Common Eye Problems In Older Adults

November 7, 2022

Filed in: {Home Safety}

Snellen Eye Chart and common eye problems in older adults
Janet Engel, OT/L, CAPS

Vision changes is one of the first declines we experience with the onset of aging. Visual impairment can occur as early as 35-40 years of age.

The best way to ward off more serious eye problems is through early detection by a doctor. Visual impairment accounts for one out of the four leading causes for falls in older adults.

The other 3 causes are taking medications incorrectly, hazards in your home, and decreased strength/muscle weakness.

Falls are the leading cause for hospitalizations and death in people 65 and older. Therefore, it is paramount that we as a society take the necessary steps to address these 4 factors.

This article will focus on common eye diseases in older adults.

How Does Age Affect Color Perception?

As we age, it’s not uncommon for our color perception to change. This is usually due to a reduction in the number of cones in the retina, which are responsible for color vision.

As a result, you may find it more difficult to distinguish between certain colors, and they may appear duller than before.

What Colors Are Harder For Older People?

One common change that happens with age is that people have a harder time seeing colors.

This is because the retina (the back part of the eye) gets thinner and less sensitive to light as we age.

As a result, older people often have trouble distinguishing between certain colors, especially blues and greens.

Do Color Preferences Change With Age?

Older people tend to prefer warmer hues as opposed to cool tones.

Monochromatic designs are more difficult for the aging eye to discern as are pale colors, especially in the blue and green tones.

  1. Chrome and nickel finishes blend into the background, especially against light
    colored tile or countertops
  2. Gray is more difficult for the aging eye to see. Gray is an achromatic color
    without hue. It is between black and white.
  3. Warm hues such as gold, red, and orange can be mixed with achromatic grays,
    turning them into a chromatic gray which is more visible to the aging eye or for
    individuals with low vision.
  4. Aging eyes lose the ability to discriminate pale colors, making yellows and other
    pastels appear white. They are also unable to differentiate shades of blue, green,
    and purple as these colors can read gray.
  5. Researchers have long known that vision can deteriorate as people get older. The
    lenses of their eyes yellow causing them to see as if they were looking through a
    yellow filter.

What Is Figure-Ground?

When we look at an object, our brain is constantly trying to figure out what it is and where it is, in relation to everything else around it.

This process is known as figure-ground. Figure-ground perception is when 2 areas in a person’s visual field share a border.

Figure-ground is one of the Gestalt Principles of Perception, which states that “our minds will tend to group together similar objects or elements into patterns or wholes.”

This Principle helps us to see the world in a way that makes sense and is easy to understand.

How Does Figure-Ground Affect What We See?

Figure-Ground Perception And Relationship

One of the first cognitive functions to develop in young babies is figure-ground perception.

Figure ground perception is where the brain takes information from the environment such as color, motion cues, and shape to register an object and distinguish the figure from the background.

This skill has evolutionary benefits including finding food, recognizing faces such as familiar humans. and recognizing a threat in the environment.

Figure-Ground Concept

Figure-Ground Concept is a cognitive function that allows a person to direct their attention to the figure rather than its background.”

For example, when I look at black font on white paper it grabs my eye much more so than if there were no contrast between these two colors and shapes; (such as green words against blue paper) because the colors are too similar.

How Does Inhibition Change As We Age?

The decline in inhibition that occurs with age can make staying on topic more difficult for older adults than for younger people.

Research indicates that a decline in inhibition also affects visual perception, meaning an older person will take longer to see and process everything around them because these mental capabilities start slowing down as we age.

Visual perception is influenced not only by what we see but also the alternatives that our brain considers.

The process of visualizing objects in space requires more than just eye movement–it involves inhibiting other thoughts or ideas while focusing on one object at a time, a process that declines with age.

“With regard to vision, age-related declines in the efficiency of inhibitory processes have been demonstrated in research involving simple perception tasks, such as the ability to detect symmetry and discriminate between shapes.”

However, sometimes our brain can trick us into seeing things that aren’t really there. This is because our brains are constantly trying to fill in the gaps and make sense of what we’re seeing.

Optical illusions are a good example of how figure ground can trick our brains.

“This is particularly interesting as it suggests that distraction is being processed extremely rapidly, and without conscious awareness, but that older adults are less able to tolerate this ambiguity than younger adults,” said Anderson of York University.

“This research may have practical importance for how perception changes with age as well, particularly in situations of low visibility, possibly fog, bad lighting, or poor contrast — when the identity of shapes is harder to discern.”

The researchers believe that age-related inhibitory deficits are due to reduced functioning of GABA neurotransmitters in the brain.

GABA neurotransmitters help control fear and anxiety when neurons become overexcited (stressful situations). However more research needs to be done in this area in order to come to a sound conclusion.

Best Colors For The Aging Eye

As we age, our eyesight changes. We may not be able to see as clearly or as vividly as we did when we were younger.

Colors may seem duller, and it can be harder to distinguish between similar colors.

There are a few ways to make the most of our aging eyesight. One is by choosing colors that are easier for the aging eye to see.

Some good colors to consider include:

-Bright, bold colors

-High-contrast colors

-Colors with a lot of red, gold, or orange (these colors are easier for the aging eye to distinguish) due to the natural yellowing of the lens as we age).

Using Contrast In Your Design Can Help Reduce Falls

Did you know that using contrast in your design can help reduce falls? It’s true! Contrasting colors can help make obstacles more visible, making it less likely that someone will trip and fall.

Color contrast can also help us function better in our home, which is a key part of maintaining independence as we age and with our activities of daily living (ADL’s) such as bathing, dressing, grooming, and most importantly toilet hygiene!

So next time you’re designing a space, keep contrast in mind! It could end up making a big difference in safety and function.

Colors can also significantly impact moods, and choosing the right scheme can go a long way in keeping you or someone you care for comfortable and happy in their space.

As we age, our eyesight usually deteriorates. This is due to the natural aging process and is not usually a cause for concern.

However, there are some eye problems that are more common in older adults and can lead to serious vision impairment if left untreated.

Common Diseases of The Eye In Older Adults

Blind Spots

One of the things that can happen as we age is that our blind spots can start to enlarge.

Our blind spot is the area on the retina without receptors that send visual information to the brain. We usually don’t notice our blind spot because our eyes will automatically move to fill in the missing information.

However, as we age, the cells in the retina can start to break down and this can cause our blind spots to get bigger.

If you have ever noticed a “shadow” in your vision, it is likely due to an enlarged blind spot. Laser treatment can help to shrink enlarged blind spots.

While an enlarged blind spot itself is not dangerous, it can be a sign of other age-related eye conditions such as macular degeneration or glaucoma.

If you notice any changes in your vision, be sure to see an eye doctor for a comprehensive eye exam.

Refractive Errors

Refractive errors are the most common type of eye problem and occur when the eye is unable to focus light correctly.

This can be due to the shape of the eye, aging, or other factors. Common symptoms of refractive errors include blurry vision, difficulty reading, and headaches.

If you think you may have a refractive error, be sure to see an eye doctor for a comprehensive eye exam.

Cataracts

The most common eye problem in older adults is cataracts. A cataract is a clouding of the eye’s lens, which leads to blurred vision.

The formation of cataracts is usually gradual. Cataract surgery is a common and effective treatment.

Macular Degeneration

Age-related macular degeneration (AMD) is another common eye problem in older adults.

AMD is a deterioration of the central part of the retina, which leads to loss of central vision. AMD is a leading cause of blindness in older adults.

Early stages of macular degeneration may not cause any symptoms, but the condition can progress and lead to vision loss.

Glaucoma

Glaucoma is another common eye problem in older adults. It leads to a loss of peripheral vision.

Open-angle glaucoma is the most common type of glaucoma. It occurs when the drainage system of the eye becomes clogged.

This leads to a build-up of pressure in the eye, which can damage the optic nerve and lead to vision loss.

Glaucoma can be treated with medication or surgery. Some risk factors for glaucoma include age, family history of glaucoma, diabetes, and high blood pressure.

Dry Eyes

Dry eye is a common problem in older adults. Dry eye occurs when the eyes do not produce enough tears. This can lead to irritation, redness, and blurred vision.

One chronic condition that can lead to dry eyes is Sjögren’s syndrome.

Presbyopia

Presbyopia is a common eye problem in older adults. Presbyopia is the loss of ability to focus on close objects.

This can make it difficult to read small print or do other close work. Presbyopia can be treated with eyeglasses, contact lenses, or surgery.

It is important to have regular eye exams after the age of 40.

Flashers And Floaters

Flashers and floaters are common in older adults. Flashers are brief flashes of light that appear in the field of vision.

Floaters are small spots that float in the field of vision. Both flashers and floaters are usually harmless.

Treatment for flashers and floaters typically is not necessary.

However, if you experience sudden onset of flashers or floaters, you should see an eye doctor right away, as this could be a sign of a more serious problem.

Tearing Or Watery Eyes

Tearing is a common problem in older adults. Tearing can be caused by dry eyes, wind, dust, or other irritants.

Treatment for tearing typically involves using artificial tears or eye drops to lubricate the eyes. In some cases, surgery may be necessary to correct a problem with the tear ducts.

Diabetic Retinopathy

Diabetes related retinopathy is a common problem in older adults. Retinopathy can be caused by high blood sugar levels, which damage the blood vessels in the retina.

Treatment for retinopathy typically involves regular monitoring of blood sugar levels and treatment with laser surgery or injections of anti-VEGF agents.

In some cases, a vitrectomy may be necessary to remove damaged blood vessels from the retina. African-Americans and Hispanics are at a higher risk for diabetes.

If you have the diagnosis of diabetes, it is important to have an ophthalmologist check your eye health regularly.

Retinal Detachment

Retinal detachment is a serious condition that can lead to blindness. The retina is the layer of tissue at the back of the eye that allows us to see.

When the retina detaches, it is no longer able to function properly. A comprehensive eye exam by an ophthalmologist is needed to make this diagnosis.

If treated with surgery in the acute stage, complete vision may be restored. If left untreated for more than a few days, it may result in permanent vision loss.

Yellowing of The Lens

“As part of the normal process of aging, the human lens becomes progressively more yellow and fluorescent, leading to a concomitant increase in light absorption in the 300–500 nm range, and thus diminishes our perception of violet and blue light.”

Because there is little or no protein turnover in the lens nucleus the proteins are as old as the individual.

Nuclear cataract is characterized by a browning of the lens nucleus and significant oxidation. This is why a silver car may appear brown to an older person.

Stiffening Of The Lens

We all know that as we age our bodies change drastically.

Over time, our skin loses its elasticity, hearing begins to decline, hair greys and thins, organ function declines, bones and joints become brittle and stiff and many other physical elements change both externally and internally.

It’s easy to see when a person is aging from the outside, but what about the changes we can’t necessarily see or feel, like those that take place in the eyes?

Unbeknownst to most people, our eyes actually begin a process of change fairly early on in adulthood.

Similarly to other organs, the eyes tend to peak in function around age 30 before beginning a slow and gradual decline into old age.

Physically, the lenses of the eyes tend to stiffen and become denser, making it more difficult to see in low light situations or focus like they used to.

The muscles of the pupil react more slowly to changes in exposure, and the nerve cells of the eye deteriorate and decrease in number.

The eye also tends to produce less fluid as a person ages, sometimes leading to irritation and dryness.

Generally, most people begin to notice these changes to their eyes as their vision becomes slightly less clear over time.

Often, people find themselves requiring more light than usual, having more difficulty distinguishing colors, or struggling to read text close up (often leading them to reach for “readers”).

These changes may become apparent to the individual as early as the age of 35.

Color Vision Problems

Tasks that rely on color vision can include distinguishing among pill colors, finding a car in a parking lot and even matching clothes colors.

Mismatched clothes could give the impression of a cognitive disability rather than a vision one.

While color-vision abnormalities were uncommon in people younger than 70, they were present in about 45 percent of people in their mid-70s, up to 50 percent of those 85 and older, and nearly two-thirds of those in their mid-90s.

Nearly 80 percent of the abnormalities involved confusion of lighter shades of blue versus purple and yellow versus green.

The researchers say that the new results confirm previous studies showing that color vision deteriorates measurably with aging and that most subtle aging-related color vision abnormalities are likely to go unnoticed if testing isn’t done.

Factors that may contribute to changes in color vision with aging, and to blue-yellow recognition especially include:

  1. Reduced pupil size which allows less light into the eye
  2. Increased yellowing of the lens inside the eye
  3. Increased rates of eye diseases
  4. Changes in the sensitivity of the vision pathways

The study was published in Optometry and Vision Science, the Journal of the American Academy of Optometry.

These are just a few of the most common eye problems in older adults. If you are experiencing any changes in your vision, it is important to see an eye doctor for a comprehensive assessment. Addressing your eye health appropriately will help you or loved one prevent a fall and continue to have quality of life well into your golden years!

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