Vision loss in older people

Vision loss in older adults is a significant health concern, with prevalence increasing with age. Approximately 37 million Americans over 50 years old are affected, and 25% of those over 80 years experience some form of vision impairment ^[1]. This condition not only impacts quality of life but also contributes to increased risks of falls, depression, social isolation, and higher all-cause mortality ^[1][2][3]. The economic burden is substantial, with direct and indirect costs of treating visual impairment estimated at $54 billion annually in the United States ^[1].

Common Causes of Vision Loss in Older Adults

Several age-related eye conditions are primary contributors to vision loss, many of which can be managed or treated if detected early through regular eye exams ^[4]. The most prevalent causes include:

• Age-Related Macular Degeneration (AMD): This is a leading cause of vision loss in people over 65, affecting central vision needed for tasks like reading and driving. AMD exists in two forms—dry (nonexudative) and wet (exudative)—with the dry form being more common but less severe ^[4][5]. Treatments and dietary supplements can help slow progression ^[4].
• Cataracts: Identified as the most common cause of blindness worldwide, cataracts involve clouding of the eye’s lens, leading to blurred or hazy vision. They are highly treatable with surgery, which is safe and widely available in the United States, significantly reducing their impact on vision ^[4][2][5].
• Glaucoma: Often caused by increased fluid pressure in the eye, glaucoma can lead to vision loss or blindness if untreated. It typically presents with no early symptoms, making annual dilated eye exams critical for early detection. Treatment options include eye drops, lasers, or surgery ^[4][5].
• Diabetic Retinopathy: A major cause of vision loss among older adults with diabetes, this condition develops slowly and may show no early signs. Managing blood sugar, blood pressure, and cholesterol, along with regular eye exams, can prevent or slow its progression. Laser surgery is an option in later stages ^[4][5].
• Refractive Errors and Presbyopia: Uncorrected refractive errors, such as myopia, and presbyopia—a normal age-related difficulty in seeing close objects—are also significant contributors to visual impairment. These can often be corrected with glasses or contact lenses ^[2][6][7].
• Dry Eye: Common in older adults, especially women, dry eye causes discomfort like stinging or a sandy feeling in the eyes. Treatments range from artificial tears to more advanced options like prescription medications or surgery for severe cases ^[4].

Impact and Prevalence

Vision impairment is more prevalent in women than men, largely due to longer lifespans, and affects daily activities, leading to challenges in independence and mental health ^[2]. Among those aged 80 and older, the prevalence of vision impairment is reported at 25.66% across all races, with variations by ethnicity ^[2]. The global burden is expected to rise, with projections estimating 61 million blind individuals and 474 million with moderate to severe vision impairment by 2050 ^[2].

Prevention and Management

Regular eye exams are essential for early detection and intervention, as many of these conditions have few or no early symptoms ^[4]. Lifestyle factors, such as managing chronic conditions like diabetes and hypertension, reducing exposure to ultraviolet light, and avoiding smoking, can also mitigate risks ^[5][8]. For older adults, maintaining vision health is critical not only for physical safety—reducing fall risks—but also for preserving overall well-being and independence ^[3].

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• https://www.aafp.org/pubs/afp/issues/2016/0801/p219.html   
• https://pmc.ncbi.nlm.nih.gov/articles/PMC10460237/      
• https://www.cdc.gov/vision-health/prevention/older-adult-falls.html  
• https://www.nia.nih.gov/health/vision-and-vision-loss/aging-and-your-eyes        
• https://www.aafp.org/pubs/afp/issues/1999/0701/p99.html     
• https://www.aoa.org/healthy-eyes/eye-health-for-life/adult-vision-41-to-60-years-of-age 
• https://www.webmd.com/eye-health/vision-problems-aging-adults 
• https://westhartfordhealth.com/news/senior-health/causes-vision-loss/