Our Eyes Have It

Don’t wait to mitigate or avoid age-related vision ailments

I remember turning 40, and it was as if a switch had flipped. Words on the computer screen and books that had once been clear were suddenly blurred. At the time, my husband and I had a trusted ophthalmologist in West Los Angeles whom we had seen for many years. During our semi-annual check-up, I mentioned this troubling development. “How old are you?” he asked with a smile. 

What the heck was he smiling about? Why was he being so glib? My vision had fallen off a cliff! At first, I felt a little betrayed by his nonchalant attitude. This is a doctor with whom I had the utmost confidence. He was eminently qualified, considered an “ocular expert” with degrees from Stanford, Columbia, USC, and UCLA, and one of the most pleasant, gentle spirits you would ever want to know. Yet here he was, grinning at my woeful news.

“40. I just turned 40.” He nodded sympathetically…still smiling. Apparently, 40 is the beginning of the magical decade when many people acquire reading glasses, and clearly, I was right on time. Ugh. It couldn’t be. I had just joined the club of “old people” who held the dinner menu either way out at arm’s length or under the little candle on the table in order to read the teeny tiny illegible type.

As he tested my eyes for the forthcoming prescription for reading glasses, he explained that this was primarily a by-product of age. If I was so inclined, I could partially mitigate the inevitable with simple exercises. I vividly remember one in particular that he demonstrated: focus on a pencil held vertically at arm's length (or the index finger would also do) and slowly bring it towards your nose while maintaining focus. Easy peasy! I could do this.

I never did it. Now, nearly 23 years later, that day keeps crossing my mind as I encounter more instances when I reach for my glasses and think, “Really? Do I honestly need glasses to see these words?” Serendipitously, I’ve seen a couple of articles about eye care as we age, and I think it was short-sighted of me to push aside my doctor’s advice, so I’m giving it a second look. (All puns intended.)

I did a cursory search of eye exercises, and indeed, there is a wide variety to soothe eye strain and fatigue and strengthen eye muscles, with promoters and detractors on both sides. Wellness advocates believe these modalities have benefits; on the flip side, because there haven’t been clinical trials with conclusive evidence to support the claims, the medical field hasn’t fully embraced them…yet.

Upstream root cause
I decided to take my own advice and to go upstream to look at the root cause of this issue. Technically known as Presbyopia, it is an age-related condition that affects the eye’s ability to focus on close objects—in my case, primarily the computer screen or books/magazines/etc. Unlike other conditions, such as nearsightedness and farsightedness that are caused by the shape of the eye or cornea, presbyopia has two main causes that go hand-in-hand with age: 1) loss of elasticity in the lens of the eye, and 2) weakening of the ciliary muscles.

When the lens loses elasticity and flexibility, it is harder for the eye to make the necessary mechanical adjustments to focus on close-up objects. Integral to the ability to focus are the ciliary muscles, which are responsible for changing the shape of the lens to focus at varying distances. As these muscles weaken, they are less able to assist the now less flexible lens, and the eye has a much harder time focusing on things close at hand. These changes also explain why aging eyes need more light to read. As the lens becomes stiffer, it thickens and lets less light in; simultaneously, it is slower to react to darkening situations, taking longer to adjust to low light.

Understanding the mechanism is fascinating. I see a direct parallel to the plethora of other conditions that creep up on us that we have do the ability to offset. For instance, we can help alleviate joint pain by decreasing inflammation with a healthy diet and increasing the lubricating synovial fluid with movement. We can counteract and reverse muscle wasting by lifting heavy weights and boosting our protein intake. We can also improve the neuroplasticity of our brains through movement, sleep, diet, and challenging learning exercises and habits.

Vision forward
Interesting. I then turned to the book How Not to Age by Dr. Michael Greger, hoping he could shed light on the subject. While he didn’t specifically address presbyopia, he did speak to four other age-related vision maladies: macular degeneration, diabetic retinopathy, glaucoma, and cataracts. In a nutshell—with confirmation from many clinical studies and trials—he contends that all four of these conditions can be prevented and reversed with healthy diet and lifestyle choices. Eat the rainbow for a wide variety of nutrients (most studies recommend leafy greens as one of the essential groups), avoid toxins, increase antioxidants (citrus, berries, beets, etc.), and get adequate daily exercise…all of which lower inflammation, which is the cornerstone of overall good health. It’s a familiar tune.

This brings me back to our kindly ophthalmologist…whose sage advice I should have put into action 20 years ago. (I have no good excuse except to say I’m now older and wiser.) I’ve learned enough in the last couple of decades to know that we have tremendous influence over our bodies, particularly through diet and exercise. Why would our eyes be any different?

We know exercise increases blood flow, bringing oxygen to nourish and create healthier cells. It’s not a far-fetched hypothesis that increased blood flow could promote elasticity in the eye’s lens, just as in the brain. Alternatively, we can build skeletal muscles and strengthen our hearts with exercise; why not the eye’s ciliary muscle?

Our bodies are miraculous healers with the right tools, and our eyes are no exception. I’m going to start with the simple exercise recommended light years ago. Also, I’m game to try tapping on my face (literally gently tapping my fingertips), which promotes increased blood flow. My diet is reasonably sound. I eat the highly recommended blueberries daily but am low on leafy greens, so I will do my level best to increase those. With fall around the corner and soup being one of my absolute favorite foods, a few new super green soup recipes are in order!

Lastly, my husband and I thought that we might be making our eyes lazy by using our reading glasses more than perhaps we needed, so we have been foregoing them for short periods. For instance, I’ll leave them at home when I go out because I find that I can power through most situations if I focus my attention on, well, focusing. It’s amazing how, with a little effort, I can bring type into focus. I see this knowledge as another tool in the longevity toolbox to live well, age great.

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