Your Vision: What to Expect in Adulthood and Middle Age

Medically Reviewed by Whitney Seltman, OD on February 04, 2020

Vision changes are one of the first ways your body lets you know you're getting older.

They're usually subtle at first, often start in middle age, and can include these problems:

You Have to Hold Books and Newspapers Farther Away to Read Them

What it could be: Presbyopia, or the inability to focus up close. It’s one of the most common vision problems in middle age. As you get older, your eye lenses get less flexible. A stiff lens can't focus clearly.

What to do: If it’s harder to read than it used to be, make an appointment for an eye exam. You might need glasses or contacts.

You can get reading glasses with and without a prescription. You can use them for close-up viewing, like when you read a menu or book or work on a computer. If you need help with both near and far vision, bifocals can fix close-up and distant focus. Progressive lenses or trifocals can also help you see both near and far.

Contact lenses can help correct presbyopia without reading glasses. You have several choices, like bifocal contacts. Multifocal contact lenses allow you to see near, far, and everywhere in between. Some doctors suggest a contact for near vision in one eye and for distance vision in the other eye. This is called monovision.

The FDA has approved a surgical implant called the KAMRA inlay and one called Raindrop to help improve near vision. These may help well selected candidates looking for an alternative to dependence on reading glasses.

See your eye doctor to discuss your options.

Your Eyes Feel Dry and Irritated All the Time

What it could be: Dry eye syndrome. As you get older, your eyes make fewer tears. Laser eye surgery or contact lenses can make the problem worse.

What to do: It’s more than just an irritation. Your eyes need to stay wet to be healthy. Dry eyes hurt your vision if you ignore them for a long time. If your dryness is mild, get some artificial tears at the drugstore. You don’t need a prescription.

See your eye doctor if these products don’t help. There are other options, and your doctor can check if your dry eyes are a symptom of a bigger problem.

You Have Diabetes and Your Eyesight Changes From Day to Day

What it could be: Your blood sugar rises and falls through the day. Unstable blood sugar causes a continuous change in your need or lack of need for glasses.

Uncontrolled diabetes can affect your whole body, including your eyes. Over time, high blood sugar damages the delicate blood vessels in your eyes. They can leak and affect your vision.

What to do: See your doctor for a checkup, even if you don't think you have diabetes. You can have it and not know it.

Your Vision is Fine, but You're Over 60 and You Have a Family History of Glaucoma

What it could be: Glaucoma is a group of eye diseases that can damage your optic nerve. It often starts without any symptoms. You may not know that you have it until you've started to lose your sight.

What to do about it: See your doctor for an eye exam that includes a glaucoma test. If you have glaucoma, eye drop medication and surgery can stop the worst side effects.

There's a Film Over Everything You See

What it could be: Cataracts. As you get older, it’s normal for your eye’s lens to get cloudy as protein inside it starts to clump together. Cataracts can also create a halo around lights at night and make your eyes more sensitive to glare, even during daytime.

What to do about it: Until the cataract causes severe vision problems, you can increase lighting and change your eyeglass prescription to help you see more clearly. Once the haze gets bad, talk to your doctor about surgery to remove the clouded lens and replace it with an artificial one.

You Have a Fierce Headache That Started With Wavy Vision and Flashes of Light

What it could be: A migraine. They don't just make your head hurt. They also can create a light show of auras and flashes in your vision. You might even briefly lose sight from certain types of migraines.

What to do about it: If this is a new problem for you, call your doctor. If you’ve already been diagnosed with migraines, learn what triggers them. That way, you can stay away from those things and avoid the headaches. Medicine can prevent a migraine or stop one in its tracks. If you lose sight with your migraines or the flashing lights and visual symptoms last more than 30 minutes, call your eye doctor right away -- it could be a sign of a more serious vision problem.

Spots and Objects Bounce Around in Your Vision

What it could be: Floaters. They appear when the fluid inside your eye starts to break down with age. Most of the time, they’re annoying but harmless.

What to do about it: If you start to see new floaters all of a sudden, or their number starts to increase -- and especially if they occur with flashes of light -- see your eye doctor. Sometimes, the floaters can be a sign of a retinal tear, which can turn into a retinal detachment if you don't get it treated. This is an emergency, because it can lead to permanent vision loss.

Eye Exams: When Do You Need Them?

If you’re 40 and have vision issues, you should see an ophthalmologist or optometrist every 2 to 4 years. Go every 1 to 3 years between 55 and 65 and then yearly after that. Visit more often:

The doctor can keep an eye on your eye health and check for any vision changes.

Show Sources


American Optometric Association: "Adult Vision: 41 to 60 Years of Age," "Spots and Floaters," "Glaucoma," "Dry Eye," "Diabetic Retinopathy," "Astigmatism."

University of Illinois at Chicago: "Presbyopia, Why Bifocals?"

Women's Eye Health: "Dry Eye Syndrome."

National Eye Institute: "Facts About Cataract," “Facts about Glaucoma.”

Cleveland Clinic: "Migraine Headaches."

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