From young children to the elderly, no one is immune from vision problems. For some, it’s genetic; for others, it’s a part of the aging process. Four of the most common eye problems are cataracts, floaters, macular degeneration, and glaucoma.
The National Eye Institute says that in the U.S., at least 24 million people over age 40 have cataracts, 11 million have age-related macular degeneration (AMD), and nearly 3 million have glaucoma. Eye floaters affect nearly 30% of the general population.
Cataracts
“Routinely, people over 60 develop cataracts, but they can also occur among children,” says David Rand, M.D., a specialist at the Rand Eye Institute, a premier eye-care facility that for 35 years has treated thousands of people throughout South Florida and around the world. “Cataracts cloud the natural lens inside the eye and can be caused by sun exposure, trauma, a medical condition, genetics, and aging.”
Warning signs include a need for more light, a lack of clarity, and glare from car lights or lampposts when driving at night. “Regardless of the degree, vision can be restored surgically,” Dr. Rand said. “There is more urgency among young children because their vision can be affected permanently.” Mild cataracts can be temporarily treated by changing the prescription of one’s glasses, but once visual quality becomes a problem, surgery is the definitive treatment.
Floaters
Millions experience eye floaters or “shadows” on the retina, and it’s a chronic problem that can impact the quality of life. Most are caused by age-related changes in the eye’s vitreous, a jelly-like substance that deteriorates over time. They occur primarily during middle age, or earlier, and develop due to an inflammatory condition.
“As a physician, I’m concerned that a patient who has an acute increase in flashes or floaters may have a retina tear or detachment,” said Carl Danzig, M.D., a vitreoretinal specialist at Rand Eye Institute. “It’s very important to seek a diagnosis as early as possible.”
Age-Related Macular Degeneration (AMD)
When new blood vessels grow under the eye’s retinal tissue, it’s referred to as “wet” AMD. When there is a thinning of the macula, a part of the retina responsible for clear vision in direct line of sight, it’s referred to as “dry” AMD.
“If you have trouble reading a menu, small print, or have problems driving at night, dry AMD may be the cause,” said Dr. Danzig. Vitamins with the AREDS2 formula are used for both types, but they’re especially recommended for patients with intermediate-stage AMD or worse. “The standard treatment for wet AMD is intravitreal injections; surgery is not a first-line treatment.”
Glaucoma
When there is damage to the optic nerve due to high or fluctuating eye pressure, glaucoma can occur, and if untreated it can lead to vision loss. Although diabetes, high blood pressure, heart disease, and a history of trauma are contributing factors, a genetic predisposition is also common. “If a family member has glaucoma, it’s very important to be examined and monitored to be certain that glaucoma does not develop,” says Dr. Rand. “The important point common to all treatment options is to adequately lower and maintain the eye pressure to an acceptable level to prevent progression well before it becomes advanced enough to threaten the vision.”
Glaucoma can be asymptomatic in its early stages, but gradual vision loss may still occur. “Sadly, many patients are unaware they have glaucoma until they lose their vision,” he said. According to the specialist, certain types produce painless vision loss, while other forms cause significant eye pain, pressure, and/or headaches. Among young children, it may lead to tearing or excessive eye rubbing.
David Rand, M.D.
Dr. Rand completed his undergraduate education at the University of Miami and received his medical degree from the university’s Miller School of Medicine, Honors Program. He completed his postgraduate internship in internal medicine at the Staten Island University Hospital and completed his residency at the State University of New York, Downstate Medical Center. He has published scientific papers and presented before prestigious organizations, including the Association for Research in Vision and Ophthalmology and the Radiological Society of North America.
Carl Danzig, M.D.
Dr. Danzig is a vitreoretinal disease specialist with experience treating a variety of complex eye disorders. He graduated cum laude from Tulane University and was accepted into the Phi Eta Sigma National Honor Society. After receiving his medical degree from Temple University, he completed an internship at Crozer-Chester Medical Center and residencies at Martin Luther King Jr. Hospital/Charles R. Drew University in Los Angeles and the State University of New York-Downstate, Brooklyn. He also enrolled in the University of Texas/Southwestern Medical Center’s vitreoretinal fellowship program.