From the Experts

Our Changing Visual Needs

By Patricia Bainter, MD
Ophthalmologist and cornea specialist

It is normal for our vision to change as we age. You can make certain adjustments in your home to compensate for some of these changes.

For example, it is normal to develop cataracts (clouding of the lens in the eye) as we age.  The good news is that this clouding can be treated surgically in most cases, but typically one must wait until the cataracts are at a certain stage (typically worse than 20/40) before surgery is performed. Until they’re ready for surgery, you may have a few months or years in which you have to put up with less than perfect vision. What visual symptoms can you expect, and how can you best deal with them?

Dimming

Because cataracts block some of the light entering the eye, you will probably find that you need more light to read, cook, and perform many tasks that require sharp vision.  It is worth increasing the lighting in your home by allowing more outside natural light in during the day and adding more light fixtures.  But one has to take into account the direction of the light as well in order to prevent glare.

Glare

Certain types of cataracts cause a significant drop in vision when light is aimed directly towards the eye,  producing glare. This type of cataract makes night driving particularly challenging with oncoming headlights. If you are bothered by glare, you may find that reading is easier if you position your furniture so the source of light (lamp or window) is behind you rather than facing you. If you have night lights to guide you to the restroom at night, you may find it helpful if the lights are aiming towards the ground rather than towards your eyes.

Color

Certain types of cataracts cause a significant shift in color perception. In particular, the color blue may be washed out or faded. Because this comes on gradually over years, most people are not aware of the color change until after their surgery. In the meantime, it becomes challenging to distinguish between black and navy-blue clothing, particularly if your closet is dimly lit.

Adapting to the Dark

Some cataracts also make it more difficult to adapt to the dark after you’ve stepped indoors from outside or after stepping away from a brightly lit computer screen. You need to give yourself more time to adjust. Trouble adapting to the dark can also be a sign of retinal disease, so be sure to have your eyes thoroughly examined by an eye doctor annually.

Blur

Cataracts often produce changes in the way the eye focuses.  Sometimes it’s subtle, but sometimes there’s a large change (often a shift towards more nearsightedness). If words on a page or street sign are out of focus, the simplest thing to do is make sure your glasses or contact lens prescription is up to date.  Most people over 55 should be getting their eyes examined annually.

And finally, keep in mind that your lifestyle choices do play a role in optimizing your vision. We cannot prevent cataracts from forming in the first place (yet), but there are steps we can take every day to preserve our eye health as best we can. The latest research is showing that in general, the same things that we know are good for heart are also good for eye health: exercise, stopping smoking, keeping blood pressure and blood sugars well controlled, and eating a heart-healthy, nutrient-rich diet. And of course, be sure to schedule routine check ups with your eye doctor to address any preventable and treatable eye conditions.