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With age, all organs in the human body undergo involution (reverse development). Age-related degenerative changes also occur in human eyeballs. As a result, an aging person gradually loses his sight. Given that with the help of the organ of vision, a person receives more than 80% of information about the world around him. It is quite natural that people who begin to see badly withdraw into themselves, become asocial.
With age, the diameter of the pupil decreases, the field of view narrows, the contrast of color perception decreases, the surface of the eye becomes dry, the retina becomes thinner and atrophies. All these changes in the structures of the eye inevitably affect the quality of human vision.
The most common age-related changes in vision include cataracts, senile farsightedness, myopia, glaucoma and various pathologies of the retina, most often of vascular etiology. Is it possible to prevent age-related vision loss and how to deal with existing changes?
Senile cataract
A cataract is a clouding of the lens of the eye. This is the most common age-related change in the structures of the eye. After 50 years, cataracts are found in every tenth patient, after 60 years – in every fifth, and after 75 – in 90% of ophthalmic patients. It is impossible to avoid this pathology, especially if a person has a burdened heredity.
Age-related cataract is characterized by the appearance of clouding of the lens in its peripheral areas, which in the initial stages of the disease does not affect visual acuity. Later, the number of foci of turbidity increases, they merge. Patients note that they begin to see worse, a fog, a veil appears before their eyes. With further development, clouding affects the entire lens: the eye loses the ability to distinguish colors, see details on objects, read or examine small objects.
At the initial stages of the development of senile cataract, conservative treatment is possible, based on stopping the progression of the pathology (eye drops, systemic vitamin complexes). However, this treatment does not solve the problem of turbidity. The only radical method of treating senile cataracts is surgery – phacoemulsification with implantation of an intraocular lens. This is an outpatient operation, which consists in the destruction of the contents of the lens and the introduction of a collapsible lens into it.
Ophthalmologists call this condition presbyopia (translated from Greek and Latin – “old eye”). Senile farsightedness develops due to a decrease in the ability of the lens to change its curvature. As a result, the lens of people in old age is always in a relaxed state, and after 60 years it completely loses the ability to accommodate.
The first signs of presbyopia appear already at the age of 40-45 years. It becomes difficult for a person to read printed text, it is especially difficult to recognize it at dusk or in poor lighting. At the same time, such changes appear even in those who have never worn glasses before.
Unbeknownst to himself, a person, when reading a magazine or a newspaper with small text, tries to keep it away, and when doing some small work (needlework, sewing, knitting) – lean back to focus his eyes. The eyes of an aging person get tired quickly, and prolonged stress provokes headaches, irritates him, which in some cases causes him to refuse to read, needlework or other small work.
It is impossible to avoid age-related farsightedness, but modern ophthalmology has learned to deal with this pathology. Ophthalmologists offer conservative and surgical treatments for presbyopia. Conservative methods include glasses and contact lenses that correct vision. Use them in most cases for reading or watching TV.
For surgical intervention on the eyes with presbyopia, low-traumatic laser microsurgery is used.
The main microsurgical treatments for presbyopia are:
- LASIK (laser keratomileusis) is an operation to correct the refractive property of the cornea, during which a microlayer of the cornea is cut off with a laser;
- PRK (photorefractive keratectomy) – an operation during which evaporation is carried out using an excimer laser of the upper layer of the cornea;
- intraocular lens implantation is an intervention in which the natural lens is replaced with an artificial intraocular lens.
The last of the methods is also a treatment for senile cataracts, which often accompanies presbyopia.
senile glaucoma
Glaucoma is a group of eye diseases characterized by a persistent increase in intraocular pressure, which leads to irreversible pathological changes in the optic nerve and retina. The outcome of untreated glaucoma is blindness.
Senile glaucoma develops for two groups of reasons:
- general (burdened heredity, systemic cardiovascular diseases, endocrine pathologies);
- local (pathologies of intraocular vessels, violation of the drainage system of the eye).
As a result of a violation of the outflow of intraocular fluid, pressure builds up inside the eye, which presses on the retina and optic nerve. With a long course of the disease or a short-term, but frequent, sharp increase in pressure in the eye, the retina atrophies, and the optic nerve dies. Senile glaucoma is manifested by specific symptoms:
- blurred vision;
- narrowing of the visual fields;
- the appearance of halos around light sources;
- a feeling of pressure, heaviness, pain inside the eyes;
- pain in the temporal and superciliary areas;
- deterioration of twilight, and later daytime vision.
In severe cases, attacks of glaucoma are possible, which are accompanied by nausea, severe headaches, deterioration in general well-being. If such a patient is not treated in a timely manner, severe attacks of glaucoma may result in blindness.
According to the mechanism of development, ophthalmologists distinguish between open-angle and closed-angle glaucoma, the treatment of which is radically different. The open-angle form of the disease occurs due to a decrease in the gaps between the septa of the pectinal ligament, and therefore the outflow of intraocular fluid worsens. Angle-closure glaucoma occurs due to age-related relaxation of the lens. An enlarged lens prevents fluid from passing into the anterior chamber of the eye (called “pupillary block”).
Age-related glaucoma is treated conservatively, and if conservative therapy is ineffective, it is treated surgically. The tactics of treatment depends on the form of the pathology (open or closed angle), the severity of the disease (acute attack or chronic course) and its stage. Most often, patients are prescribed complex treatment, when surgery is supplemented with local drug therapy.
Conservative treatment includes prescribing drugs for:
- reducing intraocular pressure by improving the outflow or reducing the production of intraocular fluid;
- improvement of microcirculatory blood supply to the membranes of the eye and optic nerve;
- normalization of metabolic disorders in the tissues of the eye.
The main methods of surgical intervention for senile glaucoma include peripheral iridotomy (excision of the iris in its peripheral areas to restore the outflow of fluid) and trabeculoplasty (artificial destruction of the septa (trabeculae) of the pectinal ligament). These operations can be performed microsurgical or with a laser.
Ophthalmologists refer to pathologies of the inner sensitive membrane of the eye (retina) as retinopathy. The retina is responsible for converting light signals into nerve impulses. With age, involutive changes occur in the retina: its thickness decreases, the vessels narrow, thrombose, and atrophy. Pathologies associated with old age (arterial hypertension, atherosclerosis, diabetes mellitus) exacerbate and accelerate involutive processes in the retina.
The most common age-related pathologies of the retina include:
- dystrophy;
- retinitis;
- retinal detachment;
- bleeding into it.
Inflammation of the retina
Senile retinitis (inflammatory pathology of the retina) is not clinically different from retinitis that occurs at a different age. Inflammation of the retina can have an infectious and non-infectious (allergic, physical, chemical) nature, but the cause of inflammation has no effect on the symptoms of the disease. The main symptoms of retinitis are a decrease in visual acuity, a change in the boundaries of the visual fields, a violation of color perception, a distortion of the outlines of objects and display of their movement.
Treatment of retinitis is conservative and consists in the appointment of systemic etiotropic therapy (antibacterial, antiviral), anti-inflammatory drugs, vasodilators, antispasmodics, metabolic agents, as well as topical medications (eye drops, subconjunctival injections).
Retinal hemorrhage
Retinal hemorrhages can occur against the background of severe diabetes mellitus, cardiovascular pathologies, and diseases of the blood system. A provocation for the occurrence of detachment can be stressful situations, hypertensive crisis, cardiac arrhythmia, eye or head injuries.
Retinal hemorrhage can be acute or chronic, limited or massive. Depending on the size of the focus of hemorrhage, patients may be prescribed conservative therapy (corticosteroids, anti-inflammatory, hemostatic, angioprotectors, antihistamines) or surgery (laser coagulation, vitrectomy).
Retinal disinsertion
Retinal detachment is usually preceded by its rupture. At the site of the rupture, intraocular fluid begins to leak under the retina, separating it from the choroid. The causes of this pathology are similar to the causes of retinal hemorrhage. Clinically, retinal detachment is characterized by a decrease in visual acuity, the appearance of “flies”, fog, a veil before the eyes, a sudden loss of lateral vision, and deformation of visible objects.
Treatment of retinal detachment is complex (surgical and conservative). The goal of treatment is to reattach the retina to the choroid with its subsequent strengthening.
Of the surgical interventions for detachment, extrascleral ballooning (filling), laser coagulation, vitrectomy (partial or complete removal of the vitreous body) are used.
Age-related pathologies of the retina are difficult to treat. Full recovery of vision after the treatment does not occur, since the retina is atrophied (optical cones and rods are partially dead).
The best way to avoid age-related blindness is to visit your ophthalmologist regularly. After the age of 40, doctors recommend checking the condition of the eyes at least once a year, even in the absence of signs of visual impairment. When the first signs of visual impairment appear, a visit to an ophthalmologist cannot be postponed: adequate treatment will help to avoid the progression and severe complications of eye diseases.