June is Cataract Awareness Month, but many eyecare experts say the top three vision issues for older adults are cataracts, glaucoma and age-related macular degeneration.

The good news? Dramatic advances in surgical techniques and materials plus greater understanding of vision health mean there’s much that can be done to restore and preserve vision for all three health issues.

We reached out to Michelle Andreoli, MD, a ophthalmologist at Northwestern Medicine, Chicago, and a spokesperson for the American Academy of Ophthalmology, along with other reliable sources to find out more.

Cataracts

When cataracts develop, the lens becomes cloudy, so vision can be blurry, with night vision especially affected. Images can look dull or yellow; it may be hard to distinguish different colors. An estimated 20.5 million Americans age 40 and older have a cataract in one or both eyes, the CDC estimates.

The solution is to remove the eye’s natural lens and replace it with an intraocular lens or IOL—a surgery that more than 6 million Americans have had.

“Cataract surgery as a technique has been similar for 20 plus years,”  Andreoli says, but specifics about the techniques and lens options have evolved to better serve patients’ needs.”

“There are currently several types of implants that did not exist 20 years ago,” she says, including toric lenses to correct astigmatism, multifocal lenses so each eye can focus on distant and far objects and monovision, with one eye corrected to distance and the other for near. (See this guide for a complete rundown of lens options for cataract and other vision issues.)

Glaucoma

Glaucoma involves a problem with excess eye pressure, which can damage the optic nerve. In early stages, it has no symptoms, pointing to the need for regular eye exams. An estimated 4.2 million Americans have glaucoma.

Eye drops to lower pressure or surgery, or a combination of both approaches, are the treatments to stop further damage.

Andreoli says one approach that has gained popularity in those who have glaucoma and cataracts, is combined cataract and glaucoma surgery, or MIGS—minimally invasive glaucoma surgery. The surgeon uses the same small incision to remove the clouded lens and the trapped fluid that increases the eye pressure.

Treatment goals have changed for some, too, Andreoli says. “In the past, getting off [eye] drops was not thought of as a clinical goal.” The thought was, once on the drops, people would take them for life. “Currently, the goal might be for some to get off the drops,” she says.

Age-Related Macular Degeneration

Macular degeneration affects a part of your retina known as the macula; it can rob your vision but have no obvious symptoms. Almost 20 million Americans have it. There’s no cure but there are treatments.

The most common form is dry age-related macular degeneration, affecting 80% of those with the condition. Parts of the macular get thinner and tiny drusen (clumps of protein) grow. Central vision is slowly lost.

“Wet is a progression from dry,” Andreoli says, when new, abnormal blood vessels grow under the retina. These vessels can leak blood or other fluids, leading to macula scarring. Vision loss occurs faster with this form than the dry form.

For dry macular degeneration, observation and special vitamins are recommended, Andreoli says.  The National Eye Institute summarizes the results of the nutritional supplement research. Some develop an advanced form of dry macular degeneration, called geographic atrophy, which can be treated with injections.

For wet, “treatment has always surrounded getting rid of the abnormal leaking blood vessels,” Andreoli says. Medications  delivered through a very slender needle can help; laser surgery is sometimes used. “We are trying to turn wet into dry,” she says. “There has been an evolution in the quality of these injectables in terms of tolerance and effectiveness.”

Other Take-Homes

Whether your vision is impacted or not by these common age-related vision issues, Andreoli has the same advice: Eat a healthy diet, wear sunglasses and don’t smoke.

Get regular eye checkups, since many vision issues don’t have early symptoms but can be picked up with testing, enabling earlier detection and treatments.

Mind The Mental Effects

If you have vision issues, it’s important to take care of your mental health, too, as experts find 1 in 4 of adults affected by vision issues have anxiety or depression.

Andreoli has no disclosures.

Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, MedCentral and other sites.  She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.

Photo of Kathy Doheny: Shaun Newton

This article offered by Senior Planet and Older Adults Technology Services is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. If you think you may have a medical emergency call 911 immediately.