Updated August 27, 2021

Vision

WHAT QUESTIONS SHOULD I AND MY FAMILY BE ASKING?

• Have there been any recent changes in my vision?

• Have these changes been for both eyes?

• Have these changes been for my center vision or my outer vision?

• Do I find it more difficult to read?

• Have I had any recent driving accidents or incidents?

• Am I managing my high blood pressure well?

• Am I managing my diabetes well?

• Have I been having really bad headaches and vision changes?

• Have I had my vision checked recently?

• Am I using the correct prescription glasses?

What actions can i take for this agenda?

• Eat a healthy diet full of vitamin A. This can help with our night-time vision. You likely do not need to take supplements

• Try to avoid driving in the dark if it is difficult for you or if you have had any driving incidents. Consider getting your driving skills tested

• Have your vision assessed if you’re noticing any changes to your vision even if there is no pain

• Make sure to maintain good control of your blood pressure, diabetes, and other health conditions

• Wear your correct prescription for glasses while reading and driving to avoid straining your eyes

• Treat dry eyes with artificial tears you can apply especially if you live in dry or cold areas

• Make sure to go to the emergency department or talk to your doctor if you have any of the alarming features mentioned above

What is vision?

• Vision is the ability of sight and how we see  

What happens to our vision when we age?

• As we age, the parts of the eye can change

• Your eyelids can also become more relaxed or “droopy”

• Night vision is reduced and eyes can become drier

• Older adults are at an increased risk of getting eye diseases such as glaucoma or cataracts

• These changes can make driving and doing our daily tasks more difficult

Our eyes and vision can change as we age causing dry eyes, droopy eyelids, and increased eye diseases

What is “Aging Sight”?

• Aging sight is called “presbyopia” in the medical world

• It is not the same as being far or near-sighted but it is still a problem that changes how well we see

• It occurs when our eye muscles become less powerful at bringing things into focus. This means we can no longer focus on objects when they are an arm’s length or closer

• This is because the lens loses its elasticity

Will vision get worse as we age no matter what?

• Not necessarily

• Certain types of vision problems can improve as we age

• One of these is being near-sighted or having a hard time seeing things that are far away

• 40% of adults aged 20 to 60 have this problem but only about 20% of adults older than 60 have this

• However, far-sightedness or trouble seeing things close to you does get worse with aging

• This is why you will see more older adults with reading glasses

as we age the eye lens can lose its elasticity. aging does not have to mean our vision will get worse

Many older adults need reading glasses because they have problems with near-sightedness

Why is it important that I keep my vision healthy?

• In older adults, poor sight has led to people having lower health and quality of life

• It has also been proven to increase the risk of falls, trouble with your thinking, and depression

• If you are having any of these issues, refer to your doctor for a vision test

What are alarming symptoms I should watch out for with my vision?

• Sometimes changes in our ability to see are not just a normal part of aging

• Sometimes they can mean something more serious is happening

• Examples of alarming symptoms are:

• If you find your vision becoming worse quickly

• If your vision is going dark or you cannot see from certain parts of your eyes even if there is no pain

• If you find yourself getting headaches that make your vision blurry

• You should see your doctor if you have these symptoms or you’re worried about your vision

poor vision can lead to increased risk of depression, falls, confusion, and worse quality of life

Alarming vision symptoms are sudden loss of vision, combined with headaches, or severe pain

what are some causes of eye or vision problems in older adults?

• Sometimes we get scary changes in our vision like vision loss

• This could be from eye disease but can also be from something else going on in the body

• Eye infections or having any direct injury to the eye from trauma can cause problems with our vision

• Diseases like high blood pressure, poorly controlled diabetes, a blood clotting problem, or stroke can all affect how we see

• Some immune and inflammatory diseases can also cause vision problems

• This is why it is important to maintain all parts of our health to keep our eyes healthy

How does diabetes affect my vision?

• Diabetics have too much sugar (glucose) in their system that can cause damage to a number of organs

• The eyes are one of these organs as high sugar makes the blood supply to the eyes worse

• Good sugar control and treating diabetes can greatly reduce this risk

• Some may need laser eye surgery for poor vision from diabetes

there are many diseases that can affect our vision such as diabetes and high blood pressure

It is important to have your long-term (chronic) illnesses under good control to keep your vision healthy

What is glaucoma and how is it treated?

• Our eyes have fluid in them. This fluid creates an amount of pressure

• If the fluid or pressure becomes too high for whatever reason, it can cause damage to the nerves in the eyes

• This increase in fluid pressure in the eyes is called glaucoma

• Glaucoma can also cause headaches, seeing halos, nausea, and eye pain

• There are medications that can treat glaucoma

• Surgery might be needed too

• If left untreated, glaucoma can cause blindness

What are cataracts and how are they treated?

• Cataracts are probably something you have heard of before

• It is a “clouding” of the lens of the eye. It can make your vision more blurry or dull

• It can also cause problems with how you see color or reading

• It can also cause you to have some trouble with driving and glare coming off of headlights

• The main treatment for cataracts is surgery that is very common and well-tolerated. The surgery entails removing your cloudy lens and replacing it with an artificial one

Glaucoma is increased fluid pressure in the eye. Cataracts are a cloudiness of the eye lens. Both can cause blindness and can be treated with medication or surgery

What is ARMD and how is it treated?

• ARMD is the name of a very common eye disease in older adults

• ARMD stands for “Age-related Macular Degeneration”

• The macula is the center part of your inner eye

• That is why ARMD causes loss of your central vision, not outer vision

• ARMD is usually painless

• Age and smoking are the biggest risk factors

• ARMD can be treated with medications to improve the blood supply to the eye

• Some procedures can also help

How often should I get my vision checked?

• There are no specific recommendations of how often you should get your eyes checked

• You should get them checked if you think there is a change in your vision

• Talk to your doctor if you have any vision symptoms you’re worried about even if there is no pain

ARMD is the most common cause of blindness in older adults. it is usually painless and affects the center part of your vision

Hearing

WHAT QUESTIONS SHOULD I AND MY FAMILY BE ASKING?

• Do I hear as well as I used to or has my hearing been getting worse?

• Has my hearing been getting worse over time or was it very sudden?

• Am I having a constant ringing or a constant sound in my ears making it hard to hear?

• Am I feeling dizzy like the room is spinning?

• Is my hearing problem the same on both sides or worse on one side?

• Is my hearing trouble impacting my relationships with others? Is my mood worse because of my hearing loss?

• What kinds of sounds and things do I have a hard time hearing?

• Could I benefit from a hearing aid or assistive listening device?

WHAT ACTIONS CAN I TAKE FOR THIS AGENDA?

• Talk to your doctor if you notice your hearing changing

• Stop using Q-tips to manage my ear wax

• Speak to your doctor if you have ringing in your ears or are feeling imbalanced

• Try to be open-minded about hearing aids and assistive listening devices

• Ask others to speak up or deepen their voice if it will help you hear

• Stop smoking to reduce your risk of hearing loss

• Reaching out for help if your hearing loss is making you feel isolated, depressed, or poorly about yourself

• Make sure your other medical conditions like diabetes are managed well

• Reviewing your medications with your doctor to see if any of them could be affecting your hearing

What is hearing loss?

• Hearing loss is a large term that can include short-term or long-term problems with hearing

• These problems can be progressive over time or can be quite sudden when something else is going on

• Older adults are at increased risk of hearing loss especially for “high frequency” noises

• High-frequency noises are noises such as birds chirping, whistles, or children voices

What are the causes of hearing loss?

• There are many causes of hearing loss

• Hearing loss is divided into two types to understand what is happening

• In one type the actual nerves, small bones in the ear, or specific hair cells that conduct the sound to the brain stop working

• This is called “sensori-neural.” That is a large word we can break down into “sensori” like sensory or do with our senses and “neural” like nerve or having to do with the brain

• The other type of hearing loss is called “conductive” loss

• This kind is anything that prevents the sound to get into the ear correctly

• It can be caused by things like too much ear wax or fluid in the ear

hearing loss can be caused by nerve problems (sensori-neural)

Another cause is from sound going into the ear problems (conductive)

What is the normal pattern of age-related hearing loss?

• The normal type of hearing loss that happens with age affects both ears the same way

• These changes take time to get worse over years. They are not sudden

• If you have a sudden change in your hearing or affecting one ear more than the other, you should speak to your doctor

How common is it to have hearing loss?

• More than half of adults by age 75 have age-related hearing loss

• This increases to most adults over 80 and nearly all adults over 90

What kinds of things put me at higher risk for hearing loss as I age?

• People exposed to loud noises have an increased risk for hearing loss

• Other less obvious risks include being of white race and smoking

• Some medication side effects can also cause hearing loss

• Many diseases like diabetes and high blood pressure can also do this

almost half of older adults over age 75 have hearing loss. normal hearing loss is usually in both ears and not painful but should be treated

Why is it important to keep hearing working well?

• Having poor hearing can negatively impact people in a lot of ways

• It can result in low self-esteem, isolation, and depression

• It can worsen the quality of life

• It can be difficult for people to communicate if they cannot hear

• Poor hearing can also contribute to developing dementia. Refer to our in our “mind” agenda for more details

Should I see a doctor if I think I am having hearing loss?

• We mentioned that hearing loss can be a normal part of aging

• But that does not mean you should not see your doctor about it

• Not being able to hear can negatively affect us in many ways

• Seeing your doctor about your hearing can help you make sure it is as best as possible

hearing loss can worsen isolation, low self-esteem, depression, quality of life, and dementia

What are other symptoms I should watch out for with my hearing?

• Sometimes other symptoms can occur along with hearing loss. One of these is called “tinnitus” which is having a steady sound in the ears at all times

• Usually, people feel like there is a ringing or a static sound that they can’t get rid of

• Another common symptom is “vertigo”. This means feeling like you or the room is spinning when you move

• This can cause imbalance and increase the risk of falling. It is important to mention these symptoms to your doctor

• Refer to the “falling” agenda for more details

What should I do about the wax in my ears?

• Ear wax is a common and normal thing to have. However, you should not be using Q-tips in your ears

• Q-tips can push the wax into your ears further and cause worse hearing problems. Also, there is a chance a Q-tip can cause injury to your eardrum and worsen hearing

• If you have wax build up over time you can go to your doctor to ask them for treatment

tinnitus and vertigo are symptoms to look out for with hearing loss. These can increase your risk for imbalance and falls

What can I do to help improve my hearing loss?

• Hearing aids are a common solution to hearing loss for older adults

• You can sometimes have a trial period with a hearing aid to see if it works for you

• If uncomfortable, the size and settings can be adjusted. Some are covered by insurance and some are not

• Other things include assistive listening devices like special telephones that can help relay the sound directly to the ear

• There are other medical treatments like implants and rehabilitation that your doctor may suggest too

• Audiologists are specialists for hearing and may be able to help diagnose and treat hearing loss

• ENT physicians are surgical ear specialists that diagnose and treat many ear diseases

What are important tips for hearing aids?

• Making sure to maintain your hearing aid is very important

• Store them in the same place safely

• You should clean them regularly

• Often they can run out of batteries and we don’t know or notice

• Following proper instructions for use is also important

• Using the hearing aids as much as possible and making sure they fit in your ears correctly

hearing aids are common and very helpful devices for older adult hearing loss that are under-appreciated and should be used more

What resources can help with this agenda? 

References

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