Health & Wellness
A clear view

A clear view

Solutions for healthy and beautiful eyes as you age
by Amy Meadows

When you enter your 40s, certain standard health topics undoubtedly will come to the forefront of your daily conversations: your blood pressure, cholesterol levels and breast or prostate health. But there’s one topic that you just might turn a blind eye to without realizing how important it actually is—your vision.

As you age, vision changes are inevitable, but that doesn’t mean there’s nothing you can do about them, especially if they are associated with a deterioration of your overall eye health. In fact, understanding what is happening to your eyes as the years go by is the key to preserving your vision and keeping your peepers in tip-top shape for as long as possible.

“The eye is the gateway to the soul,” says J. Trevor Woodhams, M.D., FAAO, founder of Woodhams Eye Clinic. “As our most important sense, we should never take our sight for granted.” Jonathan Woolfson, M.D., founder and medical director of the Woolfson Eye Institute, adds, “As we age, we’re less mobile and vision plays a more important role. Also, poor vision can lead to accidents and falls, which have more ramifications when we’re older.” And that’s why today is the perfect day for you to start educating yourself about the most common age-related vision and eye issues and what can be done to either modify or slow the development of them. With the right information at your fingertips, you’ll be able to see clearly from now on.

Presbyopia

TECHNOLOGICAL ADVANCES
IN VISION CARE

Whether you have myopia (nearsightedness), hyperopia (farsightedness) or astigmatism (an oval cornea that doesn’t allow the eye to focus clearly), you may have already explored your vision correction options. However, the vision care industry has welcomed a number of technological advances over the years, so take another look at what you have available to you. Here, the experts share some of the latest and greatest developments.

Glasses. One of the safest and most common vision correction solutions, glasses have been around for ages, but the spectacles of yesterday are no more. According to Steve Nuttall of Lugene Opticians Inc., major technological advancements have greatly improved today’s eyewear. “Freeform digital lens technology is the most advanced process by which lenses are made,” he explains. “Special equipment is used to measure frame size, shape, position of the eyes, tilt of the frame, distance from the eyes and facial wrap. The technology is used for single-vision and multi-focal (bifocal and trifocal) glasses, and wrap sunglasses and can provide accuracy to 1/100th of a diopter (an optical unit of measure). Never before have we had lenses that can provide this level of clarity.”

Contact lenses. While it may not be appealing to place a piece of plastic in your eye every day, using contact lenses can be very freeing. And thanks to modern technology, the lenses are better than ever before. Jonathan Woolfson, M.D., founder and medical director of the Woolfson Eye Institute, notes that today’s contacts not only are much more comfortable, but they also offer much better oxygen permeability, meaning that you will experience fewer problems related to oxygen deprivation. In addition, bifocal contacts are available to help with reading, and specialty contacts can accommodate some irregular-shaped corneas.

LASIK surgery. With J. Trevor Woodhams, M.D., FAAO, founder of Woodhams Eye Clinic, reporting that 97 percent of LASIK surgery patients achieve 20/20 or better distance vision, this option is one that cannot be ignored—especially since almost anyone who wears glasses or contacts is a candidate for the surgery. Of course, as with any procedure, there is a small amount of risk, but the technological advancements have made LASIK even more appealing than before. “LASIK equipment keeps getting better,” says M. Farooq Ashraf, M.D., FACS, medical director of the Atlanta Vision Institute. “For instance, we used to have to make a flap, using a blade to cut. Now it’s an all-laser procedure. And every two years or so, our technology is changing. This is a very dynamic field.” Woolfson adds, “LASIK will continue to evolve with fine tuning of the lasers, which will allow us to treat patients we aren’t able to right now.”

Have you noticed that you have to hold the newspaper or the menu farther away from your face to see the text clearly these days? Well, you’re not alone. According to M. Farooq Ashraf, M.D., FACS, medical director of the Atlanta Vision Institute, everyone experiences a decline in their ability to read with clarity as they age. “This is something that we have no control over,” he explains. “The loss of accommodation, or presbyopia, happens over the years. We simply don’t notice it until we hit our 40s when we realize that we can’t read as well up close.”

The American Optometric Association (AOA) reveals that presbyopia involves the crystalline lens in your eye losing flexibility over time, making it difficult to focus on objects that are close to you. It is not a disease, but rather a normal part of the aging process. It cannot be prevented, but fortunately there is a rather simple fix. “Before we reach 50, most of us will be using reading glasses to improve the ease with which we read,” Woodhams says. The AOA adds that because presbyopia will continue to change your lens’ ability to focus properly as you get older, you may require changes in your eyewear over time to maintain clear vision.

While it may seem that LASIK surgery would be an excellent option for correcting presbyopia, removing the need for you to wear reading glasses, Ashraf reveals that it's just not the case. "When it comes to the ability to eliminate reading glasses, we don't have anything that is perfect for doing that at this time," he says. “You actually begin to lose the ability to see well [up close] when you're born, and it keeps decreasing as you age. So it's a moving target.” Because distance vision does not change as much over time, LASIK is a viable option that can be done with great precision. And fortunately, if you do happen to be a candidate for LASIK because of your distance vision, the surgery can benefit your near vision and reduce the need for reading glasses, especially if you are under the age of 45.

Cataracts

“As we get older, the lenses inside our eyes get stiffer and more cloudy. As this advances, we call the lenses cataracts,” Woolfson says. Woodhams observes that you may begin experiencing symptoms of cataracts, such as cloudy or blurry vision, a glare when looking at headlights or lamps (including a halo effect around lights) and poor night vision, in your 50s. By your 70s, he says, “Cataracts can become medically necessary to remove and replace with an artificial lens.” In fact, the National Eye Institute (NEI) notes that by age 80, more than half of Americans either have a cataract or have had cataract surgery; some people experience a cataract in one eye only, while others may develop them in both eyes.

While eye surgery may sound frightening, Ashraf asserts that the procedure is simple. In addition, thanks to a variety of medical and technological advances, the results of cataract surgery are quite impressive. “In the old days, we would put an implant in, and that implant would be for far vision only, so you would still have to wear your reading glasses,” he says. “Now we have advanced implants that give you improved distance vision and near vision. So you can actually get through about 95 percent of your day with no glasses at all.”

Dry eye

It’s not unusual to have dry, itchy eyes during the height of allergy season. However, if you find that the condition persists throughout the rest of the year as well and your vision is actually compromised because of it, you might be experiencing one of the most common age-related eye issues: dry eye. Seen most often in Caucasian women older than 40, dry eye occurs when you do not produce enough tears to lubricate your eyes or when the quality of the tears you do produce is poor and does not effectively nourish your eyes. According to Ashraf, this lack of tears impacts not only the comfort of your eyes, but also your visual clarity. And more women are affected by the condition, he says, because of the hormone changes associated with aging and menopause. However, the AOA does note that a majority of people—both men and women—over the age of 65 experience some symptoms of dry eyes. In addition, certain medical conditions such as rheumatoid arthritis and diabetes, as well as long-term use of contact lenses and environmental conditions such as exposure to smoke and wind, can cause dry eye. Ashraf also mentions occupation-related dry eye, which can be attributed to staring at a computer screen for long periods of time without blinking.

Fortunately, many cases of dry eye can be treated very easily with over-the-counter artificial tears. “The new artificial tear solutions out there today are much better than the old saline drops that we used to have,” Ashraf notes. Furthermore, he says that if drugstore solutions don’t work, then prescription medications that increase the production of tears are available to help sufferers. What’s more, there is some evidence that vitamin supplements, including omega 3 fatty acids, can be effective in reducing the symptoms of dry eye.

Glaucoma

When you go to the doctor for your regular eye exam, have you ever wondered about the test that involves numbing drops and a machine that the technician uses to touch your eye? It’s called tonometry, and the machine is actually testing the pressure in your eye. In layman’s terms, it’s checking for indications of glaucoma, an eye disease that is marked by an increase in the eye’s fluid pressure, optic nerve damage, vision loss and possible blindness. Woodhams reveals that if the condition runs in your family, signs can show up as early as your 40s. And Woolfson notes that the risk really increases when you reach your 50s. Yet, you may never have any outward symptoms that send you to see your optometrist.

“Glaucoma is like high blood pressure. You don’t have any symptoms. There’s no blurry vision, and there’s no pain. So you simply won’t know,” Ashraf explains. “When people get really advanced glaucoma, that is when their vision may be affected. Unfortunately, the eye is a nervous tissue, and once you have damage [in the optic nerve], we can’t reverse it.”

Fortunately, if the disease is caught early, there are several treatment options. According to the NEI, medicines in the form of eye drops or pills are usually the first line of defense. If necessary, your doctor can do a laser trabeculoplasty, which is a surgical procedure that stretches the drainage holes in your eye’s meshwork and helps fluid drain out. There also is conventional surgery, during which a surgeon will physically make a new opening so fluid can drain from the eye.

Macular degeneration

Age-related macular degeneration (AMD), or the damage of sharp and central vision due to age, is the No. 1 cause of blindness among the elderly in the United States, Ashraf says. The Centers for Disease Control and Prevention (CDC) estimate that 1.8 million Americans ages 40 years and older are affected by the condition, and that number is expected to skyrocket to 2.95 million by 2020. The good news, according to Woodhams, is that macular degeneration is rare in younger patients and typically not severe in most cases, even in older patients. And while there were not many treatments in the past, Ashraf observes that some options that can slow the progression of AMD have been identified in recent years.

Of course, there are two types of AMD, so the treatment options will vary depending on the diagnosis. “Dry” macular degeneration, in which the tissue of the macula thins and stops functioning properly, results in the loss of central vision that cannot be restored. The NEI notes that this permanent loss of vision occurs when the condition is in its advanced stage; however, if caught early, research has shown that taking a specific high-dose formulation of antioxidants and zinc during the intermediate stage can significantly reduce the risk of the AMD reaching the advanced stage and causing vision loss. “Wet” AMD occurs when abnormal blood vessels behind the retina start to grow under the macula and leak blood and fluid. The process, which also can cause permanent vision loss, can be very quick and severe, according to the NEI. There are no stages, but a small percentage of people can be treated with laser surgery.

It may seem daunting to consider all of the conditions and health issues your eyes can encounter as you age, but it’s critical that you keep each possibility in the back of your mind and treat your eyes as you do the rest of your body. As Woolfson concludes, “Get regular eye exams with competent doctors and listen to their advice. Get help early if there’s a problem, and find highly experienced doctors if specialty work is needed.”


Jeepers Creepers—Check Out Those Peepers!

Expert Tips for Keeping Eyes Beautiful
by Alyson Hoag, CEO, Authentic Beauty

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Alyson Hoag, CEO
Authentic Beauty

Start using an eye cream in your early 20s, moisturizing the eye area. If your eyes are not hydrated, lines will look more noticeable. Professional eye treatments make this easier.

Keep concealer use to a minimum. Put product only where you need it. If you overuse it, it will be noticeable, which reverses the effect of concealing.
When using a concealer, make sure to choose a product that isn’t too light. Light doesn’t necessarily make the area brighter. It actually can make the eyes look more puffy and prominent.

When applying makeup to the eyes, begin by putting a foundation or some kind of base on your lid. As we age, our lids become increasingly discolored and dry. Laying down a base will assist in making a smoother application. Be sure to apply a thin layer, as too much product should be avoided.

In your 20s, wearing trendy makeup is completely acceptable—not so much when you are 50. It’s important to realize that wearing colors on your eyes calls attention to the makeup, not you. If you are comfortable with that, then color away! Otherwise, know that color on the eyes and trendy applications will call attention to everything.

The best way to enhance one’s eyes is to bring out the color of the actual eye. This can be achieved in many different ways. Refer to a color chart to best understand how this works. For example, orange is opposite blue on a color wheel. Visit a paint store and examine which colors have orange undertones—many don’t even resemble orange. It can be a bronze, a peach, or a brown with a hint of warmth.

Remember that as you mature, it is not necessarily true that you need to wear all matte shadow. Matte can look chalky on the skin; consider using a bit of shine, but carefully pick where you are putting it. Choose the lid or the brow bone, but not both.

Smile while you are applying your makeup. Smiling will give you your natural expression so you’re not walking around all day with a stony expression.

Lash extensions can define your eyes and make them look fantastic! They are individual lashes which are applied to the eyes (it takes 2 hours) with surgical glue; they last 3 weeks. You have to maintain them by filling them in, but it’s worth it! As we age, our lashes shrink. Lashes make your eyes appear more awake. Eyelash extensions can be done in several lengths so they appear completely natural (unless of course you want to bring out your inner diva).

If you are using mascara be sure to find the best one for you and does not clump. Little lashes with big clumps in them is not a good look.

Eyeliner is not necessary to make eyes pop. Liner defines the eye, and if you have small eyes, it can actually make them look smaller. However, lined eyes are sexy. Eyeshadow alone can illuminate the eyes. Makeup application is all about effect. What kind of look are you going for? Always know before you begin.

Often, using a darker color in the crease of the lid can look much too heavy. If you wonder if it is right for you, ask your best friend for an evaluation. Be open to the answer. It might be time for an update.


Expert Tips

CONTACT LENS CARE
Good hygiene is very important for contact lens wearers. M. Farooq Ashraf, M.D., FACS, medical director of the Atlanta Vision Institute, notes that there is always the risk of developing an infection of the eye if you don’t take proper precautions, including washing your hands before you put your contacts in or take them out and not sleeping or swimming with your contacts in. While it’s rare, if you do get a corneal infection, it can be very serious and difficult to treat, and it sometimes can leave a permanent scar that affects your vision.

GOTTA WEAR SHADES
The progression of some age-related vision and eye health conditions can be slowed down with the simple act of wearing sunglasses every time you leave the house. According to Jonathan Woolfson, M.D., donning quality eyewear with UV protection is as beneficial as it is fashionable. As M. Farooq Ashraf, M.D., FACS, notes, “Just like the skin, UV light is bad for the eyes. If you wear sunglasses with UV protection, it will help delay the progression of cataracts. UV light exposure may also be one of the factors in macular degeneration. So just like you wear sunscreen, be sure to wear sunglasses.”

According to the National Eye Institute (NEI), some people are at higher risk for developing glaucoma than others. These individuals include people with a family history of the disease, people over the age of 60 (especially Mexican Americans) and African Americans older than 40. If you fall into one of these high-risk groups, have a comprehensive eye exam, including dilation, every two years.


Surgery SURGICAL SOLUTIONS

According to the National Eye Institute (NEI), there are two types of cataract surgery. Today, most patients undergo Phacoemulsification, which is also known as small incision cataract surgery. During this procedure, the surgeon makes a small incision on the side of cornea, inserts a probe into the eye that emits ultrasound waves that soften and break up the cloudy lens and finally uses suction to remove the lens. Another option is extracapsular surgery, which involves the doctor making a longer incision on the side of the cornea and removing the cloudy core of the lens in one piece. The rest of the lens is then removed by suction. When considering cataract surgery, be sure to discuss both options with your doctor so you can make the right decision based on your individual needs.


HEALTHY DIET, HEALTHY EYES

You’ve heard the age-old adage that carrots are good for your eyes. Well, it’s true. They are a great source of Vitamin A (just like spinach, mango and kale), which has been shown to improve eye health. You should also be sure to get a good dose of the following to keep your eyes in top shape:
• Vitamin C (papaya, green bell pepper, broccoli, sweet potato)
• Vitamin E (almonds, turnip greens, peanuts)
• Selenium and Zinc (tuna, beef, chicken, oatmeal, eggs)
EyecareSource.com