When I began thinking about how the eye ages and the potential problems lurking - cataracts, loss of vision, focus and acuity, depth perception, and of course the possible need for reading glasses - I wondered whether we can help our eyes and help ourselves see better as we get older. Perhaps we're stuck with what life's dealt us or what we may have, over time inflicted upon ourselves. But there are certain elements which can be improved upon within our lives - even as our eyes age.
  ● Lighting: Brighter lighting and its placement can be most beneficial to our eyes.
  ● Eye Strain: created by prolonged staring at screens, whether it be computers, televisions, or video game displays (this is of some concern for children who are exposed to this on a daily basis).
  ● Ergonomics: learning to use your eyes in a way and in an environment closest to their most possible relaxed state.
  ● Exposure to The Sun: From an early age it is recommended that we wear sunglasses to prevent cumulative damage from UV rays as we age.
  ● Resources: Checking with your doctor and organizations dedicated to vision or improving vision - and not waiting until there is a problem in order to do so.

LIGHTING BY DESIGN
Stan Pomerantz founded LightTech (www.lighttechdesign.com) in 1997 in order to provide "creative lighting design and technical support for the custom home and corporate client." Pomeranz received his Bachelor of Fine Arts from Pratt Institute and relocated to the Triangle Park area of North Carolina in 1975. According to Pomeranz lighting in our home has a profound effect on the quality of our lives. "As we age, " Pomeranz said, "we become more dependent on our environment to compensate for increasing sensory loss. Visual cues become critical to all aspects of life. As early as ur 40's, we begin to lose the visual acuity of earlier years. And, although we are all affected differently, it is safe to say that as we age, our eyesight and our perception of light diminishes. Proper illumination may compensate for many age-related changes in the visual system."
Pomeranz explained how the capacity of our retina to receive an image is diminished as we age. "The time it takes our eyes to adapt to changes in surrounding lighting takes longer. Conditions like 'night blindness' becomes a common occurrence. And, as we age, we become less sensitive to color - particularly the short waves (blue and green)," said Pomeranz. Our lighting can be an effective tool for better vision - and its assistance with contrast sensitivity depends on its ability to help distinguish between adjacent areas of space. As the eyes age, the ability to adjust in different lighting conditions can slow. This slower response is due to corneal, lenticular, and vitreal thickening (pre-retinal opacities), according to the report "Recommended Practice For Lighting and the Visual Environment for Senior Living," important information prepared by the Illumination Engineering Society of North America (IESNA, www.iesna.org), the recognized technical authority.
LightTech, and Pomeranz, provides a detailed survey of the client's needs, desires and living situation. In combination with architects and interior designers, Pomeranz makes detailed drawings, taking everything into account from lighting control to to audio and video distribution. "In general, we should attempt to provide higher levels of illumination throughout the entire house," said Pomeranz. "This includes... hallways, stairs, and closets. Every area should have ambient illumination in addition to task lighting. Daylighting and dimmable flourescent are good indirect ambient light sources. An ambient lightlevel 2 to 3 times 'normal' is considered appropriate, with additional carefully designed task and accent lighting," added Pomeranz. "Designing quality daylighting is particularly challenging," said Pomeranz. "It is important that people who are homebound not become deprived of daylight which can lead to many psychological problems. Many times, however, when a person draws the shades, it is not to darken the room but to ease the discomfort from glare caused by extreme contrast between daylight and the inside general lighting. Filtered daylight is rich, energy efficient and positive to a healthy life. It is important to supplement daylighting with artificial ambient light systems where daylighting is not possible, on sunless days or those light- shortened days of winter," advised Pomeranz.

The Do's of Lighting as We Age
  ● Put more time and attention and money into quality lighting design and equipment.
  ● Since we spend more time at home as we get older - lighting during the day should be an important consideration
  ● Ambient lighting must be available at sufficient levels to ensure psychological well being.
  ● General lighting levels should be much higher (2-3 times) than normal.
  ● Task lighting should be carefully arranged in order to avoid glare.
  ● Accent lighting provides information but is not distracting visually.
  ● Daylighting must be filtered to prevent glare and sharp contrasts from area to area.
  ● Lighting should be controlled so that it is easy to use.

ERGONOMICS
Dr. Jeffrey Anshel is a leading expert on visual performance. Anshel heads Corporate Vision Consulting in Carlsbad, California. According to Anshel and Corporate Vision Consulting, today's technological age and our attendant reliance on computers has caused many people to adopt what is called a "near viewing" posture. This over extended period of gazing into computer and video screens has resulted in a syndrome known as Computer Vision Syndrome (CVS) which has become more and more prevalent at home and in the workplace. Anshel says that Computer Vision Syndrome is a set of eye and vision symptoms related to near work which are experienced during the use of a computer - or related to computer use. CVS Symptoms Include:
  ● Headaches: Anshel says, "if you work at a computer, you most likely get tension-type headaches. These can be precipitated by many forms of stress, including anxiety and depression; numerous eye conditions, including astigmatism and hyperopia; improper workplace conditions, including glare, poor lighting, and improper workstation setup. These types of headaches are mild to moderate in intensity, often occur in either or both sides of the head, are not aggravated by physical activity, develop during the early to mid part of the day, last from 30 minutes to the rest of the day, and are relieved by rest or sleep. Chronic tension headaches vary somewhat from this but have the same overall symptoms but occur much more frequently," Anshel explains.
  ● Eye Strain: Anshel notes, "this can have many meanings to any number of people. It can be caused from such problems as focusing spasm, different vision in each eye, astigmatism, hyperopia, myopia, excess light, voluntary focusing, eye coordination difficulties, and more...many people may consider the tiring of their eyes as the 'eystrain' condition. This is most often caused by a condition known as convergence insufficiency and can be easily treated with a simple vision therapy program."
  ● Blurred Vision: "Blurred vision symptoms can result from refractive error (e.g., farsighted, nearsighted, astigmatism), improper prescription lenses, presbyopia (aging changes) or other focusing disorders," says Anshel. "It has been found that small amounts of refractive error contribute to the visual discomfort of computer users. Considering the working environment, blurred images can also arise from a dirty screen, poor viewing angle, reflected glare or a poor quality or defective monitor. All of these factors should be considered when this symptom occurs."
  ● Dry or irritated eyes: Computer usage reduces the blink rate (a natural reflex) of the eye.
  ● Light Sensitivity: Because of where we sit and the discrepancy in light source locations, discomfort glare is caused when the normal light source for the room is high above you -- leaving a great disparity between the light source of the computer and the full affect of the Fluorescent overhead.
  ● Double Vision: "Diplopia" is caused when eye strain creates the inability to keep both our eyes locked on the same point in space. Thus, we deliver two separate images to our brain - something quite difficult for us to make sense of.
  ● Neck and Back Aches: We are constantly compromising our posture in order to gain a better vantage point as we work obsessively and make ourselves tired at our computers. This causes even more unnecessary stress on our necks and backs.

Most of these conditions - headaches, eye strain, blurred vision, dry eyes, light sensitivity, and double vision - require you to notice when these symptoms occur. You must bring this information to your eye doctor and explain their onset. Once, and if, any sort of visual or computer related problems have been ruled out, you must then consider other possibilities as a cause. The first step in eliminating these symptoms is a routine eye examination. Many of these conditions are treatable through different visual therapies, techniques and learning new behavior.

EXTENDING A HAND
Of note, when it comes to dispensing useful information to the public and to the most extreme cases of low vision and degenerative eyesight is the American Foundation for the Blind (AFB). Founded by Helen Keller in 1924, the American Foundation for the Blind's mission is "eliminating the barriers that prevent the ten million American who are blind or visually impaired from reaching their potential." The AFB considers the following issues to be of the utmost importance when considering this growing section of society; independent living, literacy, employment, and technology. According to the American Foundation for the Blind, "five million Americans age 65 and older are severely visually impaired." It is estimated that with the baby boomer generation heading toward old age we will see a dramatic increase in this statistic over the next 30 years. Perhaps as much as 10 million people will find themselves in this severely impaired category. As part of the Outreach and Community Awareness Program the AFB provides resources for Specialty Products - listing suppliers who carry everything from writing guides and reading and recording devices to talking and large-print clocks, timers, watches, lighting, adapted games, and sewing products. Some of these suppliers even carry computer-related access products. The American Federation for the Blind also provides support materials for family members dealing with family members experiencing vision loss, especially as they age. Their advice is:
  ● Encourage family members experiencing vision loss to go for an examination by either an ophthalmologist or medical doctor specializing in eye diseases.
  ● Get an examination by a "low vision" specialist. Many optometrists specialize in low vision and can recommend helpful devices to make daily life easier. These devices include hand-held magnifiers and high intensity lighting.
  ● The AFB recommends knowing how to talk to a visually impaired person. Never assume someone is totally blind unless you know it to be so for a fact.
Announce you are in the room and identify yourself.
Say what you are there for
Talk to them directly
Stand where you can be seen - avoid standing behind the person.
Speak distinctly but not overly loud
Be respectful by answering questions and being specific
Say when you are leaving
Leave the room and its belongings as you found them
Do not provide assistance unless you are specifically asked to do so
  ● Find out about Rehabilitation services which can help train your family member in living skills (adaptive techniques for carrying out daily activities) and learning to orient themselves in different environments (whether they be familiar or unfamilar). State agencies have an office serving the blind but the American Foundation for the Blind may also be contacted for a referral, 1-800-232-5463.
  ● It is important to support your family member during the rehabilitation process -- encourage them to participate but don't force them. Learn along with them so that you can keep encouraging them as they succeed in learning these skills.
  ● Encourage independence and aid with adaptive tools as needed; rearranging furniture, improving lighting, and using contrasting colors to aid in visibility.

THE BOTTOM LINE
Perhaps the most important thing you can do for yourself when it comes to your vision is not to wait. Don't wait until you think you need reading glasses before you see an optometrist or an ophthalmologist. The sooner you take care of your vision, the earlier you may be able to ensure the preservation of your eyesight. Why wait to do it until your over 40, 50, or 60. Even if some vision problems already exist, it is good to know that there are helpful solutions.