Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week we’re going to talk about your aging eyes. 

Over the last 3 years I have noticed that my eyesight has gradually gotten worse. I never reach for my charts without reaching for my reading glasses first! This inconvenience sparked my interest in finding new ways to get around that. You will hear some of those discoveries later on in this Note.

But first, let’s dive into what’s behind the aging eyes.   


Common Conditions Of Aging Eyes


The most common one is Presbyopia. Presbyopia is age related, blurry, near vision ( i.e. you have to wear reading glasses). Presbyopia causes your lens to become harder, less flexible, and less able to focus forms of light. With this condition you will start noticing the need for brighter lights while reading. For example, in restaurants I would find myself using the flashlight on my phone to read the menu.  

Presbyopia is when you start holding reading materials at arm’s length, or you start to squint a lot (which leads to crows feet, which leads to Botox!) This hits most people in their forties. I was fortunate to have great vision until 65. 

Glaucoma is also a disease of aging eyes (sometimes in younger eyes) and a leading cause of blindness in people over 60. Glaucoma is a disease where you get damage to the optic nerve which comes through the back of your eye and transmits signals to the brain. Your optic nerve can start having problems as a result of Glaucoma

Glaucoma is a condition when fluid builds up in the front part of the eye, which increases the pressure in your eye, which then damages the optic nerve. Your eye produces a fluid called aqueous humor. As it flows in, you need the same amount flowing out. It “refreshes” itself continuously. What happens with Glaucoma is this fluid gets backed up because the drainage angle in your eye gets clogged and pressure builds up. 

There are two types of Glaucoma: Open-Angle Glaucoma and Closed-Angle Glaucoma. Open angle glaucoma is the most common one and happens gradually. It acts like a slow clogging drain. It’s painless and at first doesn’t cause much vision loss. That’s why it’s important to get your pressure checked with the eye doctor once you turn 50 (at least, maybe sooner). 

Closed angle glaucoma is more acute and more serious. It’s painful and leads to sudden loss of vision. This happens when the iris of the eye is very close to the angle of drainage. It’s almost like a piece of paper sliding over the drain. It cuts it off which causes an immediate increase in pressure. This is a true ocular emergency and you need to see an eye doctor right then. Treatments for Glaucoma include: Eye drops, surgery, beta blockers, and even marijuana. 

Macular Degeneration is the leading cause of loss of vision after the age of 65. The macula is a central part of the retina that allows you to focus directly on an object. It’s responsible for central vision (not peripheral). 

Main risk factors besides age and family history are: 

  • Smoking
  • High blood pressure
  • Heart disease

Anything that can cause metabolic syndrome can cause an increase in macular degeneration

There are a couple of types: Dry and Wet 

Dry macular degeneration: 90% of macular degeneration is this type and it’s the less serious of the two. It’s when you have deposits in the eye called drusen. These are deposits in the macula that cause visual loss. It starts with blurred vision, spots, and floaters. 

Wet macular degeneration: This is the more serious type. Typically you have these geographical areas on the macula that are round and signifies atrophy, or wasting of the macula. These areas eventually coalesce and scar and can lead to blindness. 

There are lots of new treatments for this. Make sure you see your eye doctor and get checked. 

Cataracts: A lot of my friends have had cataracts removed, which works well. Cataracts are: clouding of the normally clear lens of the eye. It’s like looking through a fogged window. It develops slowly. If you have cataracts, you may see halos around lights and your night vision may get worse. Cataracts may cause a fading or yellowing of colors. Surgery is the treatment. It’s safe and very effective. 

Diabetic Retinopathy: As you age you have more risk of getting diabetes, especially if you’re overweight and have a poor diet. I definitely recommend getting an annual eye exam to make sure this is not happening to you, along with blood work in a medical office. Besides controlling your sugars and metabolic syndrome, there are things you can do for this (i.e. laser treatments). 

Dry eyes: This is very common. I suffer from this. There are lots of different types of eye drops you’ve probably seen advertised. The most common ones are Restasis and Xiidra, which are prescriptions. They really didn’t work for me. I found a much more affordable, over the counter medication called Lumify that works better for me. However, better than that for me was increasing my Omega 3 supplement, which helps for many other health conditions as well.


Aging Eyes Prevention 


What can you do to prevent your eyes from aging so quickly? 

  • The first is diet. It seems like all diseases are caused by inflammation. Poor diet is the cause of that every time. What we need to realize is that the microbiome in the gut can control your eyes. So stay healthy. Anything you can do to avoid heart disease will help your eyes. 

Important Note: If you have any of the symptoms we mentioned above make sure you see an eye doctor. I’ve had a lot of eye doctors send me patients based on what’s happening in their retina. In a few cases, it saved their life. See your eye doctor, especially if you’re diabetic or if you have metabolic syndrome. 

  • Increase your dietary intake of foods that are rich in carotenoids (think Vitamin A and carrots). 

The two major carotenoids are Lutein and Zeaxanthin

Examples of Carotenoids: 

  • Egg yolks
  • Kiwi 
  • Squash 
  • Spinach
  • Peas
  • Brussel sprouts 
  • Apples
  • Pumpkin seeds
  • Peppers
  • Cucumbers
  • Celery 
  • Broccoli 
  • Mangoes 
  • Sweet potatoes

These are foods I’d tell you to eat anyway if you’re trying to lose weight and stay healthy.


Vitamins For Aging Eyes 


  • Vitamin A – It’s a component of Rhodopsin, the protein in eyes that allows you to see in the dark. 
  • Vitamin E
  • Vitamin C – Studies have shown a 45-75% reduction of cataracts if you take 500mg of Vitamin C per day. 
  • Antioxidants 
  • B6
  • B9
  • B12
  • B2
  • B1
  • B3
  • Omega 3’s – Great for dry eyes (mostly because of the DHA component)

Note: You need to take a good methylated B-Complex. I recommend this to almost anybody. I take a supplement that has lutein and zeaxanthin in it. Most eye vitamins are going to include lutein and zeaxanthin. 




Remember me saying at the beginning of this Note, I had discovered a new way to get around the reading glasses?  There’s a new prescription eye drop I started using about a month ago called Vuity. I wanted to try it to see if it lived up to its hype. It worked for me! 

Using Vuity usually results in about a 3-4 line gain of reading in a near vision test, without losing more than one line on a far vision test. 

I’ve been using these drops on myself and some friends around the office. Most of them have liked it a lot. One person, who had previous vision problems, had headaches and red eyes. Everyone else really liked it. 


How Does Vuity Work? 


Vuity reduces pupil size (the opening in the middle of the eye) that helps you focus near objects better. This drug is actually Pilocarpine, a drug we’ve used for decades for Glaucoma. We don’t use it much today for Glaucoma because rarely it would cause retinal detachments. It’s still used some for Glaucoma, but there are newer treatments that are probably better, including surgeries and other types of eye drops. 

Note: The dose of pilocarpine in Vuity is very low, so less chance of side effects. 


How To Use Vuity 


I like this drop. You do one dop in each eye (I do this in the morning). It takes about 15 minutes to work. If you happen to wear contacts for far vision, wait 10 minutes after the drops to put your contacts back in. It has worked great for me so far. I don’t have to wear reading glasses in exam rooms anymore when going over extensive Cleveland Heart Panels. 

One thing I have noticed is that the light in the room is a little dimmer, but I haven’t seen side effects. It lasts about 6-10 hours. I wouldn’t use it at night while driving. 

Note: Some people only put it in one eye so they don’t get the dimming. I haven’t tried this yet, but I will. 

IMPORTANT: Think about your eyes. When they start to give you problems, you need to start thinking about this information. I’m excited about the eye drop, Vuity. 

Remember, get your eyes checked annually after age 50!