Eye Care
50+ Eye Care - Functional vision as we get older (50+)
Many people feel that their vision seems to fail them as they get older. I am not talking about the need for reading glasses, or loss of sight as a result of pathology, such as cataract and macula degeneration, that more commonly affect us with advancing years. Very often people in their middle to late years, with perfectly healthy eyes, feel that they cannot concentrate properly on a book like they used to, frequently falling asleep, in spite of wearing their reading glasses.
Although they "pass" regular eye tests, they struggle to take in road signs fast enough and avoid driving in unfamiliar places and fast or busy traffic. Some lose the ability to judge space when parking or even when walking around objects. They become a bit clumsy, misjudging their step when negotiating kerbs, spilling drinks, bumping edges of cabinets and doorways, and falling.
Below is a list of some common visual complaints that are frequently functional in origin.
- Loss of balance, prone to accidents and falls
- Insecure with small heights (kerbs and walls) and broken pavement
- Difficulty driving at higher speed such as on the motorway
- Loss of ability to park or drive in busy traffic
- Loss of ability to play sports, such as tennis and golf
- Difficulty with escalators and stairs (Loss of ability to make time distance judgements)
- Difficulty finding objects at near and far
- Loss of awareness of what is occurring around.
- Insecure in unfamiliar places
- Loss of directional concepts
- Loss of ability to visualise what is heard
- Loss of ability to read and absorb content
- Difficulty concentrating on the computer screen
- Loss of depth perception
Understanding this relatively common problem requires some explanation of how visual skills develop in the first place. Soon after entering this world our eyes are anatomically fairly mature and capable of resolving quite tiny detail, but we have to learn how to use them properly to understand our visual world. Like a camera, each eye or visual channel must be focused at the correct distance in order for us to see clearly. In early infancy the two channels work independently and we must also learn to integrate them, operating them together as a pair. During early movements, hand to mouth and crawling stages, we "measure" space using our body movement through it, and repeatedly compare this spatial information with the visual impression of space received through the eyes. By means of this constantly repeated “sharing and comparing” of information through the different body senses we refine our understanding of space so that we no longer require support or feedback from other body systems, such as touch, to know exactly where things are. This is essential to efficient focusing and eye alignment for effortless clear and single vision.
This matching and combining process continues throughout our life and, consequently, the way we use, or don't use, our bodies in sickness and in health influences the quality of functional control over the visual system. As we get older we tend to stop exploring space and experimenting with more extreme and unusual body movements. Think of the way that children hurl themselves around, rolling, jumping, stretching, skipping, twirling, dancing, crawling, lunging, under things, over them, inside them. As we mature we move much less and in more regimented, repetitive movement patterns. Limitation in movement, or undue effort to achieve movement, common in many conditions, such as arthritis, will limit or distort essential spatial feedback from body to visual system, and functional visual skills will eventually begin to suffer.
Vision Therapy can be very useful in combating decline in functional visual skills. It may be combined with modern lenses, such as enhanced readers and indoor varifocals, to significantly improve visual performance.
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