Philip J. Goscienski, M.D.
The term twilight years is taking on new meaning as Baby Boomers progress toward retirement. By the time they reach the age of 75 nearly all will have at least one of the four major causes of visual impairment: cataract, glaucoma, diabetic retinopathy and age-related macular degeneration (AMD). To some degree, cataract, glaucoma and AMD are inevitable as we grow older but total inevitability is now in doubt. In recent years medical researchers have learned that type 2 diabetes, a completely preventable disease, is a common factor in all.
The incidence of diabetic retinopathy is rising rapidly, not surprising in light of the fact that type 2 diabetes is outpacing the projections made only a few years ago. Even in the absence of frank diabetes, frequent elevations of blood sugar caused by a diet high in refined flour and sugar cause the tiniest blood vessels to become distorted. Microscopic bleeding and subsequent scarring progress so steadily and silently that by the time of diagnosis nearly one-half of diabetics have some degree of retinal damage.
About half of persons over the age of 65 have an identifiable cataract and by the age of 75 that number reaches 90 percent. Not everyone will have enough visual impairment to require surgery and total blindness is unusual in industrialized countries but cataracts sometimes progress rapidly. Diabetes, smoking and sun exposure all contribute to cataract formation.
Glaucoma affects nearly ten percent of persons over the age of 75. It is most often caused by increased pressure within the eyeball and has a high prevalence among Hispanics and African-Americans. Both groups also have high rates of type 2 diabetes, which contributes to the development of glaucoma. Screening for diabetes and eye disease should begin at age 40 among these groups and even earlier for the ones who are overweight.
AMD is the single most important cause of visual impairment in seniors, reaching levels of 30 percent among those 75 or older. Aging is only one cause of AMD. It is higher among those with a family history of the disease and in those who smoke, have high blood pressure, eat few fruits and vegetables and had high exposure to sunlight in their younger years. It is more common in persons with type 2 diabetes.
Avoiding diabetes is no guarantee that you'll enter old age with perfect vision but it will certainly help.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at firstname.lastname@example.org.