Introduction

For most people, eyesight is the most treasured of the senses. People never stop wanting to watch children play, peer at the stars, or gaze into their partner's eyes. Old age should provide an opportunity to relish these experiences, but many older people get shortchanged when their vision becomes impaired by changes due to aging itself as well as a range of disorders.

See the figure A Look at the Eye.

The eyes undergo many changes with aging. In addition, many eye disorders become more common with aging, so many people experience visual impairment as they get older. They may be able to see everything but much less clearly (decreased visual acuity). They may lose some areas of vision completely (blind spots) while retaining others. Or they may lose most or all of their eyesight.

Most commonly, vision loss among older people is due to clouding of the lens of the eye (cataracts) or to damage to the optic nerve (as occurs in glaucoma) or the retina (as occurs in age-related macular degeneration and diabetic retinopathy). A less common cause of vision loss is blockage of the blood supply to the eye. Eyelid disorders mostly change the appearance of the eye, but they can cause discomfort and contribute to vision loss as well.

Whatever the reason for vision loss, any vision change can compromise an older person's quality of life and, indirectly, health. For example, poor eyesight may contribute to a car crash or to a fall. Loss of vision can be especially devastating to older people coping with other problems as well, such as poor balance and hearing loss. In such cases, vision loss can contribute to significant injury and can impair a person's ability to perform daily activities.

See the sidebar Understanding Eye Surgery.