A holistic approach to vision care in the aging population is essential to overall health and wellbeing. Preserving vision in older adults goes far beyond maintaining independence in daily activities—it is a fundamental part of basic health and safety. As a retinal specialist serving our community, I may be biased in emphasizing the importance of visual health, but the data clearly supports this view.
Vision loss in older adults is strongly linked to an increased risk of falls and fractures. These injuries often lead to hospitalizations, nursing home placement, long-term disability, and loss of independence.
Even moderate vision impairment can interfere with daily tasks such as identifying medications, bathing and dressing safely, and navigating familiar places like the home or grocery store. Vision loss is also associated with higher rates of depression and social isolation as we age.
Among vision conditions affecting older adults, age-related macular degeneration (AMD) is the most common and the greatest threat to long-term visual function. More than 10 million Americans are currently affected, and that number is expected to rise as the population ages.
Understanding AMD allows patients, caregivers, and clinicians to recognize symptoms earlier and take steps to protect vision.
AMD affects the macula, the central part of the retina responsible for sharp, detailed vision. Most patients develop dry AMD, which usually progresses slowly but can unpredictably convert to wet AMD, the more aggressive form of the disease.
In early dry AMD, small yellow deposits called drusen form beneath the retina. Patients may notice mild central blur or metamorphopsia, where straight lines appear wavy.
As the disease progresses to intermediate dry AMD, these symptoms become more noticeable. Many patients experience reading fatigue, difficulty focusing, or find themselves closing one eye due to differences between eyes.
In advanced dry AMD, areas of retinal cell loss develop, leading to missing spots in central vision. Early atrophy causes reduced contrast, increased glare, and skipped letters while reading.
In its most severe stage—geographic atrophy—central vision loss can be profound, and patients may become legally blind with difficulty recognizing faces.
Although dry AMD typically progresses over many years, 10–15% of patients convert to wet AMD. In this form, abnormal blood vessels grow beneath the retina and can leak or bleed, causing rapid vision loss over days or weeks.
Chronic oxidative stress in the aging macula is believed to play a key role in triggering this process.
The good news is that modern retinal treatments have dramatically improved outcomes. Intravitreal anti-VEGF injections prevent further severe vision loss in more than 95% of patients when started promptly.
Even more encouraging, about half of patients experience meaningful improvement in vision with treatment.
Protecting vision as we age requires awareness, early detection, and timely care. By recognizing the signs of age-related macular degeneration and seeking treatment early, we can preserve independence and reduce the broader health risks associated with vision loss.
At Wagner Kapoor Institute, we remain committed to saving sight and enhancing lives, and we welcome the partnership of patients, families, and referring providers in this important effort.
In summary, we all need to work together as a team to protect our aging patients. Understanding the most important threat to our geriatric patients’ vision will enable us all to play a greater role in defending against severe vision loss, and deterring all the associated harmful aspects that accompany vision loss. As always, we remain committed to our mission of saving sight and enhancing lives and invite your teamwork in joining this important cause.
