In this article, we take a look at why we start experiencing eyesight impairment over time. And we also ask ANDY MEAU, an optometrist in Hong Kong at iSight Optometric Eye Care Center, to talk us through some of the things we can do to prevent and treat age-related eye problems.
What causes age-related eye problems?
Most of the time, for adults, vision will start to change in their late 30s to early 40s. Some of the typical comments we get in the clinic are:
- “I need to hold my phone further away from my eyes to read”
- “I feel like I can’t see the menus in dark restaurants anymore”
- “I feel a constant pain around or behind my eyeballs”
- “I’m starting to take pictures of small text with my phone and blow up the picture to see it”
- “I feel like my vision is not focusing right; things seem to come into and out of focus randomly”
- “I’ve had perfect vision all my life, but one morning I woke up not being able to focus on anything – it’s like my vision fell off a cliff”
These comments relate to one of the most common eye problems I encounter in my clinic for this age group. It’s due to presbyopia. This is a change in the focusing ability of our eyes, which will continue to progress as we get older. Presbyopia occurs when the crystalline lens inside our eyes starts losing its flexibility. This prevents the lens from accurately focusing light and images on the retina when changing focus from objects at a far distance to objects that are close.
For some people who have never needed glasses in their whole life, the change can be frustrating or even quite scary. Yet it’s an entirely normal part of ageing.
What are the treatment options for presbyopia?
Testing of the focusing ability (called the “near point of accommodation” and “near point of convergence”) during a comprehensive eye examination can determine whether corrective glasses will be needed. Fortunately, with advances in optical lens design in recent years, there are many options for people with presbyopia.
For example, we can provide prescriptions for people who spend most of their days in front of screens. Or for those who require frequent changes in focus from distance to near vision. We do this by getting a detailed history of a person’s daily activities, work environment and visual needs. In some cases, a pair of simple reading glasses may be sufficient – or multiple sets that can be kept in various places. Nowadays, we also see lots of advances in multifocal contact lenses, which allow wearers to change focus effortlessly.
Are there misconceptions about presbyopia?
A common myth I often hear is that once you start using glasses, there is no turning back. This is true to a certain extent, but the need for glasses is not because of the use of them; rather it’s because the presbyopia is accelerating. The vision changes associated with presbyopia will continue regardless of whether glasses are worn or not. Changes in presbyopia are age-related. And for the majority of us, regardless of where we’re from, they follow the same age curve. The fact that some people seem to not need reading glasses depends on their lifestyle, their tolerance to blurry vision, their pre-existing prescriptions, and their habitual reading or working distances.
It’s important to remember that presbyopia affects only our near vision; it doesn’t have any impact on distance vision. The other good news is that presbyopia will not go on forever. It usually plateaus in our mid-50s to early 60s. So, from our mid-40s to mid-50s, we see a clinically significant change once every two years or so, meaning that the previous prescription will not be strong enough and an adjustment will need to be made.
What are some other common eye conditions and eyesight impairments people experience as they age?
Besides losing flexibility, the crystalline lens will gradually lose its clarity and become more cloudy or hazy. This change usually begins in our mid 60s, as ageing causes the proteins in the crystalline to clump together. Cataracts occur when this cloudiness causes blurry vision at all distances – it can be like looking through a dirty, filmy window.
Common symptoms of cataracts are needing strong light to read, blurry vision that cannot be corrected by glasses, extra sensitivity to bright sunlight, glare from headlights or street lights when driving, and poorer vision in low-light conditions.
The vision loss from cataracts is gradual, and if left untreated it can have a significant impact. Again, fortunately, with advances in cataracts treatment, surgery can be performed to remove the cloudy lens and replace it with an artificial one, known as an intra-ocular lens (IOL).
This is a safe and quick treatment that can help restore clarity in our vision instantly. I often tell my patients that a cataract is not a disease, it’s an unfortunate change in our body that leads to blurry vision. As I heard a cataract surgeon once say, “If you live long enough, you will have cataracts.”
How often should we have our eyes and eyesight checked by an optometrist in Hong Kong?
For someone who is asymptomatic, I recommend a comprehensive eye examination every two years starting at age 35. For someone beginning to experience vision changes, I recommend an annual check-up. This includes for people who are myopic (near-sighted), because myopia is a risk factor in eye diseases such as glaucoma, macular degeneration and retinal detachment. Those with systemic diseases such as hypertension or diabetes should also have their retina examined once a year to monitor changes in the vascular system in their retinas.
These diseases are known to cause vascular events that can affect our vision. How can we reduce these health issues and reduce age related eye problems?
Things we can do daily to avoid developing eye diseases are protection from harmful UV from sunlight, eating a well balanced diet that includes dark leafy green vegetables and omega oil from fish, and refraining from heavy consumption of alcohol and smoking. Having routine eye examinations at recommended intervals allow for early detection of any eye diseases – the earlier the detection, the better the prognosis.
How does iSight help prevent and treat eyesight impairment, conditions and issues?
We are a primary care optometry clinic. Our role is to be the first line in vision and eye care. If you experience any ocular discomfort or changes in vision, our examination can identify the eye problem and provide the most appropriate and timely intervention.
More about this optometrist in Hong Kong
Andy Meau has had an eyesight impairment for as long as he can remember. Born here, his family moved to the US when he was still young – he spent his childhood and early adulthood living in the Boston area.
“I needed glasses when I was six or seven years old,” he says. “My eyesight got progressively worse over the years so I had special hard contact lenses fitted. But being an active teenager taking part in different sports, I kept on losing or damaging them. As the cost mounted in replacing the lenses, I decided to work part-time during my high school and college years in the optical shops or optometry clinics – mostly in the hope of getting my lenses cheaper! This was my first introduction into the field of optometry.”
If you think you are developing an eyesight impairment, visit isight.com.hk or call 2521 6060 to book an examination.
Room 1002-03 Loke Yew Building,
50-52 Queen’s Road Central
This interview with an optomestrist in Hong Kong first appeared in the Autumn 2024 issue of Expat Living magazine. Subscribe now so you never miss an issue!
Read on for more in our Health & Fitness section.
