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The Times
  • Eye health: A lifelong endeavor

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  • January is Glaucoma Awareness Month, but a lifetime of good vision for our most precious sense demands year-round attention because every stage of life poses different challenges. Let’s look at each stage.
    Infants and children
    Vision in early life is continually developing, so eye care is critical to identify and treat such issues as strabismus (both eyes not focusing on the same point) and amblyopia (“lazy eye,” where one is weaker than the other). Although less common, children may also suffer from glaucoma, cataracts and rare eye diseases.
    Children are also susceptible to eye injuries from seemingly harmless toys or fireworks, but proper vigilance by parents can avoid most childhood injuries. Regular screening at this stage is the key to prompt diagnosis and treatment and crucial to ensure normal visual function throughout life.
    Teenagers
    Young adults are at risk for sports-related injuries, with most occurring in basketball, baseball and racquet sports, and workplace injuries, which can happen at any age. Protective eye equipment can prevent 90 percent of these injuries, but a recent survey by the American Academy of Ophthalmology found that such equipment is worn only 35 percent of the time during high-risk activities.
    Poor choices can also lead to injury. Contact lens use without the supervision of an eye specialist is too common among young adults. Each year many serious infections are caused by using decorative or cosmetic contact lenses without a prescription.
    Contact lenses should be worn only as prescribed by an eye doctor, and regular eye exams are a must.
    Adults
    Adults 40 to 60 years are guaranteed to develop presbyopia (or “short-arm syndrome”), a progressive loss of ability to see objects up close, resulting in a tendency to hold material further away. Reading glasses that magnify, used when the arm isn’t long enough, don’t work for everyone, so prescription glasses may be required. An exam every two years can determine the need for prescription glasses, as well screen for eye diseases that can become prevalent over the next two decades.
    Conditions beginning in one’s 40s or 50s — notably diabetes — can affect eye health later. Diabetes, which affects 26 million people in the U.S., is the most common disorder leading to vision loss in those under 65.
    Maintaining good blood sugar control is the single most important factor to prevent diabetic eye disease. A yearly diabetic eye examination can screen for this condition, monitor progression and initiate treatment, if needed.
    Seniors
    The majority of patients I examine as an ophthalmologist are in their 70s and beyond, and their biggest complaints are blurred vision, difficulty driving at night, or poor vision despite several recent changes in glasses. My examinations often reveal the presence of one of three eye diseases.
    Cataracts, a clouding of the eye’s lens responsible for focusing, are an inescapable part of aging that can dramatically impair vision. Medications and many diseases can also lead to cataracts — and at any age. An examination by a medical eye doctor is necessary to determine the cause and how to treat it. If glasses no longer help, surgery can restore function.
    Page 2 of 2 - Age-related macular degeneration, progressive loss of central vision, is the most common cause of blindness in the U.S. for individuals over 65. The complaints are often indistinguishable from those of cataracts. Numerous studies have established a genetic link to this condition, so people with a family history of AMD should undergo routine examinations beginning in their 50s.
    Studies have also shown that consuming antioxidants (natural substances existing as vitamins, minerals and other compounds in foods such as fruits, vegetables and whole grains) can be beneficial in AMD, as well as quitting smoking. Continued care under the observation of an eye doctor will ensure the best possible outcome.
    The risk for glaucoma, a group of diseases that damage the optic nerve, increases with age. Like AMD, genetics play a role, and those with a family history of glaucoma should have regular eye examinations, again beginning in their 50s. There are no symptoms for this condition; it is nearly always diagnosed during a screening examination.
    Many diseases and commonly prescribed drugs can raise the risk of glaucoma, so those on medications, with a known association, should consult with a medical eye doctor for guidance.
    Eye health is a lifelong endeavor, and eyesight is too precious to risk. At every stage of your life the decisions you make will affect your vision, so frequent screenings are important to detect any problems.
    To help guide you, visit the AAO, the Eye M.D. Association, at www.geteyesmart.org.
    Jeffrey Gallo, M.D., is president of the Massachusetts Society of Eye Physicians and Surgeons.
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