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How Our Vision Changes as We Age

Just as our physical strength decreases with age, our eyes also exhibit an age related change in performance particularly as we reach our 60's and beyond.

Some age related eye changes, such as presbyopia, are perfectly normal and do not signify any sort of disease process. While cataracts can be considered an age related disease, they are extremely common among seniors and can be readily corrected with cataract surgery.

Some of us, however, will experience more serious age related eye diseases that have greater potential for affecting our quality of life as we grow older. Some of the more common conditions include glaucoma, macular degeneration, and/or diabetic retinopathy.

When Do Age Related Vision Changes Occur?

Presbyopia. Typically in your early 40's, you will notice it is more difficult to focus on objects up close. This normal loss of focusing ability is called presbyopia, and is due to hardening of the lens inside your eye.

For a little while, you can compensate for this decline in focusing ability by holding reading material further away from your eyes.  Eventually, that will no longer work and you will need reading glasses, multifocal contact lenses, or multifocal eyeglasses. Some corrective surgery options for presbyopia also are available, such as monovision LASIK and conductive keratoplasty (CK).

Cataracts. Even though cataracts are considered an age related eye disease, they are so common among seniors that they can also be classified as a normal aging change. According to the Mayo Clinic, about half of all 65 year old Americans have some degree of cataract formation in their eyes. As you enter your 70's, the percentage is even higher. It is estimated that by 2020 more than 30 million Americans will have cataracts.

Thankfully, modern cataract surgery has shown to be extremely safe and so effective that 100% of vision lost to cataract formation usually is restored. If you are noticing vision changes due to cataracts, do not hesitate to discuss symptoms with your eye doctor. It is often better to have cataracts removed before they advance too far. Also, multifocal lens implants are now available when cataract surgery is needed. These advanced intraocular lenses (IOLs) potentially can restore all ranges of vision including distance, middle, and near vision.  Thus, reducing your need for reading glasses as well as distance glasses after cataract surgery.

Major Age Related Eye Diseases

Macular degeneration. Macular degeneration, also called age related macular degeneration (AMD), is the leading cause of blindness among American seniors. According to the National Eye Institute (NEI), macular degeneration affects more than 1.75 million people in the United States. The U.S. population is aging rapidly, and this number is expected to increase to almost three million by 2020. Currently, there is no cure for AMD, but medical treatment may slow its progression or stabilize it.

Glaucoma. Your risk of developing glaucoma increases with each decade after age 40.  For example, from around 1% in your 40's to up to 12% in your 80's. The number of Americans with glaucoma is expected to increase by 50% to 3.6 million by the year 2020. If detected early, glaucoma can often be controlled with medical treatment or surgery and vision loss can be prevented.

Diabetic retinopathy. According to the NEI, approximately 10.2 million Americans over age 40 are known to have diabetes. Many experts believe that up to 30% of people who have diabetes have not yet been diagnosed. Among known diabetics over age 40, NEI estimates that 40% have some degree of diabetic retinopathy, and 1 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.

How Aging Affects other Eye Structures

While normally we think of aging as it relates to eye conditions such as presbyopia and cataracts, more subtle changes in our vision and eye structures are also occurring as we grow older.

  • 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. With these changes occurring, people in their 60's need three times more ambient light for comfortable reading than those in their 20's. 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 properties can help reduce these symptoms. 
  • Dry eyes. As we age, our bodies produce fewer tears. This is particularly true for women after menopause. If you begin to experience burning, stinging, or other eye discomfort related to dry eyes, consult with your eye doctor for options to treat and manage dry eye.
  • Loss of peripheral vision. Aging also causes a normal loss of peripheral vision.  The size of our visual field decreases by approximately one to three degrees per decade of life. By the time you reach your 70's and 80's, you may have a peripheral visual field loss of twenty to thirty degrees.
  • Decreased color vision. Cells in the retina that are responsible for normal color vision decline in sensitivity as we age.  This change causes colors to become less bright and the contrast between different colors to be less noticeable. In particular, blue colors may appear faded or "washed out." While there is no treatment for this normal, age related loss of color perception, you should be aware of this loss if your profession requires fine color discrimination.  For example, if you are an artist, seamstress, or electrician please be aware of your potential changes in color perception. 
  • Vitreous detachment. As we age, the gel-like vitreous inside the eye begins to liquefy and pull away from the retina.  This is called a vitreous detachment.  When this occurs, floaters, spots, and sometimes flashes of light appear in your vision.  Since floaters and flashes of light can also signal the beginning of a retinal detachment, a serious problem that can cause blindness if not treated immediately, see your eye doctor immediately if you experience any floaters, spots, or flashes of light.

What You Can Do About Age Related Vision Changes

A healthy diet and wise lifestyle choices including exercising regularly, maintaining a healthy weight, reducing stress, and not smoking are your best natural defenses against vision loss as you age.  To help provide early detection of age related vision changes and to learn more about them schedule routine comprehensive eye exams with your eye doctor. 

Be sure to discuss with your eye doctor all concerns you have about your eyes and vision. Inform your eye doctor about any history of eye problems in your family and any health problems you may have. Also, let your eye doctor know about any medications you take, including non-prescription vitamins, herbs, and supplements.

If you have any questions or concerns about age related vision changes, please call or schedule an appointment by calling our office at 512-255-7070.