For many, going blind is worst that could happen

Studies stress importance of having thorough eye exam at least once every two years

An essay published in The New York Times in November, “Feeling My Way Into Blindness,” by Edward Hoagland, an 84-year-old nature and travel writer and novelist, expressed common fears about the effects of vision loss on quality of life.

Hoagland, who became blind about four years ago, projected deep-seated sadness in describing the challenges he faces of pouring coffee, locating a phone number, and knowing to whom he is speaking.

Hoagland is hardly alone in his distress. According to Action for Blind People, a British support organization, those who have lost some or all sight “struggle with a range of emotions — from shock, anger, sadness and frustration to depression and grief.”

A recent study from researchers at the Wilmer Eye Institute at Johns Hopkins University School of Medicine found that most Americans regard loss of eyesight as the worst ailment that could happen to them, surpassing such conditions as loss of limb, memory, hearing or speech, or having HIV/AIDS.

Some 23.7 million American adults reported in 2015 that they are unable to see at all or have trouble seeing even with corrective lenses. This number is projected to perhaps double by 2050 based on the aging of the population.

Perhaps the single most valuable message to emerge from studies of vision loss is the importance of having a thorough eye checkup at least once every two years, if not annually. Many sight-robbing conditions can be effectively treated if detected early enough, in many cases limiting or eliminating the damage to eyesight.

Four eye diseases — age-related macular degeneration, diabetic retinopathy, glaucoma and cataracts — account for most cases of adult blindness and low vision among people in developed countries. Unlike many other ailments associated with aging, they cause no pain and often no early symptoms.

Macular degeneration, a leading cause of vision loss in Americans 60 and older, involves an irreversible loss of retinal cells that robs people of the central vision needed to read, watch a TV program or identify a face or object in front of them.

Steps you can take to lower your risk of macular degeneration or slow its progression include not smoking, eating lots of dark leafy green vegetables, wearing sunglasses to block ultraviolet light, and taking one or more supplements formulated to support macular health.

Diabetic retinopathy, the cause of most blindness in American adults, also affects the light-sensitive retina, damaging the vision of more than half of people with diabetes age 18 or older. The most effective preventive is maintaining a normal level of glucose in the blood through medication and a proper balance of diet and exercise.

Glaucoma, another leading cause of blindness, involves a rise in fluid pressure inside the eye that damages the optic nerve. It affects more than 4 million Americans, about half of whom don’t know they have it, and is especially common among African-Americans and Hispanics.

Although glaucoma is not curable, treatment to lower pressure in the eye with prescription eye drops and, in some cases, pills or surgery can control the condition.

Cataracts are the most common cause of vision loss among people over 40. They involve a gradual clouding of the lens, a normally transparent tissue directly behind the iris and pupil that helps to focus images on the retina.

Preventing or slowing the development of cataracts involves protecting the eyes from sun damage, not smoking, consuming a diet rich in vegetables and fruits and, if you have diabetes, keeping blood sugar under control.

In years past, doctors often advised patients with cataracts to wait until they were far advanced before removing them surgically. This is no longer the case. Cataract surgery is now done when the condition begins to affect a person’s quality of life or interferes with the ability to perform normal activities.