Take care of aging eyes

It was while he was watching television that Bernie (Boom Boom) Geoffrion realized there was something seriously wrong with his eyesight.The hockey legend, whose stellar career helped make the Montreal Canadiens a powerhouse in the ’50s and ’60s, had noticed a black spot in the centre vision of his right eye. But Geoffrion, now 71 and living in Atlanta, shrugged it off until one night in front of the TV.

“I said we better call the guy to fix the TV, the colour’s all wrong,” he remembers.

There was nothing wrong with the set. It was Geoffrion’s sight that was the problem. A specialist soon found out why. The hockey great was suffering from age-related macular degeneration (AMD or ARMD), a common cause of vision loss for older people.

Geoffrion soon lost all sight in that eye, but his left eye remained perfect. He still plays golf once a week and enjoys life.

 “I was never down,” he says. “Nobody’s going to knock me down because I can’t see out of one eye.”

Common with aging
Geoffrion’s condition is just one of a number of problems-all of which are more common with aging-that can cause low vision.

There a no firm statistics, but it’s estimated that about one per cent of the population suffers from low vision. And the figure is rising.

But research is leading to new treatments and better understanding of how to prevent vision loss.

Unlike blindness, there’s no official definition of low vision. Most experts now think of it as vision that can’t be corrected with glasses or contact lenses and that significantly limits what a person can do.

For most people, that usually starts when their acuity-the amount of detail they can see-slips to about 20/70 in the best eye, even with glasses or contacts. A person with 20/70 vision can see at 20 feet what a person with normal vision can see at 70 feet.

Macular degeneration
While some people have low vision because of lifelong problems or accidents, most cases are the result of conditions that become more common with aging. The number one cause is age-related macular degeneration, a condition that damages the central vision.

The retina at the back of your eye turns light into electric impulses that travel to the brain. At the centre of the retina is a pea-sized patch called the macula. It’s responsible for detailed vision and it tends to lose function as a part of normal aging, usually after about age 65.

“We have about 10,000 new clients a year,” says Linda Studholme, national director of rehabilitation and technology for the Canadian National Institute for the Blind.

“In the last three or four years, about 50 per cent of them have macular degeneration.”

While AMD causes total blindness in only a very small percentage of cases, it’s still the single largest cause of blindness in Canada.

Diabetes and vision
The second leading cause of vision loss is diabetes. It can cause several eye problems, the most important being diabetic retinopathy.

Tiny abnormal blood vessels behind the retina leak, causing scarring on the retina. In more advanced cases, blood vessels can be blocked, causing parts of the retina to die.

New blood vessels grow to replace the blocked ones, and these can leak into the eye, obscuring vision and causing scarring.

Laser treatments are effective, but “the better control you have of your diabetes, the fewer complications you get,” says Dr. Raymond LeBlanc, professor and head of the ophthalmology department at Dalhousie University in Halifax.

Glaucoma damage
Another age-related cause of irreversible vision loss is glaucoma. About one per cent of Canadians over the age of 45 have it, but the number shoots up to four or five per cent at age 75.

Glaucoma happens with a build-up of pressure inside the eye. That pressure, along with other factors, can damage the optic nerve. The peripheral vision is the first to go. Left untreated, it can result in total blindness.

The common treatment is eye drops to reduce the pressure, but doctors also use laser and conventional surgery. The vision loss is so gradual that most people don’t notice until it’s too late.

“The best deterrent is a regular eye exam, especially for those in the high-risk,” says LeBlanc. Older people, those with a family history of glaucoma and black people are at higher risk.

Success with cataracts
Cataracts were once one of the leading causes of low vision and blindness. But cataract surgery is so successful, the condition now rarely results in permanent vision loss-although many people wait too long before seeking treatment.

Cataracts are a clouding of the lens, which seems to be a natural part of aging. Surgeons perform 125,000 to 150,000 cataract operations a year in Canada, removing the clouded lens and slipping in an artificial replacement.

Big adjustment
Adjusting to low vision can be a major challenge, especially for an older person planning for retirement.

“If you’re looking forward to being a snowbird and playing golf, for example, low vision will smash your retirement plans,” says Bill Carroll, managing director of the Low Vision Association of Ontario.

Carroll says it’s a big adjustment for family, too. They can’t understand why their loved one’s vision might work for some things, such as peripheral vision, and not others, such as reading.

“You can’t really understand it until it happens to you,” says Carroll. When loved ones get frustrated, “you have to let them off the hook.”

Attitude adjustment
But the most important adjustment is within, says 69-year-old Stuart Jones, a retired tour company president in Toronto, who lost most of his vision to glaucoma.

Low vision has meant a far different life than the one he used to take for granted, but Jones says a positive attitude is vital.

“I’m the only problem and I’m the only solution,” he says. “The one thing that can never be taken from me is my attitude.”