Poor Vision Affects More Than Your Eyes?>

Poor Vision Affects More Than Your Eyes

by Peter Jaret

As we age, vision-related problems can make it unsafe to drive, difficult to read, and even get in the way of being active. But that’s only part of the toll failing eyesight can take. Impaired vision has been associated with social isolation, disability, and decreased quality of life.

The term vision impairment means low vision or blindness. Low vision is typically defined as having decreased vision that eyeglasses, contact lenses, medication, or surgery can’t correct. Central or peripheral vision may be lost or there may be a blind spot in the field of vision.

Vision loss isn’t caused by normal aging of the eye. It’s usually a result of an eye disease, such as age-related macular degeneration, cataracts, or glaucoma (see inset below); an eye injury; or another health condition, such as diabetes or high blood pressure, that affects the eyes.

4 Common Disorders That Can Cause Blindness

Age-related macular degeneration, cataracts, diabetic retinopathy, and glaucoma are among the leading causes of vision loss.

Mounting evidence continues to strongly suggest that impaired vision can have far-reaching consequences for both mental and physical health. Here are some ways poor vision can have an impact on your life.

Depression

Researchers have established that impaired vision is a significant risk factor for depression in older adults. Studies have found that people with vision loss are two to three times more likely to be depressed than the general population.

In a study published in July 2019 in JAMA Ophthalmology, researchers analyzed data from 7,584 people, ages 65 and older. Over five years, more than two in five participants who reported impaired vision developed clinically significant symptoms of depression or anxiety, compared with less than one in five with good vision.

Cognitive decline

High-quality evidence associates cognitive decline more often in adults with impaired vision than in those with good eyesight. A recent study by the CDC, published in May 2019 in its Morbidity and Mortality Weekly Report, revealed a strong connection between impaired vision and an increased risk of developing cognitive decline that stopped people from performing certain everyday functions, such as managing finances and using the telephone.

Discrimination

Some older adults report feeling discriminated against because of their visual impairment. In a British study published in JAMA Ophthalmology in May 2019, more than half of adults ages 50 and older with poor vision or blindness perceived that they were treated with less respect, poorer service or treatment in restaurants and stores, and poorer service and treatment from doctors and hospitals.

They tended to avoid situations where they weren’t treated well, leading to social withdrawal. They were more likely to report feeling lonely and having depressive symptoms, which also had a negative effect on their quality of life and well-being.

Chronic disease

The consequences of poor eyesight are associated with conditions that go well beyond the brain. In a study published in the American Journal of Ophthalmology in October 2017, for instance, researchers reported that people ages 65 and older with impaired vision were significantly more likely to have other serious health conditions, specifically arthritis, asthma, cancer, chronic obstructive pulmonary disease, depression, diabetes, hearing loss, heart disease, hepatitis, high cholesterol, high blood pressure, kidney disease, and stroke.

Some conditions can have a direct effect on eyesight, such as diabetes, which can cause diabetic retinopathy. Impaired vision’s impact on other conditions may be less direct. For example, people who can’t see well may be less likely to be active, which can increase their risk for high blood pressure, heart disease, diabetes, and other conditions. People with impaired vision may have difficulty reading food labels and making healthy meal choices. They may also have trouble reading medication labels, making it hard for them to follow doctors’ orders.

A study published in JAMA Ophthalmology in June 2019 found that, compared to people with good eyesight, those with severe vision loss who had to be hospitalized remained there longer and were more likely to have to be readmitted within the next 30 days.

Life expectancy

A study published in JAMA Ophthalmology in 2014 tied poor vision to reduced life expectancy. Researchers tracked the vision of more than 2,500 people ages 65 to 84 over eight years by testing them annually using a standard eye chart. A pattern emerged that tied failing eyesight to a loss of independent function such as shopping, preparing meals, and using the phone. The researchers calculated that the participants with poor vision had a 16 percent increased risk of premature death due to their declining health and loss of functional independence.

Falls

Visual impairment in older adults is associated with an increased risk of falls, fear of falling, and as a result, limited activity. A 2014 CDC study estimated that, of 2.8 million Americans ages 65 and older with severe visual impairment, nearly half had fallen at least once in the previous year. However, the researchers couldn’t establish that poor vision caused all the falls.

What Is Vision Rehabilitation?

If you have vision impairment, vision rehabilitation can teach you new ways to complete everyday tasks that have become difficult and help you remain independent, safe, and able to participate in activities.

Preserving your vision

Maintaining your eyesight is more than just a matter of seeing as well as possible. Doing everything you can to prevent vision problems, or prevent them from worsening, can help keep you healthier and more engaged. Taking the actions below can help you guard against vision loss:

  1. Get routine eye checkups. The American Academy of Ophthalmology recommends that everyone have a comprehensive dilated eye exam at age 40 to establish a baseline for eye health. After age 65, you should have your eyes checked every one to two years. A comprehensive exam can detect early signs of eye problems or damage—many age-related eye diseases have no symptoms until they’re at advanced states. If you’re at high risk for eye disease, such as having diabetes, you should visit your eye doctor yearly, no matter your age.
  2. Eat a healthy diet. Some studies suggest that a Mediterranean diet, associated with cardiovascular benefits, may offer eye benefits. The diet features vegetables, fruits, whole grains, nuts, legumes, and fish, with only modest amounts of red and processed meats. Other evidence suggests that consuming dark leafy greens like spinach, kale, and collard greens can help keep your eyes in shape.
  3. Maintain a healthy weight. Being overweight or obese raises your risk of diabetes and high blood pressure, which can threaten vision.
  4. Get regular exercise. Physical activity helps lower your risk for diabetes and high blood pressure, which can raise your risk of eye disease. Some studies have associated exercise with a decreased risk of age-related macular degeneration, glaucoma, and cataracts.
  5. Don’t smoke. If you smoke, you have an increased risk of age-related macular degeneration, cataracts, and damage to the optic nerve. Talk with your doctor about programs that could help you quit.
  6. Wear sunglasses and other protective glasses. Glasses that filter out harmful ultraviolet radiation can protect your eyes from sun damage; a wide-brimmed hat can also add protection. Use protective eyewear when engaging in sports, work, or hobbies that can increase eye injury risk.
  7. Keep blood pressure and cholesterol under control. Untreated high blood pressure can damage the retina and lead to hypertensive retinopathy, which can result in vision loss. High cholesterol can lead to eye diseases such as retinal vein occlusion, when one of the veins that carries blood away from the retina becomes blocked, causing vision loss.
  8. If you have diabetes, keep your blood sugar under control. Uncontrolled diabetes over time can damage the retina. Other eye complications related to diabetes include cataracts and glaucoma.
  9. If you think poor vision is causing you to feel depressed, speak with a health care provider. While treating depression won’t improve your vision, depression could hinder your motivation to take care of your eyesight and overall health. Your eye doctor may know of mental health specialists with experience treating low-vision patients.
This article first appeared in the November 2019 issue of UC Berkeley Health After 50.

Also see Should You Take Vision Supplements?