How to Prevent Vision Problems
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How to Prevent Vision Problems

Many people dislike seeking medical care for any reason. But when it comes to changes in your vision, do yourself a favor and get to an eye doctor.

One day in Rome, the great Norwegian playwright Henrik Ibsen saw a crowd gathered around a large red poster. Intrigued, he reached for his glasses, only to find he had left them back in his hotel room.

"Signore," said Ibsen, squinting and turning to the man beside him. "Could you please tell me what that sign says?" "Sorry, signore," said the Italian in a confidential whisper, "I don't know how to read either."

While most men today can read quite successfully, convincing them to get glasses or an eye check-up may be quite another matter.

"It's not always a matter of vanity," says David Kozart, MD, an associate professor of ophthalmology and vice chair of the department of ophthalmology at the Scheie Eye Institute in Philadelphia. "Most men don't like to admit they have any type of health problem. And some men just don't like to feel out of control."

But seeking out medical care puts a guy more in control. And medically speaking, men should care for themselves just like they would care for one of their kids. What responsible man would let his child do without eye care?

Protection: the First Step

Even before the time comes for frequent eye exams, men should first get in the habit of protecting their eyes. "One of the biggest differences between the health of women's and men's eyes is that guys suffer far more accidents," says Eric Donnefeld, MD, assistant clinical professor of Ophthalmology at Cornell University Medical College and a cornea and refractive surgeon at Ophthalmic Consultants of Long Island.

"Men should wear eye protectors around power equipment and while playing sports like racquetball or squash," he says. "I've seen many eye injuries caused by guys who were just hammering nails. But most men don't think about wearing eye protection for that."

The three primary types of eye protection—safety glasses, safety goggles, and face shields—are sometimes worn in combination. Experts say that handling chemicals, including lawn chemicals, requires goggles.

For any activity that involves chipping, grinding, riveting, sanding, banging, or masonry, safety goggles should be worn. The best goggles are those where the sides touch the skin all around, as particles can still fly up under glasses that are open on the sides. A face shield is often required if there are large flying objects or lots of debris.

Men frequently think they are the only ones who have a particular health concern and thus never say anything about it—especially to doctors. Topping the list is blurred vision.

The Most Common Vision Ailment

One of the most consistent and predicable aging phenomena usually occurs in your 40s, when you begin having difficulty focusing on close images, such as a book. You must either hold printed matter at arm's length, or if nearsighted, take off your glasses entirely to clearly see what you're reading. This phenomenon is termed presbyopia.

"It comes as a jolt but it happens to all of us," says Dr. Kozart. "To see clearly, you must either get bifocals or a pair of reading glasses. After age 45, you can't have it both ways."

The reason for the vision inconsistency is due to changes in the eye from normal aging. The lens of the eye becomes less pliable, and thus is unable to focus close images. At that point, glasses, contact lenses, or surgery are required to focus at near.

One treatment method that people either love or hate: a technique known as "monovision." Contacts or laser vision surgery allow one eye to be used for distance while the other handles close-up matters. Experts say some adapt well, while others just can't get used to it.

Catching Eye Problems Before They Start

Eye doctors also screen for disorders that, when caught early, can avert major problems later on. Ask your doctor for guidelines specific for your individual situation. The American Academy of Ophthalmology recommends a comprehensive eye examination as follows for healthy adults with no risk factors for eye disease:

  • At least once between age 20 and 29
  • At least twice between age 30 and 39
  • Age 40-64: every 2 to 4 years
  • Age 65 and older: every 1 to 2 years
You should be screened more often, or as directed by your doctor, if you:
  • Have risk factors for glaucoma or other eye diseases
  • Have a family member who has glaucoma
  • Have a personal or family history of eye disease
  • Are African American or African heritage or of Hispanic descent (due to an increased risk of developing glaucoma)
  • Have had a serious eye injury in the past
  • Had eye surgery in the past
  • Are taking a corticosteroid medication
  • Have diabetes, high blood pressure, or other chronic illness
Cautionary Note: If you currently have eye symptoms, you should call your provider immediately for an evaluation. In case of an emergency, call for an ambulance immediately.

Glaucoma

For most healthy men, glaucoma screening should start right around age 40, or sooner if they have a family history of the condition. Says William Lesko, MD, assistant clinical professor in the department of Ophthalmology at Mount Sinai and an ophthalmologist at North Jersey Eye Associates in Clifton, New Jersey: "The baseball player Kirby Puckett lost the sight in his right eye from glaucoma… and was forced to retire from big league baseball. He is now spokesman for a campaign known as 'Don't Be Blindsided!'—a program to encourage everybody over 40 to have glaucoma screening."

Nearly 120,000 Americans yearly lose all or part of their vision, while another 900,000 experience some form of gradual vision loss from the disorder, experts say.

"About 50% of all glaucoma cases go undiagnosed," says Dr. Lesko. "Regular screenings—painless and quick—are the only way to go."

Says Puckett, "I know what it is like to have a career that relies on solid instincts, split second reaction time, and perfect vision. I also know what's like to wake up one morning and have it abruptly end. So I encourage regular eye exams to help detect this disease early."

Glaucoma increases pressure inside the eye and puts unhealthy pressure on the optic nerve. Moreover, there are several different types of the disorder. Left untreated, glaucoma can lead to blindness. Fortunately, medical science has several ways to control it. Unfortunately, most people do not know they have glaucoma until diagnosed during a comprehensive eye examination. While damage that has already occurred cannot be reversed, glaucoma progression can often be halted with medical treatment.

"With a type of glaucoma known as 'acute angle closure,' a small opening can be put in the iris of the eye with a laser," says Dr. Kozart. "Other forms of glaucoma can be controlled with drops, pills, and surgeries."

Diabetic Retinopathy

Men with diabetes are also at increased risk for glaucoma and yet another ailment known as diabetic retinopathy. Diabetes causes blood vessels within the eye to leak. "The longer a person has had diabetes, the greater the likelihood the diabetic retinopathy will occur," says Dr. Kozart.

Cataracts

Cataracts—a clouding in the lens of the eye—usually come along about, or just after, the age of retirement, experts say. "Unlike glaucoma or diabetes, cataracts don't hurt the health of the eye," says Dr. Kozart. "So a cataract operation is usually an elective procedure done to improve visual sharpness. You can have cataracts taken out today or 10 years from today."

The first signs of a cataract is a clouding or lessening of vision. The condition may first make itself known as a glare at night or trouble with oncoming headlights while driving. Or, a light bulb may be seen as a display of stars. Because cataracts are slowly progressive, many people don’t even know that they have been losing vision.

"Some patients say they experience blurred vision while others simply say they can't see well enough anymore to do what they want to do," Dr. Kozart says. Cataract surgery is the most commonly performed surgical procedure in the US; surgeons remove the cloudy lens in the eye and replace it with a man-made lens.

The American Academy of Ophthalmology urges everyone to get a medical eye examination and make eye safety a priority for you and your family. "It is extremely important to have your eyes checked on a regular basis," said H. Dunbar Hoskins Jr., MD, former executive vice president of the Academy. "Many of the most common forms of eye disease, such as glaucoma, cataract, and diabetic retinopathy, when caught in the early stages, can be successfully treated. If not caught in time, these diseases can lead to visual loss and blindness."

Know "the Three O's" of Optical Practitioners

Which type of vision care practitioner should you see?

Ophthalmologists

Ophthalmologists are physicians who specialize in the medical and surgical treatment of eye disorders. Ophthalmologists attend medical school, followed by a one year internship and at least three years of an ophthalmology residency program. They check eyes for vision problems, diseases, and abnormalities. They perform eye surgery, prescribe medication, and usually write prescriptions for glasses and contact lenses.

Optometrists

Optometrists are not medical doctors, but hold a Doctor of Optometry degree. They perform examinations for glasses and contacts. They also diagnose and treat some eye disorders. The scope of practice of an optometrist varies from state to state, depending on that state’s laws. Some states allow optometrists to perform laser surgery or prescribe certain medications. Some optometrists also practice visual therapy to counter certain eye problems.

Opticians

Opticians have less training than ophthalmologists or optometrists and cannot write prescriptions. They fit, supply, and adjust glasses, using a prescription from an ophthalmologist or an optometrist.

RESOURCES:

American Academy of Ophthalmology
http://www.aao.org/

Glaucoma Research Foundation
http://www.glaucoma.org

Vision Council of America
http://www.visionsite.org



Last reviewed May 2007 by Marc Ellman, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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