Oh Say Can You See?

Vision problems become more common for those over 40. A look at some of the most common causes of vision loss and local resources that can help.

Ever had to hold a menu out at arm’s length? Struggled to read small print? Among the many changes people typically notice as they age are changes in vision, the most common being something called presbyopia — problems seeing clearly at close distances.

While presbyopia is nothing serious — likely requiring nothing more than maybe switching to bifocals or picking up a pair of cheap reading glasses — there are more serious eye conditions that can threaten vision in older adults. For this reason, it’s recommended that those over 40 make sure to schedule a comprehensive eye exam at least every two years.

There are four leading causes for vision loss as people age. The first is age-related macular degeneration, the leading cause of severe vision loss in those over the age of 50. This condition results in blurred vision or no central vision, which can make it hard to recognize faces, drive or perform other activities of daily life.

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Another common problem is glaucoma, which is actually a group of ailments that occur due to pressure buildup within the eye, which can lead to damage to the optic nerve. The condition affects nearly 2.2 million Americans over the age of 40.

Diabetic retinopathy, also known as diabetic eye disease, is a condition caused by diabetes that can lead to damage to the retina. Symptoms include loss of central vision, blurry vision and holes or black spots in vision.

The most common eye condition for people age 40 and older is cataracts, which affect about 20.5 million Americans according to the Centers for Disease Control and Prevention.

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By the Numbers

Vision problems in the U.S.

14 million

Americans age 12 and older have self-reported visual impairment (defined as distance visual acuity of 20/50 or worse).

3.4 million

(3%) Americans age 40 and older are either blind (having visual acuity [VA] of 20/200 or less or a visual field of less than 20 degrees) or are visually impaired (VA of 20/40 or less).

1.6 million

Americans 50 and older have age-related macular degeneration.

5.3 million

(about 2.5% of all people) age 18 and older have diabetic retinopathy.

20.5 million

people (about 16% of Americans) age 40 and older have cataracts.

2.2 million

Americans age 40 and older have glaucoma.


of an estimated 61 million adults in the United States who are classified as being at high risk for serious vision loss visited an eye doctor in the past 12 months.
Source: Centers for Disease Control and Prevention. (Numbers are based on data from NHANES, NHIS and a compilation of population-based studies.)

“At age 40 the lens in the eye starts to get firmer, making it harder to see objects distant and near,” said Dr. Delmar Caldwell, director of the Department of Ophthalmology at Tulane University.

The condition can also cause patients to stop seeing shades of blue, which means they must be especially careful driving at sunset and sunrise.

Treatment for cataracts has advanced significantly over the years, with cataract surgery becoming focused on providing the lens with more flexibility, resulting in improved vision.

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“The technology has improved tremendously from what it used to be,” said Dr. Ron Landry, director of Eyecare Associates in Metairie. The center employs ophthalmologists and optometrists and offers a wide range of clinical and surgical procedures for eye care.

In the past, patients have had to wait until a cataract was advanced to the point of near blindness to have surgery, which required general anesthesia. Now, cataract surgery only requires localized anesthetic and is normally an outpatient procedure. It is recommended nearly as soon as cataracts begin to affect general activity and offers an almost 99 percent success rate, according to Landry.

“People are living longer and living much more actively,” he said. “They rely so much on their eyesight that when it starts to fail them they are much more proactive about having it remedied if possible.”

For New Orleanians struggling with vision loss, Lighthouse for the Blind can be an invaluable resource. This nonprofit organization, based Uptown near Children’s Hospital, serves patients of all ages, as well as provides in-services at several nursing homes, including Poydras House.

"At age 40 the lens in the eye starts to get firmer, making it harder to see objects distant and near."

– Dr. Delmar Caldwell, director of the Department of Ophthalmology at Tulane University

Jenice Heck is vice president of vision rehabilitation services at Lighthouse for the Blind. The organization provides a range of services from the point of diagnosis to offering ways to help retain independence. Loss of central vision is a common symptom among several of their patients.

At Lighthouse’s low-vision clinic, occupational therapists help patients train to use their secondary vision.

“For example, we train some people so that they can see around the spots in their vision,” said Heck. “When we are born, our brain chooses to take in images through our central vision. When we lose it, our brains pick a second point, and we train people to focus on it.”
The training is not a procedure but more like physical therapy, she says.

Additionally, the organization is up to date with a variety of mobile apps and gadgets that make simple activities a lot easier, such as Tap Tap See, a mobile application that uses any smartphone camera to photograph and audibly identify items for the user.

“I can say many people come to us feeling hopeless because we are wired to use our vision,” said Heck. “The reality is we were designed to get information from all of our senses.”

Deborah Barrett, an occupational therapist at Lighthouse for the Blind, says her clients suffer from different degrees of vision loss, and range from toddlers to a patient who at 103 years of age learned to use a CCT reader, a video magnification aid to help her read the newspaper.

New technology is constantly being developed to aid those suffering from vision loss. Therapists at the Lighthouse for the Blind work with patients to help them use devices that aid with basic tasks such as the EZ Pour, a device that connects to the top of a mug and beeps when the liquid is an inch from spilling.

“It’s simple devices like this that take away the frustration of being visually impaired,” said Barrett. “If I can give a patient one thing that they are able to do when I leave, it gives them a renewed sense of hope. I have seen them open up and grow from just a small change.”


Top Mobile Apps for the Visually Impaired

BARD Mobile:

Offers over 80,000 books, magazines and music scores in braille and audio format

Nant Mobile Money Reader:

Instantly recognizes currency and speaks the denomination

Tap Tap See:

Photographs the items and audibly tells the user what the item is

VO Tutorial:

VoiceOver Tutorial provides an overview of how to use iOS using Voice Over

Visor (electronic magnifier):

Also known as CCT or a video magnifier, it allows the user to magnify text to help them read

Around Me:

Allows users to quickly find information about their surroundings

Blindfold Games:

Fully accessible games with audio cues for the visually impaired.

KNFB Reader:

Take a picture of a document and the app will read the print

Color ID Free:

Color identifier uses a smartphone to identify colors


Enables users to make searches using pictures.
Source: the staff at Lighthouse for the Blind


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