Seniors' Eye Problems Are Major Woes But Often Treatable

December 11, 1991|By Dr. Dorothy A. Shannon, Sinai Hospital, Baltimore June Kurtz Contributing writer

MANY SENIORS THINK OF CATARACTS — a clouding of the lens that causes a glare and blurred vision -- as a nuisance that accompanies old age.

But M. Alice Engel, 82, who was forced to stop driving at night because a cataract was making it too difficult to see, said they're not all bad.

"Nobody -- unless they've had cataracts -- has ever seen Christmas lights so pretty," she said.

However, when her vision deteriorated, Engel had the cataract removed. Since then, her eyesight has beenfine, she said.

The aging process dulls more than vision, said Brenda Lerner, Community Services Program coordinator at the Carroll County Bureau of Aging.

"Aging is losses," Lerner said. "Anybody who's living is aging, and we're all going through losses. Only, as the person gets older, it's more noticeable."

Engel's satisfaction with the cataract removal is not unusual, according to Andrew I. Kessler, a Westminster ophthalmologist, who estimates that 95 percent of the45-minute surgeries are successful.

The cost for the procedure isabout $1,500, but Medicare pays about 80 percent, he said.

"Patients, in general, do very well with cataract surgery," he said. "They benefit so quickly. It's unusual for someone to have any problems."

But not all eye problems are curable, Kessler said.

Glaucoma -- high pressure in the eye -- damages the nerve that sends information received by the retina to the brain, resulting in a slow loss of peripheral and, eventually, frontal vision, he said.

While glaucoma can be treated by controlling the pressure in the eye, early discovery is crucial to minimizing damage, Kessler said.

"You may not find out you have it until you've lost the ability to do something about it," he said. "Unlike cataracts, there's nothing you can do to gain back any vision that's been lost. That's why it's so important to catch it early."

Less serious, but a problem that affects one out of three older people, is dry eyes -- a scratching, burning feeling in the eye, Kessler said. Non-medicated artificial tear drops, which are sold without prescription, are good lubricants, he said.

Everyone's vision dims with age, Kessler said. Seniors should read with a strong incandescent light, positioned so it will shine over their shoulders from behind their backs, he said.

For 10 years, glasses have adorned the face of Russell Martin, because the 83-year-old was having difficulty reading fine print on medicines and newspapers -- a common problem for seniors.

"They gave me a magnifying glass that's about as strong as any in this country," said Martin, a Hampstead resident. "I gave up my automobile license about six years ago -- I can't read the advertisements on the billboards."

Most people 65 and older should see an ophthalmologist every two years, Kessler said.

They should also have their hearing checked, because about 30 percent of people older than 65 have some degree of hearing loss caused by a degeneration of the nerve cells, said Roy M. Bordenick, a licensed audiologist in Westminster.

Although any of the points in the auditory system, which starts in the outer ear and goes through the inner ear to the brain, can cause problems, a buildup of earwax is at the root of the hearing loss of many seniors, Bordenick said.

"Elderly people usually get a lot of it," he said of earwax. "If they do not go to a doctor often, it may not be cleaned out. They try to use home remedies, which sometimes pushes it further."

On the other hand, he said,"A lot of people go out and try to buy a hearing aid when, in reality, all it is is a little earwax."

Of course, many seniors actuallyneed hearing aids, which cost $400 to $2,000 and are generally an out-of-pocket expense, Bordenick said.

A hole in the left eardrum causes the hearing loss of Manchester resident Ethel L. Baust.

"The words don't sound plain," said Baust, 77. "You'll know somebody's talking to you, but still it's not distinct."

Baust keeps her telephone volume on loud, she said.

Another option for people who have trouble hearing over the phone is an amplifier, which ranges in cost from $13 to $65 and can be easily attached to the phone, Bordenick said.

While it's embarrassing to ask people to repeat things, a hearing aid isn't always the perfect solution, Baust said.

"When I put my hearing aid in and I go out in a group, it's too noisy," she said.

The amplified noise often causes seniors to get confused, said Carrie Nusbaum, a community health nurse for the Geriatric Evaluation Services at the Carroll County Health Department.

"They can't hear and separate those noises at all," she said. "It all kind of runs together."

It is not uncommon for people to have that type of problem when their hearing loss is in intensity rather than volume, Bordenicksaid.

"It's like tuning a radio," he said. "The louder you make it, the fuzzier it is."

In addition, many seniors avoid buying a hearing aid and, once they do, have a hard time getting used to it, Bordenick said.

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