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Age-related vision changes: What to expect

A happy older Indian woman wearing glasses smiling.

Just as our physical strength decreases with age, our vision also grows weaker as we grow older — particularly after 60 years of age.

Some age-related eye changes, such as presbyopia (the loss of our ability to focus on near objects), are normal and easily treated with eyeglasses, contact lenses or surgery. Cataracts, the leading cause of blindness in India, can be easily corrected with cataract surgery.

Some of us, however, will experience more serious age-related eye diseases (glaucoma, macular degeneration and diabetic retinopathy) that have greater potential to affect our quality of life as we grow older.

When do age-related vision changes occur?

Presbyopia

After you pass the age of 40, it's harder to focus on objects up close. Presbyopia is a normal loss of focusing ability as you grow older.

For a time, you can compensate for presbyopia by holding reading material farther away from your eyes, but eventually you will need reading glasses, progressive lenses, multifocal contact lenses or vision surgery.

Cataracts

Cataracts, which develop over the course of years, is a common condition in old age. The main symptom of cataracts is blurry vision that makes it seem as if you are looking through a hazy window.

According to the World Health Organization’s latest assessment, cataracts are responsible for 51 percent of blindness around the world. In India, one recent survey found 63 percent of blindness is traced to cataracts.

Cataract surgery is safe, so consult your eye doctor to restore your clear vision. Blurry vision caused by cataracts makes it harder to drive, to read, to shop for groceries, use your phone and get around your home.

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Despite some age-related vision changes that are inevitable, you may be able to keep your eyes healthy for a lifetime.

Other major age-related eye diseases include macular degeneration, glaucoma and diabetic retinopathy.

How aging affects our eyes

While normally we think of aging as it relates to conditions such as presbyopia and cataracts, more subtle changes in our vision and eyes also take place as we grow older. These changes include:

Reduced pupil size

As we age, muscles that control our pupil size and reaction to light, lose some strength. This causes the pupil to become smaller and less responsive to changes in ambient lighting.

Because of these changes, people above 60 years of age need three times more ambient light for comfortable reading than the young generation.

Also, seniors are more likely to be dazzled by bright sunlight and glare when emerging from a dimly lit building such as a movie theater. Eyeglasses with photochromic lenses and anti-reflective coating can help reduce this problem.

Loss of peripheral vision

Aging also causes a normal loss of peripheral vision, with the size of our visual field decreasing by approximately one to three degrees per decade of life. By the time you reach your 70s and 80s, you may have a peripheral visual field loss of 20 to 30 degrees.

Be more cautious while driving because the loss of visual field increases the risk of accidents. To increase your range of vision, turn your head and look both ways when approaching intersections.

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As we age, we naturally lose some of the visual abilities we had when we were younger.

Dry eyes

As we age, our eyes produce fewer tears. This is particularly true for women after menopause.

If you experience a burning sensation, stinging, or other eye discomfort related to dry eyes, use artificial tears as needed, or consult your eye doctor for other options.

Decreased color vision

Cells in the retina that are responsible for color vision decline in sensitivity as we age, causing colors to become less bright and the contrast between colors to be less noticeable.

In particular, blue colors may appear faded. If you work in a profession that requires color discrimination (e.g. artist, seamstress, or electrician), you should know that there is no treatment for this age-related loss of color perception.

Vitreous detachment

As we age, the gel-like vitreous inside the eye begins to liquefy and pull away from the retina, causing "spots and floaters" and (sometimes) flashes of light. This condition, called vitreous detachment, is usually harmless.

But floaters and flashes of light can also signal the beginning of a detached retina — a serious problem that can cause blindness if not treated immediately. If you experience flashes and floaters, consult your eye doctor immediately to determine the cause.

What you can do about age-related vision changes

A healthy diet and wise lifestyle choices, such as not smoking, are your best natural defenses against vision loss as you age.

Also, you need to have regular eye exams with a caring and knowledgeable eye doctor.

Be sure to discuss with your eye doctor all concerns you have about your eyes and vision. Tell them about any history of eye problems in your family, as well as any other health problems you may have.

Your eye doctor should know what medications you take (including vitamins, herbs and supplements). This will help with appropriate recommendations to keep your eyes healthy through your lifetime.