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Adults ages 40 and older in the United States are at the highest risk for eye diseases. The risk raises even more for seniors aged 65 and above.
Vision loss doesn’t just impact your eyes. It can also raise the chances of social isolation, falls and accidents, chronic health conditions, and depression.
Many health conditions that impact vision are treatable and can be managed when taken care of early. This makes regular eye care even more important for seniors. Common age-related vision problems in the senior population include cataracts, age-related macular degeneration (AMD), glaucoma, and dry eye.
Early detection and healthy lifestyle choices, including diet and exercise, can help to prevent vision loss from progressing and deter some vision issues. Traditional Medicare does not cover eye exams, but some Medicare Advantage Plans and vision insurance providers offer coverage for seniors.
Age-related vision changes can impact driving. Being aware of these changes and taking extra precautions can help seniors drive safely. Thankfully, there are various resources to help seniors with vision-related concerns.
Why Eye Care Is Important for Seniors
The body and mind go through a lot of changes as we age, and the eyes are no exception. Vision issues are directly related to a higher incidence of anxiety, depression, social withdrawal, accidents and falls, and chronic medical conditions. Taking care of your eyes also means taking care of your body and your mental health.
Seniors make up two-thirds of the legally blind population in the United States who lost their vision due to an age-related eye disease. Many of these conditions are treatable, manageable, and even preventable with regular care.
Nearly 3 million older Americans are impacted by vision impairment. Eye care that addresses eye diseases and refractive errors can help to fix close to half of these issues.
The Importance of Regular Checkups
Regular medical checkups and eye exams can decrease the chances for vision loss and impairment. These exams can help to control some of the potential causes of vision loss as well as catch potential issues early on.
Often, there are few if any symptoms for many eye-related conditions and diseases until they have progressed to an advanced state. Regular checkups, eye exams, and healthy lifestyle choices can help to preserve vision and overall health. An eye exam can also often catch other health issues, such as stroke and diabetes.
The American Optometric Association (AOA) recommends that seniors ages 65 and older get regular eye exams every year. If you are at a high risk for eye disease or vision impairment, check with your doctor to see if they want you to get more frequent exams. An annual physical with a medical professional can help to detect any diseases or conditions that can impact the eyes.
Age-Related Vision Problems
Various health issues are more likely with aging, including heart disease, diabetes, and high blood pressure — all of which can also damage the eyes. This is why health and vision care are so important, especially for seniors.
The body and eyes change with age. A common side effect of aging is presbyopia, which is the loss of clear vision up close. This generally sets in after the age of 40 and can progress with age. It happens as the lens of the eye becomes more rigid and less able to adapt to focus on close-up tasks, such as reading.
These are common vision problems for seniors:
- Cataracts: These occur when the proteins in the lens of the eye start to break down and clump together, causing the lens to get cloudy. The most common cause of cataracts is aging. Most often, they can occur any time after age 40, and the risk increases each decade. By age 75, around half of all Caucasian Americans have a cataract. This statistic jumps to nearly three-quarters by age 80. Symptoms of cataracts include:
- Light sensitivity
- Blurry vision
- Trouble with night vision
- Seeing double
- Halos appearing around lights
- Colors being muted
You can slow the progression of cataracts by protecting your eyes from UV light.
- Age-related macular degeneration (AMD): AMD blurs central vision by impacting the macula. It is the number one cause of vision loss in people over the age of 50.It is a common condition that causes a blurry spot to appear in the middle of your vision. Late-stage AMD can also make your vision appear wavy. There is no direct treatment for AMD, but there are ways to slow its progression and lower your risk.
- Do not smoke.
- Eat a healthy diet that includes fish and leafy green vegetables.
- Keep your cholesterol and blood pressure in healthy ranges.
- Exercise regularly.
- Glaucoma: There are often no early symptoms or warning signs for this group of diseases that can damage the optic nerve. Glaucoma is the second leading cause of blindness in the world and the number one cause of blindness in seniors. African Americans over 40, and everyone over age 60 are at risk for glaucoma. Other risk factors include being diabetic or having a family history of glaucoma. Glaucoma occurs when fluid builds up in the front of the eye and raises eye pressure. This can put strain on the optic nerve, causing damage to it. The damage cannot be undone, but there are ways to keep glaucoma from progressing or to prevent it from occurring.
- Get regular eye exams where your eye pressure is checked.
- Use medications, such as eye drops, to stall the progression of glaucoma.
- Consider laser surgery to help drain fluid from the eye.
- Consider optical surgery to make a new drainage channel in the eye.
Glaucoma typically impacts peripheral vision first before moving on to central vision. Let your doctor know if you are experiencing any changes to your vision.
- Dry eye: This is a common and chronic condition that happens when tears do not properly lubricate the eyes. Dry eye can impact vision and be generally uncomfortable. Dry eye is especially common in older adults, and the majority of seniors experience dry eyes. Women are more likely to have dry eyes than men. Environmental factors, medications, and some medical conditions can all be risk factors for the condition.
These are symptoms of dry eyes:
- Burning or eye irritation
- Redness of the eyes
- Blurry vision
- Light sensitivity
- Watery eyes
Dry eyes can be treated by adding tears, such as artificial tear solutions, as well as through measures to increase tear production, preserve tears, and treat potential inflammation in the eyes. Nutritional supplements with essential fatty acids can also be beneficial to some people. It can also be helpful to stay hydrated by increasing water intake.
Prevention and Preservation of Eye Health
Preventative care can help you maintain your vision and eye health. Routine medical and vision checkups can catch issues early and keep them from impacting your vision and general health.
Seniors need to pay special attention to changes in their bodies and eyes. Report these problems to your doctor, as they can be signs of additional issues that should be addressed.
Here are some additional tips to help seniors maintain healthy eyes:
- Prevent injuries by wearing eye protection when doing home improvement projects.
- Increase the lighting in rooms to improve visual acuity.
- Secure rugs and stair banisters, use slip-proof mats in the bath or shower, use rails when needed, and remove trip hazards.
- Exercise regularly and within a healthy range. Walking, yoga, and stretching can all be beneficial.
- Protect your eyes from UV light by wearing sunglasses outside.
- Get enough sleep and allow your eyes to rest.
- Eat a healthy and balanced diet.
Insurance & Medicare Coverage
Traditional Medicare does not cover routine eye exams or prescription corrective lenses, but certain Medicare Advantage Plans (Part C) can include vision insurance.
Check with your local insurance carrier and Medicare Advantage Plan to find out about their vision insurance coverage and what exactly will be included. Typically, these vision plans will cover an annual eye exam, fittings for contacts or glasses, and either contacts or prescription eyeglasses.
Medicare covers the following eye care services:
- Cataract surgery or necessary surgery to repair the eye due to a chronic condition
- A standard pair (custom pair is covered if deemed medically necessary) of eyeglasses or contacts after cataract surgery
- Diagnostic eye exam in the event of vision problems
- Annual eye exam if diabetes is diagnosed or there is a high risk for glaucoma
There are many vision insurance providers that offer coverage for routine eye care. Vision insurance can save you money on larger expenses, and you’ll need to pay your monthly premium to maintain your coverage. Vision insurance is typically separate from your standard health insurance plan.
The Seniors Program through EyeCare America offers free and low-cost vision care for eligible seniors. People who do not have coverage through the VA or an HMO, are ages 65 and older, are US citizens, and have not been to an ophthalmologist in three years can qualify for a medical eye exam and one year of follow-up care.
Driving Safety Tips
Aging can impact reflexes, physical fitness levels, and vision. All of these can affect driving abilities.
Close to 20 percent of all traffic fatalities involve people ages 65 and older. The National Highway Traffic Safety Association (NHTSA) offers a self-assessment to help seniors recognize when driving abilities could be impaired. Seniors can keep driving as long as it is safe to do.
Some states have restrictions on “older drivers.” Check with your local Department of Motor Vehicles (DMV), as they can vary from state to state. Aging can make it more difficult to transition between light and dark, which can make driving at night or in the rain more challenging.
Here are some safety tips for senior drivers:
- Drive during the day and in dry weather.
- Reduce overall speed.
- Consider a driving course aimed at seniors.
- Use extra caution at intersections.
- Keep the inside and outside of the car windshield (and any eyeglasses) clean.
- Avoid eyewear with wide frames that can further decrease side vision.
- Adapt the vehicle to enhance driving ability and comfortability.
Vision Resources for Seniors
The following vision resources are available for seniors:
- AMD resource through the American Academy of Ophthalmology (AAO)
- Programs offered for seniors through the National Federation of the Blind (NFB)
- A host of resources for seniors through VisionAware, which promotes independent living
- The Glaucoma Foundation’s resources for seniors
- Resources on how to preserve sight via Vision Atlas through the International Agency for the Prevention of Blindness (IAPB)
- Information on understanding and influencing older drivers, as well as resources on safe driving through aging, through the National Highway Traffic Safety Administration (NHTSA)
- Detailed videos in both English and Spanish to educate seniors on eye health and age-related vision issues and concerns from the National Eye Institute (NEI)
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