There is no question that as we age our body begins to weaken. We notice more aches and pains, our joints and bones weaken and yes, our eyes and vision also begin to decline. While we may begin to see changes as early as our 40’s, a more rapid deterioration begins from age 60 and accelerates as we grow older.
Certain age-related eye and vision changes are totally normal and do not signify the development of a disease. These include color vision loss, dry eyes, reduced contrast and night vision, pupil shrinkage and presbyopia. Cataracts is another age related condition that can cause blindness but is easily treated with a common eye surgery. Unfortunately, there are many other age-related diseases that are much more serious and can cause permanent vision loss and blindness, having a significant impact on the quality of life during the later years. These include glaucoma, age-related macular degeneration and diabetic retinopathy, three diseases that affect millions of people around the world.
How the Eyes Changes As We Age
Subtle changes in our vision and eye structure take place as we age. Some examples include:
After age 40, many people begin to notice difficulty seeing close objects – they have to hold books, menus and even their cell phone further away to see the text clearly. This is the sign of presbyopia, the hardening of the lens inside the eye which results in a loss in the ability to focus on near objects.
At first it may be sufficient to hold things at an arm’s length to see clearly but eventually you will probably seek a better solution, specifically reading glasses or multifocal glasses or contact lenses. If you are really bothered by wearing glasses or contacts and your eyes are otherwise healthy, surgery to replace the lens could be a possibility. Speak to your eye doctor about your options and the best solution for you.
Color Vision Loss
Color vision is made possible by retina cells which begin to deteriorate as we age. As a result colors appear more dull and contrast between color is diminished. While many people don’t notice this subtle change, people who are quite attuned to color will notice a reduction in color distinction, particular in the blue palette.
Shrinkage of the Pupil
As we age, the muscles in the eye which control the reaction and size of the pupil begin to weaken. This makes the pupils less responsive to changes in light, making it common for individuals over 60 to require more light to see clearly. It may also make glare and bright sunlight more problematic. Photochromic lenses (which darken when you enter the sunlight) and an anti-reflective, anti-glare lens coating can be helpful to reduce the sensitivity.
As we age, our eye ducts produce fewer tears, especially in postmenopausal women. Dry eyes can cause eyes to feel dry, red, irritated and gritty and sometimes cause excessive tearing. If you have any of these symptoms you should see your eye doctor for treatment, which can include eye drops or prescription medication as well as treatments to release or clear the blocked tear ducts.
Reduced Peripheral Vision
As we age, the peripheral field of vision begins to narrow reducing the size of the visual field progressively with time. While totally normal, this can be of particular concern when it comes to driving as the decreased range of vision increases the risk of accidents. Individuals should be aware of this and make a larger effort to scan their surroundings while driving.
The vitreous is a gel-like substance within the eye which begins to pull away from the retina as we age. This can cause visual symptoms such as spots, floaters and flashes of light in the field of vision. While vitreous detachment is usually not a cause for concern, floaters and flashes of light can also be a sign of the beginning of a retinal detachment – a very serious condition that can result in blindness if not treated immediately. If you experience any of these symptoms, contact your eye doctor immediately.
Cataracts are one of the most common eye conditions in the older population, in fact about half of Americans 65 years and older have some extent of cataract formation. As the eye ages, the natural lens begins to cloud, reducing clear vision. Cataracts are typically treated with a common surgical procedure which removes the clouded lens and replaces it with a clear, artificial lens. Today, cataract surgery is extremely safe and effective, usually being successful at restoring full vision. If a patient also has presbyopia, there may be the option to place a multifocal lens in the eye to fix both issues at once.
Eye Diseases Associated with Age
There are a number of serious eye diseases that are associated with age including:
The risk of developing glaucoma, a serious eye disease that causes progressive damage to the optic nerve, increases as you age. In fact there is a 12% risk of developing the disease at age 80. When detected and treated early, glaucoma can be controlled through medication or surgery, preventing vision loss. However once vision is lost it cannot be restored and often the disease progresses quickly without many symptoms. It’s important to have regular eye exams to detect and treat glaucoma early before vision loss occurs.
Age Related Macular Degeneration (AMD)
Age related macular degeneration (AMD) is a leading cause of blindness worldwide. AMD occurs when the macula in the eye progressively breaks down causing vision loss, specifically in the center field of vision. While there is no known cure yet for AMD, early detection and treatment may slow the progression of the disease and stabilize it enough to prevent vision loss.
Diabetic retinopathy is a vision threatening condition caused by the deterioration of the retina in individuals with diabetes. It’s currently estimated that 40% of people over 40 who have diabetes have some extent of diabetic retinopathy and one out of every 12 has advanced, vision-threatening retinopathy. In order to prevent permanent vision loss it is essential to control the diabetes and the insulin levels. Along with their regular diabetes doctor, patients with diabetes should have regular eye exams to monitor the status of the retina and the vision.
What Can Be Done About Age-Related Vision Changes?
There are many ways to prevent vision loss associated with age. Maintaining a healthy diet, exercising regularly, not smoking, protecting your eyes from UV rays and managing stress are all a wonderful place to start. Further, being aware of your family history and your personal risk factors will help you to take the necessary steps to protect your eyes. Lastly, schedule regular eye exams with your eye doctor to ensure that your eyes are healthy, provide you with optimal vision and to catch any diseases beginning to develop in the early stages.