The first infants born in 1946 turned 68 this year. And their fellow baby boomers — born between 1946 and 1964 — also have reached a time in life where they are susceptible to age-related eye diseases.
Because this is a large population, more incidences of such diseases are showing up at doctors' offices. With age comes wisdom, but it also brings less pleasant outcomes such as presbyopia, macular degeneration and diabetic retinopathy.
Some medical problems that may put people at high risk —such as diabetes, hypertension, and high cholesterol — can affect the eye, because the eye is an organ like any other organ in the body.
The eye has a high density of blood vessels and is particularly susceptible to changes in blood pressure or blood sugar that can damage the eye.
From ages 40 to 65, patients should have a complete eye exam every two to four years Over age 65, an exam every one to two years.
Children's eyes are getting more attention. Pediatricians do eye screening during school exams, and school nurses are taught to screen.
Eye exams sometimes catch more than eye problems. They can spot possible illnesses.
“Sometimes through screening the eyes, we pick up signs of an underlying medical problem affecting the eye such as blood pressure, diabetes, cancer,” Ingvoldstad said.
“The eye has been called 'the window to the body,'” he said. “Inside the eye is the only place in the body that we as physicians can examine blood vessels and nerve tissue in real time without doing a biopsy or X-ray.”
— Judy Horan
The good news is that research is keeping up, developing treatment for many of those diseases.
In a few years, there probably will be an approved procedure for the treatment of presbyopia, said Dr. Harold Bares of Eye Specialists in Bellevue. If you are reaching for reading glasses right now, you know what we're talking about.
The new surgical procedure would implant a device in the cornea of the non-dominant eye, increasing the ability to read without glasses.
“As we are blessed with a few birthdays, our human lens stiffens to the point where we need to have supplemental reading help,” Bares said in describing presbyopia.
Current treatment for presbyopia is either bifocal reading glasses or bifocal contact lens.
“Macular degeneration is a hot topic right now and specifically the 'wet' type of the chronic eye disease,” said Dr. David Ingvoldstad of Midwest Eye Care.
“This is a condition that not long ago had few treatments available,” he said. “Within the last 10 years, treatments have become available that can significantly slow or stop the disease progression.”
Eylea and Lucentis are new FDA-approved medications that are injected into the eye.
“A third, Avastin, has not been approved for this use, but it has been shown to be safe and effective,” Ingvoldstad said.
The medications cannot cure, but can stop or slow down progression of wet macular degeneration in the majority of cases. Laser treatments have been used as an adjunct to injection, “but the gold standard is injections,” he said.
Macular degeneration is usually linked to aging. But some types affect young people.
An infectious disease called histoplasmosis that occurs in areas such as the Missouri Valley, which includes Omaha-Council Bluffs, can eventually cause retinal problems for children.
“It can be passed from mom to child in utero,” Bares said. “The individual gets this bug harbored in the retina when born.“
The subsequent retinal problem can activate at any time in life to create a type of macular degeneration. Watch for decreased vision as an indicator that something could be wrong.
Bares said patients now show up at their doctor's office each month for injections of drugs to treat retinal problems such as macular degeneration. In the near future, they might be able to cut back those doctor visits to every six months or one year with improved medication.
Ingvoldstad notes another recent discovery that has received attention.
“A telescopic implant that can help patients with macular degeneration is essentially a low-vision aid for patients who lost central vision. It can be effective for some patients, but not all.”
Patients taking better care of their eyesight has led to fewer problems.
“We're not seeing types of work-related injuries that I saw 20 years ago because of better safety awareness and protection,” Bares said.
“We're seeing less severe diabetic retinopathy. It's standard now for primary care physicians to routinely send newly diagnosed patients to eye specialists.”
Diabetes is one of the leading causes of preventable blindness in the country. If the condition is caught early, it's almost always treatable.
“Genetics and the length of time somebody has diabetes predisposes to eye trouble,” Bares said. “Even with good control, people can lose their eyesight to diabetic retinopathy.”
Science-fiction fans will be intrigued by a new “bionic eye.” In the past year, the FDA approved Argus 2, a retinal prosthesis that is implanted in the eye.
“Argus 2 is basically an electronic eye for patients with severe retinitis pigmentosa,” said Ingvoldstad. “It acts like a camera and helps to stimulate the eye to function.”
The retinal prosthesis might help patients with essentially no vision see large shapes and movement. The effectiveness of Argus 2 for the rare, hereditary eye disease is still to be determined.
“It's a first step toward artificial vision, and it is exciting because, though not now useful for the general public, it will get better in the future so that one day it will increase options for patients who have lost their vision.”
“We get a lot of people asking about it,” Ingvoldstad said. “It's exciting. It's cool technology. But it's not yet ready for prime time.”