Have you had your eyes checked lately? Everyone — especially those over age 60 — needs a yearly eye exam. These important checkups evaluate eye health and help catch serious problems early, when they are most treatable. Experts at the Department of Ophthalmology for the North Shore-LIJ Health System offer specialized care in eye diseases and disorders. The following are three of the most common age-related eye problems.
Chronic dry eyes, caused by a lack of tears, can cause burning, stinging and irritated eyes. Dry eyes can develop naturally over the years, but some factors can aggravate the condition, like long-term contact lens wear, smoking, allergies, antidepressant medicines, prolonged computer use and even plastic surgery.
“Dry eyes can result in some vision loss in a small percentage of sufferers. But for most, it’s a tremendous annoyance that can greatly affect quality of life,” said Ira Udell, MD, chairman of ophthalmology for North Shore University Hospital and LIJ Medical Center.
Treatment for dry eyes primarily includes the use of over-the-counter artificial tears. “If artificial tears don’t provide relief, see an ophthalmologist or cornea specialist,” advised Dr. Udell. “There are other treatment options available, such as prescription eye drops, punctal closure [a permanent or temporary procedure that restricts the amount of natural tears that drain away from your eyes], oral agents [over the counter and prescription] and in some cases topical steroids. Promising new prescription drops in clinical trials hold potential for dry eye sufferers in the future.”
Sometimes called eyesight’s “thief in the night,” glaucoma is the leading cause of blindness in the United States. Glaucoma is a chronic disease that often requires lifelong treatment to control. According to the National Eye Institute, about 2.2 million Americans have been diagnosed with glaucoma, and another two million do not know they have it. It has no early symptoms and can sometimes lead to complete loss of eyesight within months. The disease occurs when the optic nerve is damaged by increased fluid pressure inside the eye.
There are a host of therapies that can help delay or prevent vision loss once glaucoma is diagnosed. Some used by North Shore-LIJ’s Department of Ophthalmology include medications, minimally invasive procedures to lower intraocular pressure and a new laser treatment called selective laser trabeculoplasty (SLT) that may work by repopulating the cells in the eye that are involved in draining fluid.
“People are living longer, and we’re finding out we have to take better care of ourselves in the process,” said Arnold Prywes, MD, ophthalmologist and chief of North Shore-LIJ’s glaucoma service. “We can delay vision loss by decades by getting screened for signs of glaucoma and starting treatment soon after a glaucoma diagnosis.”
Age-related macular degeneration (AMD) is the leading cause of vision loss among Americans ages 60 and older. It affects cells in the macula — the part of the retina responsible for sharp central vision.
“There are two forms of macular degeneration — wet and dry. The wet form accounts for only 10 percent of cases. But it leads to 90 percent of AMD-related vision loss,” explained Vincent Deramo, MD, retinal specialist for the North Shore-LIJ Health System. “The dry form, by far the most common, usually progresses very slowly.”
Dry macular degeneration occurs when the macula gradually thins. Eventually, this can reduce vision. But there are ways to stave off the deterioration. Patients with dry AMD are encouraged by Dr. Deramo and other retina specialists to take the National Eye Institute’s Age-Related Eye Disease Study (AREDS) formulation of vitamins. These vitamins are proven to help slow vision loss in people with moderate AMD by up to 25 percent.
Wet AMD occurs when blood vessels begin to grow under the retina. Therapy for wet AMD involves injections of new biologic drugs into the eye. The treatment takes only minutes in the ophthalmologist’s office.
“These new options offer tremendous success in improving or stabilizing vision that we’ve never had before," said Dr. Deramo. “It’s game changing.”
Marcus Wittenberg, age 87, calls these biologic drugs “a gift.” Mr. Wittenberg was diagnosed more than 20 years ago with dry macular degeneration in his left eye. But in later years, it turned to the wet — and more devastating — form of the disease. The condition caused dramatic and almost total loss of sight in his left eye. As a result, Mr. Wittenberg relied on his right eye to perform everyday tasks.
A few months ago, however, Mr. Wittenberg noticed that vision in his “good” eye was becoming blurry and he had to strain when reading or watching television. He consulted Jeffrey Shakin, MD, a retinal specialist who is a partner of Dr. Deramo. “he performed a miracle” “I was extremely worried,” remembers Mr. Wittenberg. “I thought it would limit life’s activities. And without clear sight in my one remaining eye, I would lose my independence.”
Mr. Wittenberg had developed the wet form of macular degeneration in his right eye, which caused his quickly deteriorating vision. To treat the problem, Dr. Shakin performed a painless injection of a new biologic drug into Mr. Wittenberg’s eye.
“In the past, there was nothing we could do to help most patients like Mr. Wittenberg. He would have lost all of his central vision and only have side vision remaining,” explained Dr. Shakin. “We are very excited about these injections, which are effective, painless and very safe. The medication prevents blood vessels behind the retina from growing and causes them to shrivel up and regress.”
After the injection, Mr. Wittenberg quickly noticed a difference in his vision. “I woke up the next morning and could actually read a magazine. I called Dr. Shakin and told him that he performed a miracle.”
Although not all patients have as dramatic a response, a second injection helped to correct lingering vision problems in Mr. Wittenberg’s right eye. Today, he can participate in all the activities he did before the procedure. “It literally gave me back my eyesight,” he said.
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