As we age, our sight deteriorates steadily and almost everyone over the age of 60 years uses spectacles. There are also certain diseases which affect the vision in old age. With regular sight tests, suitable spectacles, surgery, drugs and special visual aids, most people can maintain a good sight and lead a full and independent life.

Regular sight tests

A sight test is not just a ‘spectacles’ test but a check-up of the health of one’s eyes. If one has developed a new eye disease, it can be detected early. It is therefore very important to get the sight tested regularly. It is recommended that one should have a sight test done at least once every two years and more frequently if one notices any change in one’s vision. Sight test is a specialized test and is carried out by ophthalmologists (doctors specializing in eye care) or optometrists (ophthalmic opticians). If one’s sight test reveals any abnormality that needs further treatment and investigation, it is important to consult one’s family doctor.

Spectacles and other low-vision aids

It is always advisable to use made-to-order spectacles which suit one’s needs best. Now-a- days ready-made reading spectacles are also available. Though it is unlikely that they will harm one’s eyes, using ready-made spectacles can result in eye strain and headaches. Remember to keep one’s spectacles clean. Never place spectacles with the front of the lens facing down on a surface which may cause scratches. Scratched lenses can cause glare and reduce clear vision.

Magnifiers make things look bigger so that one can perform tasks one otherwise finds difficult because one’s eyesight has deteriorated. Adequate lighting

The amount of light the eyes need at 60 years of age is about three times more than that required at 20 years. Natural daylight must be allowed to enter one’s home unhindered. One should also ensure that one has adequate electric lighting, particularly at the top and bottom of stairs. For reading or close work, make sure that one has direct light coming from behind on to one’s book or work. Fluorescent lamps are particularly efficient as they produce a lot of light but very little heat.

Reasons for sight deteriorating further

Some eye conditions cause the vision to deteriorate further in older people so that they have difficulty seeing even with spectacles. These are:

Cataract

This is a condition where one’s lens, which is normally transparent, becomes opaque. It produces gradual, painless deterioration of eyesight. Initially one may overcome the problem with glasses but eventually everyone would require surgery. Cataract surgery involves removal of the opaque lens. Vision can be restored by the implantation of a plastic intra-ocular (inside the eye) lens in its place or providing spectacles.

Diabetic retinopathy

Diabetics are prone to develop changes in the retina that can impair eyesight. The changes are usually irreversible. Now-a-days further deterioration of vision can be prevented by laser treatment if the condition is detected early. Apart from ensuring a strict control of blood sugar it is essential that every diabetic must have a detailed eye examination by a qualified ophthalmologist every year.

Glaucoma

Glaucoma is another cause of irreversible loss of vision in which the pressure inside the eye increases. Early detention and timely intervention is important. All individuals who have a family history of glaucoma and are above the age of 40 years should be screened for glaucoma at regular intervals.

Age-related macular degeneration

Macula is the centre of vision on the retina. Age-related degeneration of the macula produces progressive loss of vision which can sometimes be rapid and severe. In certain cases laser therapy is required and is of some help. In others, spectacles, low-vision aids, a healthy diet of fresh fruit and vegetables, avoidance of direct exposure to sunlight and supplementation of vitamins and minerals are helpful.

Some of these diseases respond to treatment. Even if the treatment is ineffective or unavailable, much can be done to help people use their remaining sight. Only a small proportion of people cannot see at all; even people who are registered blind often retain some vision. People with impaired vision can often learn how to get around safely, both indoors and outdoors, so that they can continue to shop, cook and run their homes as well as participate in leisure and social activities. If one’s sight has deteriorated, it is important that one maximizes the amount of light in one’s home and one may find low-vision aids particularly helpful.