How Vision Loss Can Affect the Brain

A growing body of evidence suggests that when older people’s brains have to work harder to see, declines in language, memory, attention and more could follow.

Medical practice tends to divide its clients — you and me — into specialties defined by body parts: ophthalmology, neurology, gastroenterology, psychiatry and the like. But in fact, the human body doesn’t function in silos. Rather, it works as an integrated whole, and what goes awry in one part of the body can affect several others.

I’ve written about the potential harm of hearing loss to brain health, as well as to the health of our bones, hearts and emotional well-being. Untreated hearing loss can increase the risk of dementia. Even those with slightly less than perfect hearing can have measurable cognitive deficits.

Now, a growing body of research is demonstrating that vision loss can affect the brain’s function, too. As with hearing, if the brain has to work extra hard to make sense of what our eyes see, it can take a toll on cognitive function.

The latest study, published in JAMA Network Open in July, followed 1,202 men and women aged 60 to 94 for an average of nearly seven years. All were part of the Baltimore Longitudinal Study of Aging, and had vision and cognition tests every one to four years between 2003 and 2019.

The researchers found that those who scored poorly on initial tests of visual acuity — how well, for example, they could see the letters on an eye chart from a given distance — were more likely to have cognitive decline over time, including deficits in language, memory, attention and the ability to identify and locate objects in space.

Other vision issues, like with depth perception and the ability to see contrasts, also had deleterious effects on cognitive ability. The lead researcher, Bonnielin Swenor, an epidemiologist at the Johns Hopkins Wilmer Eye Institute, said that the new study “adds to mounting longitudinal data showing that vision impairment can lead to cognitive decline in older adults.”

Lest you think that the relationship is reversed — that cognitive decline impairs vision — another study that Dr. Swenor participated in showed that when both functions were considered, vision impairment was two times more likely to affect cognitive decline than the other way around.

This study, published in 2018 in JAMA Ophthalmology and led by Diane Zheng from the University of Miami Miller School of Medicine, included 2,520 community-dwelling adults ages 65 to 84, whose vision and cognitive function were periodically tested. She and her co-authors concluded that maintaining good vision as one ages may be an effective way to minimize the decline in cognitive function in older adults.

“When people have vision loss, they change the way they live their lives. They decrease their physical activity and they decrease their social activity, both of which are so important for maintaining a healthy brain,” Dr. Swenor said. “It puts them on a fast tack to cognitive decline.”

But identifying and correcting vision loss early on can help, Dr. Zheng said. She suggested regular eye checkups — at least once every two years, and more often if you have diabetes, glaucoma or other conditions that may damage vision. “Make sure you can see well through your glasses,” she urged.

There are “vision impairments that glasses won’t fix,” Dr. Swenor said, like age-related macular degeneration and glaucoma. Retinal disease began to compromise Dr. Swenor’s vision in her mid-20s. Those with problems like hers can benefit from something called low vision rehabilitation, a sort of physical therapy for the eyes that helps visually impaired people adapt to common situations and help them function better in society.

Dr. Swenor, for instance, can see objects in a high-contrast situation, like a black cat against a white fence, but has trouble seeing the difference between similar colors. She can’t pour white milk into a white mug without spilling it, for example. Her solution: Use a dark-colored mug. Finding such accommodations is an ongoing task, but it enables her to continue to function well professionally and socially.

Society, too, needs to help people with visual impairment function safely outside the home. Most things in hospitals are white, for example, which creates safety hazards for people with diminished contrast sensitivity. As a driver of 50 years, I’ve noticed that road barriers that used to be the same color as the road surface are now more often rendered in high contrast colors like orange or yellow, which undoubtedly reduces crashes even for people who can see perfectly.

“We need to create a more inclusive society that accommodates people with vision impairment,” Dr. Swenor said.

People who have trouble with depth perception can also incorporate helpful design features into the home. Placing colored strips on stair risers, varying textures of furniture and color-coding objects can all improve the ability to navigate safely. People who can no longer read books may also listen to audiobooks, podcasts or music instead, Dr. Swenor said.

The link between visual impairment and cognitive impairment “is not a doomsday message,” she added. “There are many ways to foster brain health for people with vision loss.”

Step one may be getting a Medicare extension bill through congress, which in turn might prompt private insurers to also cover vision care and rehabilitation. The Democrats’ current proposal to extend Medicare benefits to cover vision care would more than pay for itself in the long run by diminishing already-covered medical costs for cognitive and physical decline.

Case in point: The cost of a single hip replacement resulting from a vision-impaired fall would exceed the cost of many hundreds of eye exams and needed vision corrections.

Portrait of Jane E. Brody

Source: How Vision Loss Can Affect the Brain – The New York Times

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What Happens To Your Eyes When You Stare At Screens All Day

We spend a lot of time staring at screens. There’s the small screen in our pocket, the big screen we watch our shows on, and the medium screen that many of us stare into for eight hours a day to help pay for those other screens. Are all of these screens ruining our eyes?

Probably not, although rumors abound. If you grew up with big ol’ tube TVs, you probably remember being told that sitting too close would ruin your eyes. Scientific American traces that myth to a 1967 recall of early color TVs that emitted radiation (like, actual radiation) that were probably harmful to health, as well as to a misunderstanding about nearsighted kids who sat close to the TV. Most likely, they sat close so they could see better; the TV didn’t cause their nearsightedness.

When it comes to the variously sized screens we stare at all day, there are some new myths (and facts!) about how they affect our vision.

Eyestrain is real

Looking at screens for too long can cause eyestrain, but eyestrain existed long before screens. (Driving long distances is another cause, the Mayo Clinic notes.) Eyestrain may involve fatigue of the tiny muscles in and around our eyes, and people who get eyestrain may experience discomfort that includes headaches, blurry vision, watering of the eyes, and sensitivity to light.

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Nearly a third of adults spend more than half their waking hours using a digital device. Cornell Medical Center ophthalmologist Dr. Christopher Starr joins “CBS This Morning” to discuss what looking at screens is doing to our eyes.
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Eyestrain from looking at screens is called digital eyestrain, or sometimes “computer vision syndrome.” Eyestrain can be caused or exacerbated by other vision problems, like farsightedness or an astigmatism that hasn’t been corrected. In those cases, getting proper treatment (like glasses) may help.

Eyestrain is often temporary, and will get better if you look away from the computer screen every now and then as you work. But if you experience eyestrain often or if it seems to be getting worse, see an optometrist so you can fix any underlying problems.

Blue light from screens isn’t ruining your eyes

There’s a rumor that the blue light from smartphones (or other screens) can ruin your vision, perhaps even leading to blindness, but it’s not backed up by evidence. “The amount of light coming from a computer has never been demonstrated to cause any eye disease,” the American Academy of Opththalmology states in an article on their website recommending against blue-light-blocking glasses.

There is research that finds blue light can damage cells in certain lab conditions, but those conditions are very different from what happens in the actual cells of our retina. We dug into this myth here, noting that the AAO has emphasized that—in their words—“[b]lue light from electronic screens is not making you blind.”

Unfortunately, there are companies citing research like this to sell their blue-light-blocking glasses or screen overlays, but they aren’t selling a solution to a real problem.

Blue light may affect your health and your sleep, but blue light isn’t just about screens

Blue light from screens has gained a bad reputation for interfering with sleep, but remember your rainbow facts from grade school: blue light is just one part of white light. You get plenty of blue light from the sun, for example.

Blue light-blocking filters also don’t block very much blue light; they just reduce it a tiny bit. (Experts have pointed out that you could get the same effect by holding your screen one inch farther away from your face.) Avoiding screens at bedtime is probably a good idea, but not because there’s anything especially damaging about the screens themselves.

There is research that finds blue light can damage cells in certain lab conditions, but those conditions are very different from what happens in the actual cells of our retina. We dug into this myth here, noting that the AAO has emphasized that—in their words—“[b]lue light from electronic screens is not making you blind.”

Unfortunately, there are companies citing research like this to sell their blue-light-blocking glasses or screen overlays, but they aren’t selling a solution to a real problem.

Blue light may affect your health and your sleep, but blue light isn’t just about screens

Blue light from screens has gained a bad reputation for interfering with sleep, but remember your rainbow facts from grade school: blue light is just one part of white light. You get plenty of blue light from the sun, for example.

Blue light-blocking filters also don’t block very much blue light; they just reduce it a tiny bit. (Experts have pointed out that you could get the same effect by holding your screen one inch farther away from your face.) Avoiding screens at bedtime is probably a good idea, but not because there’s anything especially damaging about the screens themselves.

How to take care of your eyes when you’re looking at screens

When you’re spending time in front of screens—any kind—the rule of thumb for eye health is the “20-20-20” rule. Every 20 minutes, take a 20-second break to look at something 20 feet away. This could mean looking down a hallway or through a window, or you could go for extra credit and get up and take a short walk outdoors. Giving your eyes a variety of things to focus on breaks up the monotony that can cause eyestrain.

We also tend to blink less when looking at something for a long time, so if your eyes feel dry when you look at a screen all day, use some eyedrops. (Look for the ones labeled “artificial tears.”)

By: Beth Skwarecki

Source: What Happens to Your Eyes When You Stare at Screens All Day

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