This document provides information about eye health and common eye conditions as people age. It introduces Dr. Vinnie Shah and his background and practice. It then describes and provides images of cataracts, glaucoma, age-related macular degeneration, diabetes, and other common eye conditions. For each condition, it discusses signs, risk factors, treatments, and ways to prevent vision loss. The document aims to educate older patients on maintaining eye health and understanding common eye diseases.

1. Keeping Eyes Healthy
as You Age
Vinnie P. Shah, MD,
Ophthalmology
February 15, 2018

2. Vinnie P. Shah, MD
• Board-certified ophthalmologist
• Subspecialty training and expertise in
diseases of the retina
• Specialist in:
 Medical Retina: Macular Degeneration, Diabetic
Retinopathy, Retinal Vein Occlusions
 Retinal laser treatments, intravitreal injections
• Fellow of the American Academy of
Ophthalmology and a Member of the
American Society of Retina Specialists.

3. Summit Medical Group
• Joined SMG Ophthalmology group in 2017,
after 6 years practicing and teaching
Ophthalmology
• At SMG I work with three board-certified
ophthalmologists to provide patients with a
wide range of eye care, screenings and
surgery

4. Parts of the Eye

5. Cataracts
Before Surgery: After Surgery:
Signs of Cataracts:
• Glare while driving at night
• Trouble with reading
• Difficulty watching T.V.

6. Cataract Risk Factors
• Aging is the most common cause
• Parents, brothers, sisters, or other family
members who have cataracts
• Certain medical problems, such as diabetes
• Having had an eye injury, eye surgery, or
radiation treatments on your upper body
• Spending a lot of time in the sun, especially
without sunglasses that protect your eyes from
damaging ultraviolet (UV) rays

7. What can I do about cataracts?
• Eye exam every year if you're older than 65, or every 2 years if
younger.
• Protect your eyes from UV light by wearing sunglasses that
block at least 99 percent UV and a hat.
• If you smoke, quit. Smoking is a key risk factor for cataracts.
• Use brighter lights for reading and other activities. A magnifying
glass may be useful, too.
• Limit driving at night once night vision, halos, or glare become
problems.
• Take care of any other health problems, especially diabetes
• Get the right eyeglasses to correct your vision
• When it becomes difficult to complete your regular activities,
consider cataract surgery

8. Glaucoma
• Leading cause of blindness for
people over 60 years old
• Family history
• High eye pressure, damage to optic
nerve
• Can be treated with eye drops, lasers,
• Or surgery
• Loss of peripheral vision

9. 2 Major Types of Glaucoma
• Primary open angle: most common
• Happens gradually: eye does not drain fluid as well as it
should (like a clogged drain). Eye pressure builds and
starts to damage the optic nerve.
• Painless and causes no vision changes at first.
• Angle closure glaucoma:
• This type happens when someone’s iris is very close to
the drainage angle in their eye. The iris can end up
blocking the drainage angle. You can think of it like a
piece of paper sliding over a sink drain.

10. Angle Closure Glaucoma Attack
• When the drainage angle gets completely blocked, eye pressure rises very
quickly. This is called an acute attack. It is a true eye emergency, and you
should call your ophthalmologist right away or you might go blind.
• Here are the signs of an acute angle-closure glaucoma attack:
• Your vision is suddenly blurry
• You have severe eye pain
• You have a headache
• You feel sick to your stomach (nausea)
• You throw up (vomit)
• You see rainbow-colored rings or halos around lights
• Many people with angle-closure glaucoma develop it slowly. This is called
chronic angle-closure glaucoma. There are no symptoms at first, so they don’t
know they have it until the damage is severe or they have an attack.
• Angle-closure glaucoma can cause blindness if not treated right away.

11. Who is at risk for glaucoma?
• Higher than normal risk of getting glaucoma. This includes
people who:
• are over age 40
• have family members with glaucoma
• are of African or Hispanic heritage
• have high eye pressure are farsighted or nearsighted have had
an eye injury
• have corneas that are thin in the center
• have thinning of the optic nerve
• have diabetes, migraines, poor blood circulation or other health
problems affecting the whole body

12. Age Related Macular
Degeneration
• Affects 10-25 % of Senior Citizens
• Two forms: Wet and Dry
• AREDS 2 Vitamins
• Amsler Grid

13. Macular Degeneration: 2 Kinds
• Dry AMD: more common. About 80% people
who have AMD have the dry form. Parts of the
macula get thinner with age and tiny clumps of
protein called drusen grow. You slowly lose
central vision. No treatments for dry AMD yet.
• Wet AMD: less common but much more serious.
New, abnormal blood vessels grow under the
retina. These vessels may leak blood or other
fluids, causing scarring of the macula. You lose
vision faster with wet AMD than with dry AMD.
Treated by injecting medication into the eye

14. Who is at risk for
macular degeneration?
• More likely to develop AMD if you:
• eat a diet high in saturated fat (found in foods
like meat, butter, and cheese)
• are overweight
• smoke cigarettes
• are over 50 years old
• have a family history of AMD
• are Caucasian (white)
• Having heart disease is another risk factor for
AMD, as is having high cholesterol levels.

15. Amsler Grid
• If you need reading glasses, please
wear them while you use the Amsler
grid. The grid should be at about the
same distance from your eyes that
any other reading material would
be.
• Cover one eye, then focus on the
dot in the center.
• Do any of the lines look wavy,
blurred or distorted? (All lines
should be straight, all intersections
should form right angles and all the
squares should be the same size.)
• Are there any missing areas or dark
areas in the grid?
• Can you see all corners and sides
of the grid?
• Don't forget to test both eyes.

16. Diabetes
• Dilated eye exam every year
• Control blood sugar

17. Diabetic Retinopathy
• This is when high blood sugar levels cause
damage to blood vessels in the retina. These
blood vessels can swell and leak. Or they can
close, stopping blood from passing through.
Sometimes abnormal new blood vessels grow
on the retina. All of these changes can steal
your vision.
• Treated with BLOOD sugar control and if
needed laser treatments and injecting
medication into the eye or surgery

18. Preventing Vision Loss From
Diabetic Retinopathy
• Talk with your primary care doctor about controlling your blood
sugar. High blood sugar damages retinal blood vessels. That
causes vision loss.
• Do you have high blood pressure or kidney problems? Ask
your doctor about ways to manage and treat these problems.
• See your ophthalmologist regularly for dilated eye exams.
Diabetic retinopathy may be found before you even notice any
vision problems.
• Get treatment for diabetic retinopathy as soon as possible.
This is the best way to prevent vision loss.

19. Dry Eye Syndrome
• Burning and itching
• Foreign body sensation
• Tearing
• Eye hurt at the end of the day

20. Ptosis
• Drooping upper eyelid
• Visual loss often worse with
reading and at night

21. Subconjunctival Hemorrhage
• Bright red patch on the white part of
the eye
• Can occur after a sudden or severe
sneeze or cough, heavy lifting,
straining, vomiting, or even rubbing
one’s eyes too roughly
• More common in people taking blood
thinners
• Painless, does not affect vision
• Usually disappears within 2 weeks
• No treatment

22. Ocular Migraine
• Visual symptoms are short lasting (10-30
minutes). A migraine aura involving vision
will usually affect both eyes
• Flashes of light
• Zigzagging patterns
• Blind spots
• Shimmering spots or stars
• May be followed by headache, nausea,
vomiting, and light sensitivity

23. Questions

24. Thank You!
Vinnie P. Shah, MD
1 Diamond Hill Road
Berkeley Heights, NJ 07922
908-277-8682