From the moment we first open our eyes, they are aging. We just do not realize it until somewhere between the ages of 35 and 45 when we develop “short arm syndrome”. Seemingly over night, we start moving our cell phones back and forth, jockeying to find a comfortable place to see the screen. Medicine bottle directions seem to shrink to impossibly small, and the printers all conspire to make everything ridiculously tiny. At this point we need a different prescription in our glasses to see clearly far way and close. This is not because the muscles in the eye no longer work, its the lens in the eye aging and getting denser and less flexible. This is called presbyopia. You may notice at first that you can force it to change focus but after prolonged near work it takes several seconds to regain clear distance vision as the lens gets “stuck” in that position. At this point, typically, we will prescribe progressive multifocal lenses or multiple pairs of glasses.
As the lens continues to age, it becomes more dense and begins to become more opaque. It grays gradually just like our hair. The grayer it gets the more difficult it is to see. Its like looking through a dirty window; like in the winter when they salt the roads and the windshields gets grimy. The cloudy lens diffuses the light just like that grime on the windshield. If you are driving into the sun with a dirty windshield, the glare is blinding. The same happens with the opacifying lens, headlights glare and street lights can seem to have halos or spikey rings around them. Just as our hair does not change from gray to white overnight, it takes years for the lens to become completely opaque. At first it may seem like you just need new glasses. When the glare or the vision becomes troublesome making it difficult to drive or read, it is time for cataract surgery, removing the cloudy lens and replacing it with a transparent plastic lens.
The inside of our eye is filled with a collaginous jello-like substance. It is a solid but it is squishy, called the vitreous. Just like the collagen in our skin changes and gravity is slowly sliding my cheeks down my face, the collagen in our vitreous changes and liquifies with age. As the vitreous becomes more and more liquid, you will see pieces of the “jello” floating around and casting shadows on your retina. They usually look like little bugs or hairs that move when you try to look at them. While these floaters are highly annoying, they are usually harmless. If the “jello” is still tightly adhered to the retina, as the support gives away, the jello can pull on the retina causing you to see flashes of light. If it pulls hard enough, it can cause a tear or break in the retina and fluid can get through the hole and push the retina forward causing a retinal detachment. While everyone gets floaters, very few have retinal detachments. If you are seeing flashes of light and floaters, your eyes need a dilated examination within the next day or two.
These are just a few of the “exciting” changes that occur with age.
Teresa A. Larcom, OD
