD, which accounts for almost 90% of cases, is characterized by deposits of abnormal amounts of cellular debris in the macula. Wet AMD involves a buildup of abnormal tiny blood vessels in the macula, which can leak blood and fluid thus impairing vision. The causes of both are still unknown, but include heredity and environmental factors. Risk factors include older age, smoking, obesity, high cholesterol, excessive exposure to UV light and consuming high amounts of saturated fats. Althoughdry AMDaccounts for 90% of cases, only about 10% of those will develop severe visual loss, whereas wet AMD is associated with a much higher risk of severe vision loss. Although there is no known effective treatment for dry AMD, recent advances in the treatment of wet AMD include the regular injection of certain drugs into the eye, which will often slow the progression of the disease. Advances in technology − including large print computers and video magnifiers − have helped many. Glaucoma: Although glaucoma is the second leading cause of blindness in the world most cases, if detected early, are easily treated. When diagnosed during routine eye examinations, early treatment and followup can halt further progression. Glaucoma involves damage to the optic nerve and, inmost cases, is associated with an elevation of pressure in the eye. This buildup of intraocular pressure occurs without obvious symptoms in the early stages before vision loss is noticeable and, when diagnosed early, is usually treated successfully. In addition to age, other risk factors include a family history of glaucoma, diabetes, myopia (nearsightedness) or hyperopia (farsightedness), eye injury or the use of cortisone. Treatment is dictated by the type of glaucoma diagnosed. For most, the use of eye drops that lower the pressure in the eye is effective. In some cases, laser treatment or surgery may be indicated. If detected early and treatment and close followup occur, prognosis is usually good. Later diagnosis where optic nerve damage has occurred is more likely to be associated with future visual loss. Diabetic Retinopathy: Diabetics who have had their disease for 10 years will have an 80% chance of developing this condition. Early diagnosis and proper treatment can significantly reduce the risk of vision loss. Diabetic retinopathy occurs in two stages.The first stage involves the development of bulges (microaneurysms) in the arterial walls of the retina, whichmay be associated with swelling of the macula. There may be no vision loss. The second stage involves the development of abnormal new blood vessels at the back of the eye, which eventually may bleed and blur vision and without treatment, may result in permanent vision loss. Regular screening is very important for all diabetics in order to detect and manage the condition. Achieving optimal control of blood sugar levels, blood pressure and cholesterol are important steps in reducing the effects of the condition. Avoiding tobacco use is a must. If diagnosed and treated early, more than 95% of persons with the disease will keep their vision. Treatments include laser therapy, injection of drugs into the eye and surgery. Less common conditions are, in many cases, being more effectively treated. These include temporal arteritis, lid ptosis, giant cell arteritis and fungal conditions. Sudden onset of eye pain, flashes of light, sudden vision impairment or red eye may indicate retinal detachment, acute glaucoma, stroke or other serious eye conditions and require immediate attention by a physician. Having regular recommended eye examinations may detect early signs of disease for which we have no symptoms. Earlier treatment usually means less risk of vision loss. Modern and evolving treatments mean a better chance for light at the end of the tunnel for many eye conditions. 36 | www.snowbirds.org
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