Your Vision in the Senior Years

It's normal for vision to change as you get older. With good eye care, you can often limit the impact those changes have on your daily life. You might just need new glasses, contact lenses, or better lighting.

Common age-related vision changes include:

Presbyopia

Your eyes start having trouble focusing on objects close up. Doctors call that presbyopia.

Symptoms include:

  • Trouble reading small print
  • Headaches
  • Eye strain

What causes presbyopia? Over time, the lens of the eye hardens. Muscles around the lens also change with age. These changes make it harder for the lens to work.

An eye doctor can diagnose presbyopia and correct it with eyeglasses or contact lenses. Bifocals are glasses with the higher focusing power in the lower part of the lens. If you do not need glasses for distance, you may need only reading glasses.

Or, your doctor may suggest contact lenses, which can correct your vision and the need for glasses. Even if you can see far off, contacts can help your close vision. Options include bifocal contacts or monovision, in which you wear one contact to see close up and if needed a contact in your other eye to see far away.

Multifocal contact lenses allow you to see near, far, and everywhere in between.

Rarely, surgery is used to correct presbyopia, although the FDA has given approval to a device called the Kamra Inlay which can be surgically placed in one eye of a patient with presbyopia to help improve near vision. A Raindrop implant can also be placed under a LASIK type flap in one eye to improve reading vision.

Cataracts

Cataracts cloud vision. They are often associated with aging. Half of all Americans have cataracts by the time they reach 80.

Symptoms of a cataract may include:

  • Blurry, cloudy, or dim vision
  • Double vision with one eye
  • Trouble seeing at night or in dim light
  • Halos around lights
  • Sensitivity to light and glare
  • Faded or yellow colors, or trouble telling the difference between blues and greens
  • Trouble seeing an object against a background of the same color

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At earlier stages, simply changing your eyeglass or contact lens prescription is all you need. Using brighter lights for reading or a magnifying glass may also help. If halos or glare are a problem, night driving may be difficult. Sunglasses and tinted lenses can improve driving comfort during the day. See your eye doctor for any concerns you have.

If a cataract begins to interfere with your day-to-day life, an ophthalmologist specializing in cataract surgery can remove the cloudy lens and replace it with a clear lens implant.

Floaters

These are usually a harmless, natural part of aging. They are shadows of vitreous, which is the gel-like substance that makes the eye round, cast on the retina.

Floaters can appear as spots, threadlike strands, or squiggly lines that drift around, even when your eye stops moving. They are most obvious when you look at something bright, like a blue sky. They are more common in people who are very nearsighted or who have had cataract surgery.

If you suddenly notice many floaters, it may mean a part of the vitreous has pulled away from the retina all at once, sometimes with a tear in the retina. If you also have a loss of side vision, and light flashes, the retina may be lifting from its normal position. This is a retinal detachment. It can cause permanent vision loss, even blindness, if not treated. Seek immediate medical attention by seeing your eye doctor. If surgery is necessary, an ophthalmologist or a “retina specialist” may be called upon.

Dry Eyes

Tears moisten your eyes, lessen the risk of infection, and keep the eye surface (cornea) smooth and clear.

Sometimes your eyes don't make enough good-quality tears. This makes it hard for the eyes to stay healthy. Dry eyes can happen at any age, but are more common in people older than 65. Hormonal changes at menopause can also raise the risk of dry eyes in women. Other factors that may contribute are medications, contact lenses, and certain medical or environmental conditions, such as a dry climate.

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Symptoms of dry eyes include:

  • Burning
  • Scratchy, gritty, or irritated feeling
  • Extra watering
  • Blurred vision

If dry eyes become too severe, the cornea can become damaged, impairing vision.

For mild dry eye, over-the-counter artificial tears may do the trick, along with self-care, such as increasing humidity.

Prescription eye drops or other types of treatment may be best for more severe cases of dry eye. You should see your eye doctor if nonprescription drops don’t relieve your dry-eye symptoms, since dry eyes can be a symptom of other eye problems.

Other Eye Changes From Aging

These are some other changes that are common with age:

  • Pupils become smaller and don't open as well as they used to.
  • Eyelids droop or become inflamed. This sometimes affects vision.

You can make some adjustments to deal with these changes, such as:

  • Use extra lighting and put shades on lightbulbs.
  • Choose "high color" fluorescent bulbs with a color-rendering index of 80 or above.
  • Wear glasses with anti-reflective coating.
  • Get rid of distractions when driving.
  • Get an eye exam at least once a year.
  • Exercise regularly, don't smoke, and protect your eyes from ultraviolet rays and injury.

 

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on May 06, 2017

Sources

SOURCES:

National Eye Institute: "Presbyopia."

American Academy of Ophthalmology Preferred Practice Patterns: "Refractive Errors & Refractive Surgery PPP."

American Academy of Ophthalmology's EyeSmart: "What Are Cataracts?"

University of Illinois Eye & Ear Infirmary: "The Eye Digest: Eye changes with aging."

American Optometric Association: "Dry Eye."

Lighthouse International: "Vision Loss Is Not a Normal Part of Aging: Open Your Eyes to the Facts!"

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