Q&A: How does aging affect vision?

Well, it's recommended that most of us get an eye exam about every two years. But you know, the eyes are the window into the body, and many common medical problems can actually be seen in the eyes. Dr. Stacy Chronister is an internal medicine specialist with OSU Medicine. She talks to us about some of the common changes that occur with our eyes as we age.

Q: Why is it difficult to notice vision changes over time?

A: Honestly, the eyes change so slowly. Sometimes it's very rapid, and that's an emergency, but sometimes the vision just changes so slowly that you get used to it, and you adapt to it, and you don't really notice how much your vision has changed until something happens.

Q: What is retinal detachment, and what are the warning signs?

A: So the retina, which is that layer of nerves that helps you see, has kind of detached from the back of the eye, that will result in them having a blackness like a curtain that's kind of gone over that part of the eye. They might suddenly have a lot of floaters. A lot of us have a couple of floaters that we notice floating around.

They'll have a sudden rush of floaters, or they may have some lightning, some flashes happening. That is an emergency. If you can't see an eye specialist within the next hour, go to the emergency room.

Q: What is acute angle glaucoma, and how is it different from other types of glaucoma?

A: Well, we think about glaucoma, we kind of think about it with aging, and we hear about it a lot with, you know, people that are older having to use eye drops. But acute angle glaucoma is something that happens right away. So this is not just that high blood pressure that happens in the eye over a long period of time.

This is something where something has blocked the flow of the fluid in the eye, and all of a sudden the pressure becomes very high. So this is actually painful. The retinal detachment is painless. This is very painful. You can see that the eye looks uncomfortable, and you can see right in the pupil, it looks kind of fuzzy, and that's because it's so inflamed right there. So the pressure has gone up in the eye.

And oftentimes people have nausea, vomiting, and headache. But visual changes are not so much the curtain over the eye like you get with the retinal detachment, but you get a blurriness, so the lights will have halos around them.

Everything will look a little bit fuzzy, and that's an emergency if you can't see someone right away.

Q: How common is cataract surgery, and what are the symptoms of cataracts?

A: Super, super common these days, to the point that everyone, if you live old enough, will need cataract surgery, right? And it's the most common cause of blindness in the world. We're lucky in America to have access to ophthalmologists that can take these out.

But this is where the lens, which is that area right behind that iris, starts to harden and calcify, kind of like all of our joints seem to do as we age, and so that has become calcified and it clears out. You probably know someone who has an eye that looks very similar to this.

You can actually see pretty good until it gets really bad. So it happens so slowly that people don't always notice. So at first, it might just be having trouble seeing at night, and then it might be trouble reading some signs when you're driving, but colors, seem to be affecting colors more than anything else.

Colors just don't look as bright, and vibrant as they used to. So one of the ways that I often kind of see in patients is you have an older patient come in, probably a female, and she has bright blush and bright blue eyeshadow, and you're like, okay, check your eyes. Yeah, she might have a cataract. She probably can't see how much blush she put on.

Q: What is macular degeneration, and how does it affect vision?

A: Macular degeneration actually also very common. You probably hear about it a lot on TV. There are a lot of different medications that are available to have commercials out there. What macular degeneration is when we have a lot of meds for, but it looks like this.

The macula is the part of the retina that gives us our clear vision right in the center. So when I want to look at your face, I'm looking at you clearly with my macula. As that breaks down, we can have that breakdown.

So if it's wet, we have some vessels coming into the eye and covering that up, and we can give you some medications to stop that. But if it's dry, that's just starting some breakdown of that macula. We don't have a lot of treatment for that.

Q: What causes peripheral vision loss, and how does it impact daily life?

A: Actually, when we think about things happening with the eyes and the vision, we think about it with the eyes, but sometimes things can be a problem in the brain itself. And this is typically something that's happened in the brain, maybe not so much in the eye.

The normal vision, however, is like this panoramic view, but if you have peripheral vision loss, it's not black on the sides. You just have a narrowed scope, so you see the same thing. You just might have to turn your head a little bit more to see the job, and you don't realize that other people aren't doing that to see that.

So oftentimes, a person, as you're tripping more than you typically would because you didn't see that there was something there. If you're driving, you're running into curbs, or you get into a wreck, and say, they came out of nowhere, I didn't see them. And it's true, you have great vision. You just can't see very well on the side.

Q: How can doctors diagnose and treat peripheral vision loss?

A: We would start with probably an MRI of the brain and some visual testing to make sure that that's what's going on. But yeah, we can look and see, and if there's something happening there, we can take that lesion right out.