Why Ageing Eye Is Not A Disease - Dr Manoj Chandra Mathur

Everyone experiences some loss of vision after the age of 40. The natural loss of near focus, difficulty in reading the small print and having problems seeing objects that are close are but natural. Dr Manoj Chandra Mathur dispels many myths and unfounded fears

Q. After the age of 40, people lose the ability to focus on what is near. Can it be delayed and what precautions should one take?

A. This phenomenon is known as Presbyopia. The human lens is capable of accommodation which adjusts itself to focus on both far and near objects. The ageing process makes the lens hard and also affects the strength of the small muscles resulting in sequential loss of accommodation. This results in defective vision for near. 

This condition generally sets in around the age of 40 years and progresses till about 55 years when the correction becomes maximum.

This is a physiological process and not a disease to be delayed or precautions are taken.

Q1. There is a belief that wearing corrective lenses will weaken eyesight. Is it true?

A. That is not true. Generally, we slightly undercorrect myopia and fully correct Hypermetropia to relax the small muscles of the eye and prevent eyestrain. In children, if we do not correct the vision, the child may develop a condition called amblyopia, where the sensitivity of retina is compromised and the vision does not improve even after the correct glasses are prescribed.

Q2. Are vision problems a result of genetics? Is everyone afflicted by it?

A. The refractive errors are generally genetic but the Presbyopia is physiological and due to ageing.

Q3. One discovers eye changes suddenly as if the problem started just that morning. People panic what is your advice?

A. Sudden loss of vision is possible in a few emergency situations like vascular occlusions or retinal detachment but mostly the loss of vision is slow in most conditions.  Generally, if one eye is affected, the patient may not notice it as the other eye is good. By chance, if he happens to close the good eye, he suddenly realises that the other eye is bad and thinks it is sudden.

Q4. Are gels, ointments and drainage holes in inner corners of eyelids really helpful for combating dry eye problem?

A. Eye drops, gels and ointments are the first line of treatment in dry eyes along with the other supportive treatment. In severe cases, the sealing of the drainage holes (Not making holes)can be an option.

Q5. What diet is recommended to protect eyes after 40?

A. Diet has no role in adults. A diet high in Vitamins A & D may be good for Children. A normal balanced diet is what is required.

Q6. What should one do when one discovers that he/she is finding it difficult to drive at night?

A. A comprehensive Eye test with measurement of Intraocular pressure is mandatory. The common conditions of early cataract and Glaucoma have to be ruled out.

Q7. People when confronted with vision problems first go through a denial period. What are the treatments available to tackle issues and what are the latest developments in this field? Please elaborate. 

A. This is a misconception in the society. people refuse to believe that their children can have issues so early in life. They tend to ignore the child's complaints until they get a note from the teacher. The child's intellect is affected not due to lack of intelligence but due to a defective vision.

Adults generally tend to ignore the early symptoms as a vitamin deficiency and try to eat foods rich in Vit A&D.

Any visual problem after the age of 40 has to be addressed to an Eye specialist.

Even normal healthy adults should have a mandatory comprehensive Eye Checkup including IOP to establish a baseline and move forward from there.

Q8. Many school-going kids are now increasingly getting vision problems? Why is it so and what are the remedies?

A.  The rapid increase in vision problems in children, especially in urban areas, is due to increased engagement with near work. The current day associations with television, mobile phones and computers make the children focus more for near objects, resulting in spasm of the small muscles of the eye and resulting in conditions like Pseudo-myopia.

Of course, there is no life without these systems, but the child should be encouraged to spend some time in outdoor activities as well to relax the small muscles of the eye. That's the reason more children in urban areas are seen with spectacles compared to children in rural areas.

Q9. On an average how many children are brought to you in a month with eye sight problems?

About 15-20% of the OP that one sees caters to this issue

Q10. Can vision problems in children be reversed? If so how? 

A.  Refractive errors can generally be controlled by proper exercise and Diet in Children below 8 years of age. Diet has no role after that.

The child should follow the instructions of the doctor and parents should also be supportive. It is also seen that the parents are sceptical and do not encourage the child to wear glasses.

 A very good way to keep the eyes healthy is to follow the Rule of 20 - always look at a distance of 20ft for 20 secs after every 20 mins. This rule holds good for everyone, especially for children and adults, working long hours on the computer.

 Always the level of the Computer screen or the mobile phone should be below the eye level. This results in the eyelids to be semi-closed. Otherwise, the eyelids are open wide if the person is looking at the screen which is at a higher level or seeing mobile phone lying down. This results in increased evaporation of tear fluid causing dry eye issues and eyestrain

[Dr Manoj Chandra Mathur is a Senior Consultant, Glaucoma / Comprehensive Ophthalmology at Swarup Eye Centre, Medivision, Brij Netralaya Eye Clinic and President Telangana Ophthalmological Society (TOS) & President Hyderabad Ophthalmological Association (HOA]