Aristotle placed sight at the top of the hierarchy of the senses. Plato called vision “humanity’s greatest gift,” and Leonardo da Vinci described the eyes as “the window of the soul.”
Which of our senses deserves top billing is debatable, but survey respondents consistently rank eyesight as the one they would most regret losing. With that in mind, let’s look at the most common eye problems and what can be done to prevent, slow, and reverse them.
Twitches and Styes
A twitch in your eyelid can drive you crazy, but take heart. These annoying muscle spasms, which are often related to stress, excessive caffeine, or fatigue, usually go away within days. Treatment is rarely required, but supplemental magnesium (400–500 mg) may tone down involuntary muscle contractions.
Eye compresses help as well. Warm, moist washcloths are often recommended, but they cool down after a couple of minutes. Hydrating eye masks, which are sold in drugstores and online, retain heat much longer. An inexpensive option is a small baked potato or hard-boiled egg, cooled to a comfortable temperature, wrapped in a clean damp cloth, and held over the affected area. (To reuse, reheat the potato in a microwave or the egg in hot water.) Just make sure you don’t put too much heat or pressure on the eye.
Compresses are also great for styes (infections in an eyelash follicle or oil gland) and chalazions (blocked oil glands). These bumps on the eyelid can be quite painful and unattractive, but they too generally clear up without treatment, although chalazions may take several weeks. To speed things along, use warm compresses for 10–15 minutes three or four times a day. With all these conditions, be patient and give them some time to heal, but if they persist or worsen, consult a doctor.
Dry or Watery Eyes
If your eyes feel gritty, itchy, and dry, you may have keratoconjunctivitis sicca. That’s the medical term for dry eyes, and it’s one of most common reasons people consult eye doctors. Artificial tears are worth a try, but regular eye drops don’t cut it—and the preservatives in multi-dose products may make matters worse. That’s because dry eyes are not just about the quantity of tears but also their quality.
Tears are composed of water to moisturize the eyes, mucus to spread tears over the eye’s surface, and oils to prevent rapid evaporation. Dry eyes are often due to blockage of the oil-producing meibomian glands that line the edges of the eyelids, which allows the tears to dry up too quickly. Warm compresses and gentle cleansing and massaging of the eyelids with diluted baby shampoo or commercial eyelid scrubs once or twice a day help open these glands.
Inflammation is another factor. A 2019 meta-analysis of 17 clinical trials involving 3,363 patients concluded that omega-3 fatty acids significantly improved dry eye symptoms. Wind, heating, air conditioning, and staring at a computer can also dry out your eyes. A number of medications including antihistamines, diuretics, antidepressants, and estrogen are linked with dry eyes as well.
At the opposite end of the spectrum is excessive tearing (epiphora). Hay fever and other allergies, irritants like onions and smoke, viral or bacterial conjunctivitis (pink eye), and eyelid issues are obvious culprits for “leaky” eyes. Another common cause, which can be treated by a physician, is blockage of the tiny ducts that drain tears into your nose. Finally—and counterintuitively—watery eyes often go hand-in-hand with dry eye syndrome and may respond to the same treatments.
Outlook for Cataracts and Glaucoma
Nearly 4 million Americans per year have cataract surgery to replace damaged, cloudy lenses with clear artificial ones. This surgery has a long track record of safety and efficacy and can even fix other vision problems, provided you pay extra for corrective intraocular lenses. But why not do what you can to prevent cataracts?
Sunglasses, hats, and an antioxidant-rich diet and supplements provide some protection, since oxidative damage from UV radiation is a primary factor in cataract formation. Glycation, which occurs when sugars bind to and damage proteins, also clouds the lenses. This is particularly problematic in diabetics, who develop cataracts much earlier than average—yet another reason to get a handle on blood sugar. Eye drops containing N-acetyl-carnosine, which inhibits glycation, have also been shown to slow cataract formation.
A much less common but more serious problem is glaucoma, a group of diseases that damage the optic nerve, usually due to high pressures in the eye. The most important thing you need to know about glaucoma is that early-stage disease has no symptoms, but without treatment vision will slowly deteriorate. Therefore, periodic checkups are essential, especially if you have a family history of glaucoma.
You also need to know about Mirtogenol, a Pycnogenol/bilberry supplement. Research shows that when patients with glaucoma used Mirtogenol (120 mg per day) alone or with prescription eye drops, circulation in the eyes and intraocular pressures improved.
Leading Causes of Vision loss
The number-one cause of vision loss in people over age 60 is age-related macular degeneration (AMD). The macula is a small, yellowish area in the back of the eye that is responsible for central vision. AMD damages the macula, resulting in blank, blurry, or distorted central, straight-ahead vision.
Millions of older Americans have AMD, and every year about 250,000 of them develop the most serious “wet” form, marked by excessive blood vessel growth and leakage. AMD interferes with reading, writing, driving, and even recognizing faces, and it often leads to reclusiveness and loss of independence.
In younger adults, the leading cause of vision loss is diabetic retinopathy. Chronically elevated blood sugar causes blood vessels in the retina to swell, leak, and eventually lose their ability to transport blood. This triggers the release of growth factors that stimulate the proliferation of new blood vessels that damage the retina. In the worst cases, fluid builds up in the macula, resulting in diabetic macular edema and loss of central vision.
Drugs developed in the past 15 years are a game changer for AMD and diabetic retinopathy. Vascular endothelial growth factor (VEGF) is a protein that stimulates the growth of abnormal blood vessels in both conditions. VEGF inhibitors such as Avastin, Lucentis, and Eylea injected into the eyes block VEGF, which stops disease progression and usually improves vision.
Another breakthrough is the recognition of nutrition’s role in eye diseases. The landmark Age-Related Eye Disease Studies (AREDS and AREDS2) found that supplements containing lutein, zeaxanthin, vitamins C and E, zinc, and copper lowered the likelihood of developing advanced AMD by 25 percent and slowed vision loss. Although the research is less robust for diabetic eye disease, studies suggest that these nutrients—along with others such as magnesium, vitamin A, and B vitamins that are often depleted in diabetics—enhance eye health and help stave off retinopathy.
The Most Common Vision Problem of All
One common vision problem you unfortunately can't do anything about is presbyopia ("short-arm syndrome").
Starting around age 40, the lenses of the eyes become stiffer and less flexible, which makes focusing less efficient and worsens close-up vision. Reading glasses become necessary since you can't read small print without them.
However, many other eye problems are preventable, so do what you can today to help ensure you protect your eyes and vision for decades to come.