How Your Vision Changes as You Age

We are all well aware of how much physical strength wanes as we age. Not surprisingly, our eyes, similarly, decline with age, perhaps even with accelerating declination from age 60 onward.

Specific age-related eye changes, such as cataracts or farsightedness caused by loss of elasticity of the lens of the eye (presbyopia), are perfectly normal and don’t signify a disease process. These are absolutely common along with age and can be readily corrected with treatment.

Millions, however, will experience more serious age-related eye diseases with a far greater impact on their quality of life during the aging process. Diseases that cause serious vision loss and even sometimes blindness such as glaucoma, macular degeneration, and even diabetic retinopathy will affect millions of people globally.

 

When Do The Age-Related Vision Changes Begin?

Passing the age of 40 is typically a first trigger. You may begin to notice more difficulty focusing on close objects. This is normal. The lens inside of your eye is slowly hardening – presbyopia – resulting in related loss of focusing ability.

Many people find that they can compensate for this focusing decline by simply holding their reading materials farther away from their eyes. Hence, the feeling that the older you get the longer your arms needs to be. Eventually, proper reading glasses, multifocal contact lenses, or multifocal eyeglasses are the correct solution. Corrective surgery options for presbyopia may also be possible; you can discuss CK and LASIK with your caregiver.

 Cataracts are quite common among seniors as part of the typically expected age-related changes. A cataract is a clouding of the natural lens located inside the eye. About half of all 65-year-old Americans have some cataract formation. Closing into age 70 and beyond, that number jumps much higher. [National Institute of Health]

Modern cataract surgery is extremely safe and effective so much so that100% of vision lost due to cataract formation can usually be restored. As you experience vision changes, possibly due to cataracts, do not hesitate to discuss the symptoms with your eye doctor. It is generally better to have cataracts removed before they advance too far. Artificial replacement lens implants, or intraocular lenses (IOLs), may be advised to restore ranges of vision issues. You may even reduce your need for reading glasses and/or distance glasses post cataract surgery with multifocal lens implants.

Age-Centric Eye Diseases

  • Diabetic Retinopathy
  • Macular Degeneration
  • Glaucoma

The NEI counts over 10 million Americans past age 40 as having diabetes. Experts expect that as much as 30% of people with diabetes are undiagnosed. Best estimates show that 40% have diabetic retinopathy at some level and one out of every 12 people with diabetes in this age group has advanced, vision-threatening retinopathy. Controlling the underlying diabetic condition in its early stages is the key to preventing vision loss.

Macular degeneration – age-related macular degeneration or AMD, is a leading cause of blindness among seniors. According to the NEI (National Eye Institute) macular degeneration affects more than 1.75 million people in the United States. The U.S. population is aging rapidly, and these numbers are expected to rise to 3 million by 2020. There is no known cure for AMD although medical treatment may slow its progression and the hope is to stabilize and eventually cure it.

Individual risk of developing glaucoma increases per each decade after age 40 – from around 1% during the 40s soaring to 12% at age 80. The number of Americans with glaucoma is expected to grow by 50% by 2020. If detected early, glaucoma can be controlled with medical treatment or surgery. Vision loss can be prevented, so get tested early and follow your eye doctor’s guidance.

 

Aging Also Affects Overall Eye Structure

We should not only think of aging as it relates to presbyopia and cataracts. Subtle changes in vision and eye structure as well take place as we age.

Changes include:

  • Color Vision Loss
  • Pupil Shrinkage
  • Vitreous Detachment
  • Dry Eyes
  • Peripheral Vision Loss

Retina cells, responsible for proper color vision, decline in sensitivity with aging. This causes the color to appear duller with less contrast between colors. Blue color, in particular, will fade and wash-out. Since treatment for this age-related loss of color perception is not conclusive you must be conscious of this loss especially if your profession (artist, fashion, etc.) depends on fine color distinctions.

Muscles that control pupil size and reaction to light weaken with age. This results in smaller and less responsive pupils, to changes in ambient lighting. Due to this, people above age 60 require up to three times the ambient light for comfortable reading vs. age 20s. Seniors are also more likely to be dazzled by bright sunlight and glare when emerging from a dimly lit building. Eyeglasses with photochromic lenses and anti-reflective coating help resolve this issue.

With age, the gel-like vitreous inside of the eye begins to liquefy and pull away from the retina, causing “spots and floaters” and “flashes” of light. This condition, called vitreous detachment, is typically harmless but floaters and flashes of light can signal the beginning of a retinal detachment – a serious problem that can cause blindness unless it is treated immediately. Contact your eye doctor immediately if you do experience flashes and floaters.

Aging bodies produce much fewer tears. This is especially true of women, postmenopausal. Any experience of burning or stinging, or for that matter any other eye discomfort such as dry eyes, should be brought to your eye doctor for immediate help. You may be advised to use artificial tears or prescription dry eye medication to provide increased comfort.

Aging causes a normal narrowing of peripheral field of vision. The size of visual field decreases by approximately one-to-three degrees per decade of life. Ages 70-80s can expect a peripheral visual field loss of 20-30 degrees.

Because a loss of visual field increases the risk for automobile accidents, increased caution is called for when driving. The decreased range of vision requires more specific head-turning to scan all directions at traffic intersections.


What Can Be Done About Age-Related Vision

Much can and should be done, to lower risk and increase life quality to age more gracefully. A healthy diet and wiser lifestyle choices begin and end with more regular exercise. Maintain a healthy and steady weight. Reduce stresses to absolutely controlled and low levels. No smoking! Healthy, natural choices are the ideal defense mechanisms against vision loss. Schedule regular eye exams with a caring optometrist or ophthalmologist.

Discuss all concerns about your eyes and vision with your eye doctor. Record and explain any history of eye problems in your family and any related health problems you may have. Be sure to clarify with your eye doctor the specifics of any medications you take, including non-prescription vitamins or supplements.

Treatment and Preventative Measures for Age-Related Vision Loss

Age-related vision difficulties and vision loss can be a challenge, but there are many solutions to help you cope and lessen the impact it can have on your daily life. Simple strategies from getting the right pair of glasses, to improving lighting, to purchasing some vision aids or magnifiers, can significantly help to compensate for reduced vision. Vision changes are normal with age yet it’s important to speak to your eye doctor so you know what to expect and ensure that the changes you are experiencing are normal and not a sign of a more serious eye or vision condition.

Normal age-related vision changes include reduced near vision (presbyopia), trouble seeing in dim light (due to the pupil shrinking and letting less light into the eye) and difficulty driving at night. Additionally, color vision and contrast sensitivity may be reduced. Most of these issues can be corrected with the right pair of eyeglasses to increase visual acuity and contrast and reduce glare. Improving lighting conditions within the home and office can also help. You may want to purchase some good portable lamps to brighten workspaces, especially when you are reading or performing fine motor skills such as typing, painting, or sewing.

Cataracts are a common age-related condition in which vision is gradually reduced due to a clouding of the lens of the eye. When it begins to seriously affect vision, a surgical procedure to remove the lens and replace it with a clear artificial lens can be done. This procedure is extremely common and typically very successful in restoring vision.

 

Options for Permanent Vision Loss

 Age-related and other eye diseases such as glaucoma, age-related macular degeneration, and diabetic retinopathy can result in permanent vision loss or blind spots. This results in a condition called low vision, in which some vision remains, but the quality is compromised. This can be devastating for many people that are used to living independently but suddenly require a lot of assistance for daily living.

 Thankfully, there are many products out there to help individuals with low vision manage daily tasks without assistance and the technology is always improving.

Some examples include:

  • Handheld and stand magnifiers, some with lights included
  • Large screen televisions and computer screens
  • Phones and other devices with larger numbers or fonts
  • Lenses and shields to reduce glare on screens

Screen reader programs and wearable devices

The most important thing you can do to preserve your vision as you age is to schedule regular eye exams. Many vision-threatening diseases only begin to show symptoms when vision loss has already begun and may not be able to be restored. A thorough eye exam can detect early signs of disease and allow for treatment and preventative measures to reduce vision loss. As you begin to notice changes you should schedule regular exams to monitor your eyes and vision and to rule out any serious diseases that could cause irreparable vision loss.