Identifying and treating the causes of eye pain are very important. If not treated properly, it may lead to blindness or even permanent damage to your eyes. A common cause of eye pain is glaucoma. Glaucoma is a disease that damages the optic nerve causing vision loss. The most common type of glaucoma is called choroidal neovascularization (CNV). CNV occurs when there is excess fluid within the vessels supplying blood to the retina. When this happens, the optic nerve becomes damaged.
Glaucoma is a condition that affects both men and women equally. It usually develops between the ages of 20 and 40 years old. Glaucoma can develop at any age but it is more likely to occur in older adults due to their increased risk factors such as smoking, high cholesterol levels, diabetes mellitus, obesity and certain genetic disorders.
Eye pain is one of the symptoms of glaucoma. However, some people do not experience eye pain. These individuals are referred to as “silent” glaucoma patients. They have no visible signs of glaucoma and they don’t need treatment because their eyes are functioning normally.
People with silent glaucoma will probably never develop blindness or other complications from their condition.
To avoid eye pain, it is important that you have regular eye checkups. You might also want to protect your eyes from exposure to loud noises or bright lights. These factors can trigger or worsen glaucoma symptoms. If you experience symptoms of eye pain, see an ophthalmologist immediately for a proper diagnosis and treatment plan.
Proper care and precaution can help you avoid complications and permanent vision loss caused by glaucoma.
DIFFERENTIAL DIAGNOSIS
There are several conditions that may mimic glaucoma. It is important to consider these diseases when diagnosing patients with eye pain. A proper diagnosis can help you and your patient avoid the side effects of unnecessary medications and surgeries.
Optic neuritis is a disease of the optic nerve which results in temporary or permanent vision loss. Like glaucoma, it is also caused by increased pressure in the eye. People diagnosed with optic neuritis may also experience pain in the eye or vision loss after exposure to bright lights. However, most patients with optic neuritis have specific symptoms of brain lesions or a history of multiple sclerosis (MS).
These conditions should be considered when diagnosing patients with eye pain.
Optic neuropathy is another disease that causes vision loss. Like glaucoma, it may be caused by increased pressure in the eye or abnormalities within the optic nerve. Unlike glaucoma, patients with optic neuropathy will usually experience pain in only one eye. They also experience other symptoms such as a loss of color perception and temporary vision loss after exposure to bright lights or fatigue.
Retinal artery occlusion is another cause of sudden vision loss. The blood supply to the retina is blocked, damaging the cells. This condition most commonly affects people between the ages of 40 and 70 years. The symptoms are similar to glaucoma.
Like glaucoma, retinal artery occlusion can cause vision loss after eye exposure to bright lights or fatigue. On the other hand, it does not usually cause pain in the eye.
Complications from cataract surgery are another possibility when diagnosing patients with eye pain. Although rare, the surgery can cause temporary or permanent vision loss. Symptoms include seeing flashes of light, reduced color perception and pain in the eye.
LENS DISEASE
A cataract is a clouding of the lens inside the eye. It is a common condition that develops as people age. However, it can occur at a much younger age. Cataracts can cause vision loss by decreasing the sharpness of vision or causing a blurry effect.
They can also cause glare, multiple images, and a grayish or whitish hue to vision. People with cataracts may experience changes in their visual field. It is very common for people with cataracts to experience pain inside the eye.
It is important to distinguish lens clouding caused by cataracts from other conditions such as glaucoma or retinal disease. Cataract surgery is the primary treatment for cataracts.
Aging is a normal biological process. As a person grows older, cells divide and die at a slower rate. This slows down many bodily functions, including vision. Accommodation is the process of focusing on an object at different distances.
This process is controlled by the elasticity of the lens inside the eye. As a person ages, the lens loses elasticity. This results in a loss of near vision typically starting at around 40 years of age.
Presbyopia does not cause vision loss in and of itself, but it can certainly be a frustrating condition. There is no way to reverse the effects of presbyopia, but there are many ways to treat it. Some people find reading glasses useful for providing clearer vision for near tasks such as reading. Others find magnifying lenses useful for the same purpose.
Lenses that correct presbyopia are available in many different strengths.
ARTERY DISEASE
Nerves inside and outside the eye require a blood supply in order to function properly. If the blood vessels leading to or away from the eye are clogged or damaged, vision loss or other problems can result. There are two main arteries that supply blood to the back of the eye: the ophthalmic artery and the central retinal artery.
There are a number of diseases that can restrict blood flow to the eyes. These include diabetes and high blood pressure. Arteries can become hardened and narrowed due to the same factors that cause heart disease and stroke: high blood pressure, elevated cholesterol, and cigarette smoking.
Stroke is a sudden loss of blood flow to part of the brain. Vision loss can be one of many symptoms.
The symptoms of eye disease or any combination of these diseases can include vision loss, floaters, a grayish or black shadow over part of the visual field, poor night vision or nocturnal (night) blindness, sudden onset of pain in or around the eye, redness, swelling or tearing of the eye.
BRIGHT LIGHTS
There are many ways in which bright light can damage the eyes. Sunglasses are a very important protective measure against the sun’s UV rays, which can cause cataracts. Other bright lights such as lasers, solar beam reflectors or welder’s arc lights can burn the retina, causing permanent vision loss.
Laser Safety: All lasers emit light that is focused into a small area. Depending on the laser’s power, the focused light can be harmless or it can burn a hole in a sheet of paper. If the laser is powerful enough, it can burn skin or eyes on contact. Whether a laser is safe for use or not depends on many factors including the wavelength of light, the size of the laser beam, the power of the laser, and the duration of exposure.
Sunglasses: Sunglasses protect the eyes against UV light from the sun. They come in all shapes, sizes, colors and materials. They all have one thing in common: they prevent UV light from damaging your eyes.
Goggles: Goggles are safety glasses that fully enclose the eyes. They are used in industrial and laboratory settings where there is a risk of injury to the eyes from flying particles or liquids or where vision could be obscured by dust or smoke. In these situations, it is best to have goggles that fully protect the eyes and are resistant to whatever might be flying around. Goggles should be regularly inspected for cracks or other damage.
Filters: Welder’s goggles and glasses come with different filters. The filter shade number tells how much light the filter lets pass through. The lower the number, the less light passes through and the darker the lens. Shade numbers range from 9 (almost no light) to 13 (normal daily exposure).
14 and higher are for very bright light.
Glare Visors: Glare visors are worn like eyeglasses or clipped to the front of a hard hat. They can be used to reduce the glare from bright lights or the sun.
COMMON ILLNESSES
The following are some common eye problems among elderly people.
Cataracts: A cataract is a clouding of the lens inside the eye, which is usually gray in appearance. It decreases the amount of light that penetrates the lens and reduces vision. As the cataract grows larger, it prevents light from passing through at all, which creates a milky appearance on the eye’s surface. Eventually it changes the way light is focused so that images are not clear.
It also makes it hard to see colors and can make a person extremely sensitive to light.
Diabetes: A disorder of the way the body handles sugar (glucose), diabetes affects the whole body, but especially the eyes. It is the leading cause of blindness among adults. People with diabetes have an increased risk of developing glaucoma and diabetic retinopathy, which occurs when blood vessels in the retina develop abnormal growths or become damaged by high blood pressure.
Sources & references used in this article:
Common eye diseases of elderly people: identifying and treating causes of vision loss by PT Harvey – Gerontology, 2003 – karger.com
The eye in systemic infection by WA Lynn, S Lightman – The Lancet, 2004 – Elsevier
Improving awareness, identification, and management of meibomian gland dysfunction by GN Foulks, KK Nichols, AJ Bron, EJ Holland… – Ophthalmology, 2012 – Elsevier
Eye treatment by D Korb – US Patent App. 10/453,123, 2003 – Google Patents
Non-motor symptoms: identification and management by S Muzerengi, D Contrafatto, KR Chaudhuri – Parkinsonism & related …, 2007 – Elsevier
