When it comes to staying on top of our health, far too many people take their eyesight for granted. It’s obvious that we should get regular eye exams (see below, but there are other steps that often slip under the radar. Here are the strategies that ensure you’re doing all you can to protect your vision…

Eye-health secret #1: Use the right eyedrops. Older adults and those of any age who are heavy users of computers and/or electronics know that they’re more likely to suffer from dry eye. Lubricating drops, sometimes called artificial tears, are effective for this condition. But when you’re in the store, it’s easy to mistakenly pick up redness-reducing eyedrops, which temporarily constrict the blood vessels. These drops do not help with dry eye.

In fact, daily use of redness-­reducing drops can cause rebound redness and set off an unhealthy cycle of using more eyedrops. For this reason, redness-reducing drops should be used only occasionally—and if the redness persists, see your eye doctor to find out why.

Best for dry eye are lubricating drops such as Refresh, Systane, GenTeal, Bion Tears and even pharmacy brands. Caution: If the preservatives they contain irritate your eyes, look for preservative-free brands.

Lubricating drops come in three viscosities—liquid, thicker gel-like formulas and ointments. The thicker drops and ointments last longer but can temporarily blur vision.

Eye-health secret #2: Watch your medication. Steroids—taken orally, inhaled or in eyedrop form—can cause cataracts and glaucoma. Cataracts can start to develop within months of regular steroid use, while glaucoma is slower and subtler. If you must take a steroid, ask your doctor for the lowest dose possible, schedule an eye exam one to two months after starting any form of the drug, then return every six to 12 months for monitoring. Other drugs that can affect the eyes…

• Tamoxifen (Nolvadex), used to treat and prevent recurrences of breast cancer, can cause eye irritation and dryness…lead to cataracts (usually after five years of use)…and accumulate in the retina, weakening color vision and central vision. Fortunately, as oncologists have started prescribing lower doses of tamoxifen, these side effects happen less often. Self-defense: Have an annual dilated eye exam with a retina specialist while you are taking tamoxifen and have him/her examine your retinas to be sure there is no accumulation in the retina.

• Tamsulosin (Flomax), used to treat an enlarged prostate, can make the iris, which is normally fairly rigid, turn floppy. Ordinarily, this shouldn’t lead to vision complications, but if the patient undergoes cataract surgery, it can cause a condition called intraoperative floppy iris syndrome (IFIS), possibly complicating the procedure by preventing the pupil from dilating well and causing the iris to herniate out of the incision. Self-defense: If you plan to undergo cataract surgery, let your eye surgeon know if you are taking tamsulosin or have in the past.

• Erectile dysfunction drugs such as sildenafil (Viagra) and tadalafil (Cialis) can, in rare instances, cause irreversible damage called nonarteritic anterior ischemic optic neuropathy (NAION), which is like a stroke of the optic nerve. Incidences are not dose-related and can happen after a single use of the drug. Self-defense: Avoid erectile dysfunction medications if you have hypertension or diabetes (which put you at greater risk for NAION), and/or if you take nitrates to lower blood pressure—erectile dysfunction drugs can lower blood pressure even more.

Eye-health secret #3: Keep diabetes well-controlled. People with diabetes tend to develop cataracts at an earlier age than people without diabetes. They also have an elevated risk for visual impairment and blindness due to diabetic retinopathy, when high blood sugar levels damage blood vessels in the retina. What to do: Get a dilated eye exam annually or more often if recommended by your doctor, particularly if you struggle to keep your sugar under control. Early treatment can prevent an astonishing 95% of diabetes-related vision loss!

Also important: The better you are able to control your blood sugar with diet, lifestyle changes and medication, the better your chances of delaying the onset of cataracts and diabetic retinopathy.

Eye-health secret #4: Take this eye supplement. If you’re at high risk for advanced age-related ­macular degeneration (AMD)—that is, you have intermediate AMD or advanced AMD in one eye only—taking high levels of certain antioxidants plus zinc can reduce the risk of developing an advanced form of AMD by about 25%, according to a major National Eye Institute clinical trial called the Age-Related Eye Disease Study (AREDS). A leading cause of blindness among Americans age 50 and older, AMD causes damage to the retina that may lead to central vision loss.

What to do: Look for a supplement labeled “AREDS formula” (such as Bausch & Lomb PreserVision AREDS 2 Formula). It’s not an AMD cure, but it may help preserve vision in susceptible individuals. Ask your ophthalmologist if it’s right for you.

When Was Your Last Eye Exam?

Adults between the ages of 55 and 64 who are risk-free and have no eye symptoms should have eye exams every one to three years, but nearly half of those recently surveyed have not.

People who are over age 65 or of any age with a risk factor, such as high blood pressure, diabetes or a family history of eye disease, should have an eye exam at least every one or two years, according to the American Academy of Ophthalmology.

Because your eyes offer an unobstructed view of your blood vessels, nerves and connecting tissue, any abnormalities that show up in an eye exam may indicate similar changes elsewhere in the body. This means your optometrist or ophthalmologist can give you crucial information about your risk for serious conditions such as stroke, high blood pressure, diabetes and autoimmune disease, such as Graves’ disease, a thyroid disorder. Insurance should cover these exams.

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