Women are more likely to have eye problems

At the June 26 Healthy Woman Ladies Night Out event, ophthalmologist Arvind Saini, M.D. presented “Women’s Eye Health: Diseases and Conditions That Affect Women More.” The evening was hosted by the Fallbrook Healthcare District which provided a nice dinner from Trupiano’s since the program did not have a big anniversary dinner this year.

A room full of ladies learned that women are more likely to have eye problems simply because they tend to live longer than men, (there are five times as many women as men age 90 or older), and good health has a significant impact on eye health.

Saini said that in the US, there are over one million legally blind people and 700,000 are women; 3.4 million Americans suffer from visual impairment, 2.3 million are women.

Women also tend to have more autoimmune diseases than men; they constitute 75 percent of the 8.5 million Americans who have multiple sclerosis, lupus, rheumatoid arthritis, Sjogrens syndrome; all of which affect eye health.

According to Saini, the risk factors for vision loss include age, hormonal, and immunological conditions, as well as access to healthcare, smoking, poor nutrition, obesity – the same factors that cause premature death. He added that the risk behaviors are the same that lead to heart disease, stroke, diabetes and some cancers – smoking, obesity, physical inactivity, fast food diet, and high blood pressure.

Living a healthier life will help keep one’s eyes healthy too he said. Daily physical activity, a healthy diet and not smoking have been shown to decrease the chance of vision loss from macular degeneration.

Age-related macular degeneration (ARMD) is the leading cause of legal blindness in the US. Thirteen million people have some form of the disease which damages the macula (the central part of the retina) ; approximately 1.6 million have significant vision loss. ARMD is associated with aging, smoking, and exposure to ultraviolet light, has a genetic pattern of inheritance (a higher concentration is found in people of Northern European descent), and leads to central vision loss.

There are two primary forms of ARMD – dry (cells breakdown) which 90 percent of patients have, and wet (blood vessels leak) in 10 percent of cases but also 90 percent of legal blindness. The first signs of ARMD are central vision loss and central vision distortion (seeing wavy lines in a grid of straight lines).

Saini said that because of life expectancy, women are twice as likely as men to develop macular degeneration – six percent of women versus three percent of men. To help prevent it or slow its progress, women can stop smoking, wear sunglasses, and take AREDS vitamins (Vit. C,E, beta carotene, zinc/copper) if they have moderate or advanced disease.

Saini said that the second leading cause of blindness in America, after ARMD, is glaucoma. Of the various types of glaucoma, open angle glaucoma is the most common form. It usually affects people over the age of 40 and there is a higher incidence in African-Americans.

Glaucoma is defined as damage to the optic nerve, usually caused by intraocular pressure, causing visual field loss. Over two million Americans have the disease and half do not know they have it. It is not painful and not related to high blood pressure. People with the condition can go blind because the disease wasn’t diagnosed or diagnosed at a late stage.

High risk factors for glaucoma include high eye pressure, age (over 40), family history, being diabetic, and taking long-term steroids. Regular visits to an eye doctor for exams are important in diagnosing glaucoma early enough for treatment.

One of the main reasons for visits to eye doctors is dry eye disease; 10 to 15 percent (more than 20 million) of middle-aged and older Americans have some symptoms. Women are three to five times more likely to have the condition.

The cause of dry eyes is either insufficient tear production or excessive tear evaporation. Not having enough tears to lubricate the surface of the eye leads to discomfort, blurry vision, a foreign body (gritty or sandy) sensation, burning, and/or red eyes. These symptoms are usually worse as the day goes by. Dry eyes also might tear in bright lights or wind.

As people age, their eyes produce less tears, a common problem after age 55. Other causes of low tear production include inflammatory diseases like Sjogens or rheumatoid arthritis and LASIK or other eye surgeries. Excessive tear loss or evaporation can be caused by several conditions of the tear glands/ducts, eye lids, thyroid eye disease or Parkinson’s.

He explained that another cause of dry eye is when a person focuses on something like television or computer screens, the pages of a book or a needlepoint project; they may not blink often enough to keep their eyes moist. Several kinds of medications can also cause dry eyes including chemotherapy agents, diuretics, beta blockers, antihistamines, sleeping pills, anxiety drugs, and estrogen supplements.

Women also have more factors to consider with LASIK procedures. Saini gave a detailed description of the surgery which changes the shape of the cornea; “it etches a person’s eyeglass prescription into their eye,” he said. High estrogen levels can increase regression of the treatment. He does not recommend it for women who have just changed their birth control, pregnant women, breast feeding women, or women on hormone replacement treatment. He also warned, “If you are over 55, make sure you don’t have cataracts before you have LASIK surgery.”

Saini reminded the ladies that women sometimes ignore their health and delay medical care while caring for their families. This is not good as vision loss can reach the point of irreversible damage. Cataracts are the only reversible eye condition he said.

The next Healthy Woman Ladies Night Out event will be held Thursday, Sept. 25, at 5:30 p.m. at Fallbrook Library.