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Ask the expert: Vision health as you age

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Many people expect their eyesight to decline with age — perhaps requiring a stronger eyeglass prescription or “readers.” Some vision changes are linked to age, but there are steps to consider to help our eyes stay as healthy as possible.

Dr. Linda Chous, OD, chief eye care officer, UnitedHealthcare, answered the following questions:

1. Are my eyes going to keep getting worse as I age?

While your eyesight is not guaranteed to deteriorate with age, it is normal to notice changes to your vision as the years pass, including:

  • Minor adjustments to your eyeglasses prescription or needing to use “readers” for the first time;
  • Trouble distinguishing colors, such as blue from black; and
  • The need for more light to see well.

Although these changes are often normal, they can also be signs of conditions like cataracts or even diabetes. It is important to maintain regular appointments with your eye doctor to help identify pressing concerns. If you experience sudden vision loss or any rapid change to your eyesight, contact your eye care provider immediately.

2. What are the tiny spots or specks that float across my vision?

These tiny threads of protein float across the gel-like substance between your eye’s lens and retina.

Usually there is no need to worry if you notice these spots occasionally and they disappear after a few minutes, but only a dilated eye examination can determine the cause of the “floaters.”

If your vision is overcome by these specks or you notice vision loss, contact your eye doctor, as it could be a symptom of a sight-threatening condition.

3. What are some common vision-related diseases that come with age?

Age-related macular degeneration (AMD)

AMD is the leading cause of vision loss in people over 65. AMD causes damage to the macula, the small spot on the retina that enables people to see clearly and view things straight ahead of them.

Common symptoms are distortion and blurring of the center of your field of vision. If caught early, there are potential benefits from certain prescription medications and nutritional supplements. Late-stage AMD is much more difficult to treat.

Certain factors like heredity, ultraviolet light exposure and smoking may increase the risk of AMD. Consult with your eye doctor to determine if a preventive treatment plan is right for you.

Cataracts

A cataract is the clouding of the lens in your eye, blocking the flow of light to the back of your eye (retina), which ultimately causes loss of sight. Most form slowly and do not cause pain. Significant clouding can form in some people and, ultimately, negatively impact vision.

Cataracts are treatable via surgery that replaces the clouded lens with a clear plastic lens. Cataract surgery is generally safe and one of the most common surgeries in the U.S. Once a cataract is removed, it cannot grow back.

Glaucoma

Glaucoma is caused by increased pressure inside the eye, which can cause permanent vision loss and blindness if untreated. The most common form usually has no noticeable symptoms in the early stages — the only way to detect it is routine testing.

Treatment may include prescription eye drops, oral medications, laser treatment surgery or a combination of any of these. It is important to find glaucoma early because once vision is lost, it cannot be regained.

4. What are the best ways to keep my eyes healthy as I age?

Some of the best ways to protect your eyes include:

  • Stop smoking. Smokers are up to four times more likely to develop AMD and may contribute to development of cataracts.
  • Maintain a healthy weight. Conditions associated with being overweight, like diabetes and heart disease, increase your risk of vision loss from cataracts, glaucoma and retinopathy.
  • Wear sunglasses. Help protect your eyes from harmful ultraviolet rays.
  • Be physically active. People who are physically active experienced less vision loss over 20 years compared to those who are less active.
  • Eat a healthy diet. Colorful fruits and vegetables contain nutrients that can keep your eyes healthy and reduce AMD risk.

5. Do sunglasses really protect my eyes?

Sunglasses act as a buffer between your eyes and the sun’s ultraviolet (UV) rays. Exposure to these rays can put you at greater risk of cataracts and AMD. Look for a pair that blocks 99% to 100% of UV rays.

Note that polarization is different from UV protection; however, most polarized sunglasses also provide UV protection. Check the product tag or ask for assistance in choosing the right pair.

6. How often should I see my eye care doctor?

Eye exams are crucial to maintaining eye health as you age. Many eye diseases, like glaucoma, have no symptoms in early stages. And many systemic conditions, such as diabetes and high blood pressure, can be first found during a routine eye exam. Aim to see your eye doctor annually even if your vision hasn’t changed, so your doctor has a record of your eye health. See your doctor immediately for sudden changes.

For UnitedHealthcare Medicare Advantage members, many plans include routine vision services as well as additional services not covered under Original Medicare. It’s helpful to learn how to take advantage of these and other benefits.

Plans insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

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WHO chief warns against ‘catastrophic moral failure’ in COVID-19 vaccine access

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A “me-first approach” to COVID-19 vaccines on the part of some countries and manufacturers is putting equitable access to these lifesaving treatments at risk, the head of the World Health Organization (WHO) warned on Monday. 

Addressing the agency’s Executive Board, WHO chief Tedros Adhanom Ghebreyesus expressed fear that “even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots.” 

Describing the rapid development of vaccines as a literal and figurative “shot in the arm” during the pandemic, Tedros reported that while 39 million doses have been administered in nearly 50 richer countries, only 25 have been given in one lowest income nation. 

A self-defeating approach  

“I need to be blunt: the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries”, he said, speaking from WHO headquarters in Geneva. 

Ensuring all countries will have access to any COVID-19 vaccines is the promise of a global mechanism established last April, known as the COVAX Facility. It has secured two billion doses so far, with a billion more in the pipeline, and deliveries should begin next month. 

“Even as they speak the language of equitable access, some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue. This is wrong”, Tedros stated. 

Additionally, most manufacturers also have prioritized regulatory approval in rich countries, where profits are higher, rather than submitting their dossiers to WHO for prequalification. 

“This could delay COVAX deliveries and create exactly the scenario COVAX was designed to avoid, with hoarding, a chaotic market, an uncoordinated response, and continued social and economic disruption”, he said. 

“Not only does this me-first approach leave the world’s poorest and most vulnerable people at risk, it’s also self-defeating.” 

Change the rules of the game 

Underlining that vaccine equity also has economic benefits, Tedros urged countries to “work together in solidarity” to ensure inoculation of all health workers and older people at most risk worldwide is underway, within the first 100 days of the year. 

He pressed for action in three areas to “change the rules of the game”, starting with an appeal for transparency in any bilateral contracts between countries and COVAX, including on volumes, pricing and delivery dates. 

“We call on these countries to give much greater priority to COVAX’s place in the queue, and to share their own doses with COVAX, especially once they have vaccinated their own health workers and older populations, so that other countries can do the same”, he said. 

Tedros also called for vaccine producers to provide WHO with full data for regulatory review in real time, to accelerate approvals, and he urged countries to only use vaccines that have met international safety standards, and to accelerate readiness for their deployment.  

“My challenge to all Member States is to ensure that by the time World Health Day arrives on the 7th of April, COVID-19 vaccines are being administered in every country, as a symbol of hope for overcoming both the pandemic and the inequalities that lie at the root of so many global health challenges”, he said, adding, “I hope this will be realized.” 

‘Vaccinationalism’ threatens recovery: UN chief

UN Secretary-General António Guterres has again stressed that COVID-19 vaccines must be a global public good, available to everyone, everywhere. 

Speaking in New York at a ceremony for the world’s developing nations, he underlined the need for funding for medicines and diagnostics to defeat the virus. 

“We need manufacturers to step up their commitment to work with the COVAX facility and countries around the world, in particular the world’s leading economies, to ensure enough supply and fair distribution,” said Mr. Guterres. 

“‘Vaccinationalism’ is self-defeating and would delay a global recovery.” 

The Secretary-General said recovery also represents a chance to “change course”, away from the old “normal” of inequalities and injustices, and he continues to advocate for greater support from developed countries and international financial institutions. 

“With smart policies and the right investments, we can chart a path that brings health to all, revives economies and builds resilience,” he said. “But developing countries must have the necessary resources to do so.”

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UN agencies supporting mammoth India COVID-19 vaccine rollout

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Health workers pose with a vial of COVID-19 vaccine after receiving their shots at a hospital in India. UNICEF/Vinay Panjwani

India has begun what is the world’s biggest COVID vaccination campaign so far, deploying hundreds of thousands of health workers, with the training and support of the UN World Health Organization (WHO). 

On 16 January, the first day of the campaign, 207,229 vaccine shots were given across the country, one of the worst-hit by COVID-19, with over 10 million COVID-19 infections and 150,000 deaths. 

“[We] provided technical assistance to the Government of India for the development of operational guidelines and other training materials for state and district programme managers and vaccinators, and establishing tracking and accountability frameworks”, Roderico H. Ofrin, WHO Representative in India said. 

“WHO field officers have facilitated the highest-level oversight through regular task force meetings at state and district levels, which are chaired by the Principal Secretaries (Health) at the state level, and District Magistrates at the district level”, he added. 

According to media reports, an estimated 10 million health workers are targeted to be vaccinated in the first round, followed by other front-line workers such as police, security forces and municipal staff, with plans to inoculate 300 million people by August. 

Supporting preparations 

Prior to the start of the campaign, UN agencies help with detailed preparations. 

For its part, WHO participated in dry-run simulations and provided feedback on management of vaccines, registration of beneficiaries, as well as reporting on vaccination coverage and adverse events following immunization. 

It also worked with the Government and the UN Development Programme (UNDP) on real-time reporting and problem-solving when issues arose at the vaccination sites, according to Dr. Ofrin. 

At the provincial level, WHO also supported implementation and monitoring of health policy, such as developing standard operating procedures, preparing technical briefs, and providing best practices from other parts of the India as well as other countries. 

Reliable information 

Similarly, the UN Children’s Fund (UNICEF) supported communication and advocacy efforts to ensure the dissemination of factual information to stakeholders and communities. The agency also helped train healthcare staff in infection control and prevention, and psychosocial support to children and caregivers.  

Aside from directly supporting vaccine rollout, UN agencies continued their programmes to assist the most vulnerable communities impacted by COVID-19 and its socio-economic fallouts.  

For instance, the UN World Food Programme (WFP) supported NGOs in order to identify and register some 19,000 vulnerable households and distributed food packets; while the UN Population Fund (UNFPA) conducted awareness raising programmes on sexual and reproductive health, and prevention of gender-based violence, on behalf of some 30 million vulnerable individuals.  

The three W’s  

Though vaccination programmes are underway, continued vigilance against COVID-19 and preventing its spread remain as important as ever. 

WHO’s Dr. Ofrin urged continued vigilance over tracking cases, cluster investigation, isolation and clinical care, and quarantining to break the chain of transmission. 

Alongside, he also highlighted the “three W’s – wear a mask, wash your hands and watch your distance.” 

“These efforts must continue to stop the spread of COVID-19. We as individuals and communities must work with the Government to save lives and the economy by protecting health and livelihoods,” he added.

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Independent panel finds critical early failings in COVID-19 response

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The global system for pandemic alert and response is “not fit for purpose”, highlighting the need for a new framework in the wake of COVID-19, experts appointed by the World Health Organization (WHO) said in an interim report presented on Tuesday. 

The Independent Panel for Pandemic Preparedness and Response found critical elements to be “slow, cumbersome and indecisive” in an era when information about new disease outbreaks is being transmitted faster than countries can formally report on them. 

“When there is a potential health threat, countries and the World Health Organization must further use the 21st century digital tools at their disposal to keep pace with news that spreads instantly on social media and infectious pathogens that spread rapidly through travel”, said Helen Clark, former Prime Minister of New Zealand and co-chair of the panel.   

“Detection and alert may have been speedy by the standards of earlier novel pathogens, but viruses move in minutes and hours, rather than in days and weeks.”  

‘Lost opportunities’ at the outset 

The Independent Panel was established to review lessons learned from international response to COVID-19, which first emerged in Wuhan, China, in December 2019. Nearly 94 million confirmed cases and more than two million deaths have been reported globally as of Tuesday. 

The panel’s second progress report said countries were slow to respond to the new coronavirus disease, noting “there were lost opportunities to apply basic public health measures at the earliest opportunity”. 

Although WHO declared on 30 January 2020 that COVID-19 was a Public Health Emergency of International Concern (PHEIC), the panel found many countries took minimal action to prevent spread both within and beyond their borders. 

“What is clear to the Panel is that public health measures could have been applied more forcefully by local and national health authorities in China in January”, the report said.  

“It is also clear to the Panel that there was evidence of cases in a number of countries by the end of January 2020. Public health containment measures should have been implemented immediately in any country with a likely case. They were not.” 

The report also outlined critical shortcomings at each phase of response, including failure to prepare for a pandemic despite years of warning.  

“The sheer toll of this epidemic is prima facie evidence that the world was not prepared for an infectious disease outbreak with global pandemic potential, despite the numerous warnings issued that such an event was probable”, it said. 

Deepening inequalities 

Pandemic response has also deepened inequalities, according to the panel, with inequitable access to COVID-19 vaccines a glaring example as rollout has favoured wealthy nations. 

“A world where high-income countries receive universal coverage while low-income countries are expected to accept only 20 per cent in the foreseeable future is on the wrong footing – both for justice and for pandemic control. This failure must be remedied”, said the panel’s co chair, Ellen Johnson Sirleaf, former President of Liberia. 

The report further highlighted the need to strengthen the UN’s health agency. 

“The WHO is expected to validate reports of disease outbreaks for their pandemic potential and, deploy support and containment resources, but its powers and funding to carry out its functions are limited”, Ms. Sirleaf said. “This is a question of resources, tools, access, and authority.”   

Countries are also urged to ensure testing, contact tracing and other public health measures to reduce virus spread, are being implemented, in efforts to save lives, particularly as more infectious virus variants emerge. 

The Independent Panel began its review last September and will present a report to the World Health Assembly, the decision-making body of WHO, in May.

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