What happens to our eyes as we age?

At The Greens at Cannondale’s Community Health Series on Nov. 16, The Aging Eye was the subject. Cataracts, macular degeneration, glaucoma, detached retina, floaters, were all described, as well as the most current treatments, which change so often that a specific listing could be quickly outdated, according to Dr. Armand Daccache, who led the discussion. An eye surgeon with Danbury Eye Physicians and Surgeons and assistant clinical professor at the Yale School of Medicine, he began by explaining macular degeneration, one of the most serious diseases of the aging eye.

“The center of the retina, at the back of the eye is called the macula. At about the sixth or seventh decade of life, when cells of the macula may start to die, they stay in the retina, impairing central vision. There is still peripheral vision, but vision at the center of the eye deteriorates.

“Dry”’ macular degeneration (the most common type) consists of slow, chronic changes we see with aging. “Wet” macular degeneration is when there is oozing of blood and/or fluid. The good news is that macular degeneration is not the visual death sentence it used to be. It will never cause total blindness. In the early stages, people have coping mechanisms — shifting the focus to a healthy part of the retina. The initial treatment is to slow down the deterioration with a formulation of special eye vitamins. The best treatment so far requires a monthly or bi-monthly injection of medication into the eye. The injectable treatment has been a breakthrough for the wet variety. “It has helped stabilize or stop the progression of the disease,” Daccache said.

Assisting him, optometrist Dr. Lauren Plass explained glaucoma, which is caused by excess fluid inside the eye and a pressure build-up closing off drainage and slowly destroying the optic nerve, which connects the retina to the brain. Glaucoma is the leading cause of blindness for people over 60. It is a painless, slow loss of sight which starts with loss of peripheral vision. Glaucoma can be treated with eye drops aimed at decreasing fluid production.

Compared to the seriousness of macular degeneration and glaucoma, cataract surgery is the most common of all surgeries. The techniques used today, with instruments that suck out the cloudy lens and replace it with a clear lens are remarkably successful. Years ago, doctors recommended waiting until the cataract was “ripe,” but now cataract removal is indicated as soon as daily life is affected by changes in vision. Extra-thick glasses need not be worn and cataracts don’t come back.

Our eyeballs are protected organs, Daccache explained. “The eye has a separate circulatory system. Though we may have a bodily infection, the eye won’t be infected. I’m very hopeful that current studies will provide more new ways to treat and perhaps even cure eye disease. Meanwhile, wear your sunglasses!”