Vision Loss

WHEN TO SEE YOUR DOCTOR

* Any degree of vision loss should be seen by a doctor.

What Your Symptom Is Telling You

For many of us, wearing glasses or contacts to correct less-than-perfect vision is as much a part of our everyday wardrobe as underwear.

More than ten million Americans, however, have some degree of visual impairment that can't be completely corrected with glasses.

The list of sight stealers is long and varied, with Father Time at the head of the list. As the years pass, the lens inside the eyes can gradually thicken and become opaque with cataracts, leading to cloudy spots, blurriness, blinding halos around lights and poor night vision.

Time can also take a toll on the macula—the part of the eye responsible for straight-ahead vision. In fact, a lifetime of sun exposure and other factors that break down the blood vessels and tissues that nourish the macula is responsible for most vision loss that occurs past age 60. This wear-and-tear process—called macular degeneration—gradually shrivels the macula and affects the straight-ahead vision needed to see fine detail. People with macular degeneration often find that words look broken and bunched up. Blank holes appear on street signs and in the fine print on food labels. Straight-lined objects like door frames take on a wavy, warped look.

Other causes of vision loss include tears in the retina and eye diseases such as glaucoma and diabetic retinopathy. In glaucoma, fluid builds up inside the eyes, and the increasing pressure damages the optic (eye) nerves. Diabetic retinopathy is a complication of diabetes that damages the blood vessels in the retina.

A sudden and often temporary loss of vision may occur from an injury to the eye, a stroke or even a migraine headache.

Symptom Relief

Once your ophthalmologist has diagnosed your vision problem and prescribed treatment, here's what you can do to make the most of your remaining vision.

Shed lots of light on the subject. "An ideal reading lamp should have a 60- to 100-watt coated light bulb to reduce glare enclosed in a reflective interior to intensify the light," says Amalia Miranda, M.D., director of the Low Vision Clinic and clinical instructor of ophthalmology at the Oklahoma University Health Sciences Center in Oklahoma City. High-intensity halogen lights are super bright but also hot. It's better to use them with a dimmer adjustment, she says.

Bring the world closer. Magnifiers in all shapes, sizes and strengths can restore your ability to read and enjoy your surroundings, according to Eleanor Faye, M.D., an ophthalmologic surgeon at the Manhattan Eye, Ear and Throat Hospital. A hand-held magnifier, for example, can help you read books and food labels. And special glasses with built-in telescopic-type lenses can help you read street signs or watch your grandson make a touchdown.

Blow up your books. If you can afford the investment, a special closed-circuit TV (read/write machine) can magnify your books on a TV screen up to 60 times their normal size. Large-print publications and books on tape are cheaper alternatives. A simple, yellow plastic sheet over a book page can make words pop up and give contrast, according to Lorraine Marchi, founder and executive director of the National Association for Visually Handicapped (NAVH) in New York City. Other useful low-vision aids include large telephone dials and high-contrast watch faces. For more information about these products, write to NAVH, 22 West 21st Street, New York, NY 10010.

Sight Preservers

The following sight-sparing measures may help slow, reverse or perhaps even halt vision loss.

Become a fruit-and-vegetable fan. "Before I began advising patients about proper nutrition, I was only doing half my job in helping them keep their eyes healthy," says Dr. Faye. Her advice: Eat fruits, vegetables and other foods rich in zinc and vitamins C, E and A and beta-carotene (it converts to A in the body). "Ample evidence shows that these so-called antioxidants may counteract the sun-related oxygen damage to the eye's cells and slow down age-related vision loss," says Dr. Faye.

Consider supplements for the eyes. For good measure, take a commercial eye supplement featuring the prime antioxidants mentioned above. "My patients report improved well-being after taking these nutrients and many demonstrated improved vision," says Dr. Faye. Preliminary studies confirm her findings. In a study from the University of Utah, for example, researchers gave daily doses of antioxidant supplements to 192 people with macular degeneration. Another 61 people received no treatment. After six months, a third of the first group scored better on vision tests. Other studies show cataract risk is also reduced in multivitamin users.

Wear blue blockers and a sombrero. Amber-tinted sunglasses may help block out blue light, a component of sunlight that may contribute to age-related vision loss over prolonged periods, says Dr. Miranda. These sunglasses reduce glare and improve contrast, while offering protection from the harmful ultraviolet (UV) rays of the sun, she says. Top your head with a wide-brimmed hat and you have good protection from sun damage to eyes.

Quit smoking. Researchers from Harvard Medical School found that compared with people who never smoked, people who smoke 20 or more cigarettes per day had about twice the risk of cataracts.

Watch for wavy doorways. One way to keep alert to any vision loss from macular degeneration is to regularly test yourself by looking at straight-line objects such as window frames, says Matthew Farber, M.D., an ophthalmologist in private practice in Fort Wayne, Indiana. Let your doctor know if any lines appear distorted, wavy, faded, missing or shimmery, as if seen through heat waves on a highway.

Don't delay—remove the haze. If cataracts are interfering with your vision, a surgeon can remove the cloudy lens. Clear vision is then possible with the help of a lens implant or special glasses or contacts. Your eyes will remain sun-sensitive, however. "For people who have had cataract surgery, blue-blocking sunglasses and a wide-brimmed hat are recommended," says Dr. Miranda. The latest implants have a special coating to protect against UV rays.

Look into laser surgery. Ultra-powerful high-beam laser light can seal or dissolve eye tissues and halt certain disease-caused vision loss, according to Dr. Faye. In the case of macular degeneration, a laser can sometimes repair leaking areas of the macula. This allows the retina to heal and can slow down the disease, says Dr. Faye. In some types of glaucoma, lasers can make small openings in the iris to relieve built-up pressure.

Winning against Glaucoma

Early on, glaucoma doesn't have any symptoms, but as optic nerve damage progresses, peripheral vision gets blanked out, making it seem as though you're looking through a tube. Besides laser surgery, here's more ammunition for controlling glaucoma.

Get an annual eye exam after age 35. This is especially important if glaucoma runs in your family or if you're nearsighted or have diabetes. It's also important for black people, who are more susceptible to glaucoma.

Make eyedrops a daily habit. If you have glaucoma, you'll need to take eye-pressure-controlling medicine faithfully and correctly, says James McGroarty, M.D., associate clinical professor of ophthalmology at State University of New York Health Sciences Center in Brooklyn. Each time you insert the drops, close your eye for 60 seconds. That way you won't lose any of the medicine.

Jump on your two-wheeler. Drops are the traditional way to control glaucoma. But studies show that when people with raised eye pressure used a stationary bike for 30 minutes three times weekly for ten weeks, they reduced their eye pressure. In fact, the exercise worked as well as anti-glaucoma drugs. "Elevated eye pressure in glaucoma is similar to high blood pressure in heart disease," says Linn Goldberg, M.D., associate professor of medicine at the Oregon Health Sciences University in Portland."If you control the pressure, you can in many instances help prevent or control the disease."

Follow-up studies showed that the exercise effects were long-lasting, but that the pressure went back up to former levels once the exercise stopped. Do not stop taking anti-glaucoma medications on your own, warns Dr. Goldberg. If you want to try exercise as an alternative, you'll need to work with your doctor to create a program suitable for you and to monitor the pressure in your eyes, he says.