The most common age-related eye problems are presbyopia, glaucoma, dry eyes, and age-related macular degeneration (AMD)
Presbyopia
Presbyopia is the gradual loss of the eyes’ ability to focus on nearby objects, caused by the loss of elasticity in the lens inside the eye. It’s a natural, often frustrating part of aging. Presbyopia typically becomes noticeable in your early to mid-40s and continues to worsen until about age 65. Although it cannot be reversed, it is easy to correct. The simplest solution is to wear reading glasses. Laser treatment and surgery offer few advantages and are associated with significant risks.
Symptoms: Difficulty seeing objects up close, needing to hold reading materials farther away to focus on them, eye strain (when your eyes feel tired or sore), and headaches after reading or doing close-up work. These symptoms may worsen if you are tired or in dim lighting. It’s important to see your doctor or optician if you experience sudden vision loss in one eye (with or without pain), hazy or blurred vision, flashes of light, black spots, halos around lights, or double vision.
Anatomy of the Eye
Your eye is a complex and compact structure, measuring about 1 inch (2.5 centimeters) in diameter. It receives millions of pieces of information about the outside world, which are quickly processed by your brain.
Presbyopia
With normal vision, an image is sharply focused onto the retina. If you have presbyopia, your lens becomes inflexible and doesn’t adjust to focus light properly, causing the point of focus to fall behind the retina. This makes close-up objects appear blurry.
When your eye forms an image, it relies on both the cornea and the lens to focus light reflected from objects. The closer the object, the more the lens flexes. The cornea is the clear, dome-shaped front surface of your eye, while the lens is a clear structure about the size of an M&M candy. Both structures refract light entering your eye to focus the image on the retina, located on the inside back wall of the eye.
Unlike the cornea, the lens is somewhat flexible and can change shape with the help of a circular muscle that surrounds it. When you look at something in the distance, the circular muscle relaxes, but it constricts when you look at something close. As your lens becomes less flexible, it can no longer change shape to focus on close objects, making them appear out of focus.
Glaucoma
Glaucoma is a common eye condition where the optic nerve, which connects the eye to the brain, becomes damaged. It is typically caused by fluid buildup in the front part of the eye, which increases pressure inside the eye. Glaucoma can lead to vision loss if not diagnosed and treated early. While it can affect people of all ages, it is most common in adults in their 70s and 80s.
Symptoms: Glaucoma usually does not cause symptoms at first. It develops slowly over many years and initially affects your peripheral vision. As a result, many people do not realize they have glaucoma until it is detected during a routine eye test. If symptoms do occur, they may include blurred vision or seeing rainbow-colored circles around bright lights. Although both eyes are usually affected, one eye may be worse than the other.
In rare cases, glaucoma can develop suddenly and cause:
- Intense eye pain
- Red eye
- Headache
- Nausea and vomiting
- Blurred vision
- Tenderness around the eyes
- Seeing rings around lights
You must visit your optician or GP if you have any concerns about your vision. Early diagnosis and treatment can prevent further vision loss. Without treatment, glaucoma can eventually lead to blindness.
Types of Glaucoma:
- Open-angle glaucoma: No early symptoms; gradual, patchy blind spots in side vision; difficulty seeing things in central vision in later stages.
- Acute angle-closure glaucoma: Severe headaches, severe eye pain, nausea or vomiting, blurred vision, halos or colored rings around lights, eye redness.
- Normal-tension glaucoma: No early symptoms; gradual blurred vision; loss of side vision in later stages.
- Pigmentary glaucoma: Halos around lights, blurred vision after exercise.
Dry Eyes
Many people experience dry eyes. It’s usually not serious, and there are several things you can do to relieve the discomfort.
Dry eyes can cause:
- Itchiness
- Soreness
- A feeling like you have grit in your eyes
- Redness
- Blurry vision
- Sensitivity to light
- Excessive watering
Causes: You can develop dry eyes if your eyes do not produce enough tears, or if your tears dry up too quickly. Your eyes may also be unable to produce the natural lubrication that keeps them moist, even while you sleep.
You are more likely to get dry eyes if:
- You are over 50
- You wear contact lenses
- You look at a computer screen for long periods without taking breaks
- You spend time in air-conditioned or heated environments
- It’s windy, cold, dry, or dusty
- You smoke or drink alcohol
- You take certain medications, such as some antidepressants or blood pressure medications
- You have had eye surgery or an illness that affected your eyes
- You have a condition such as blepharitis, Sjogren’s syndrome, or lupus
Treatment:
- Clean your eyelids every day
- Take breaks to rest your eyes when using a computer screen
- Use a humidifier to prevent the air from becoming too dry
- If you wear contact lenses, remove them and use glasses to rest your eyes
You can also consult your GP, optician, or pharmacist for advice. They can guide you on how to treat the symptoms on your own, such as cleaning and protecting your eyes. They may also prescribe or recommend eye drops, gels, ointments, or allergy medication.
Age-related Macular Degeneration (AMD)
AMD is a common condition that affects the central part of your vision, typically impacting people in their 50s and 60s. While it doesn’t cause total blindness, it can make everyday activities like reading and recognizing faces difficult.
Without treatment, vision may worsen. This can happen gradually over several years (dry AMD) or quickly over a number of weeks or months (wet AMD). The exact cause of AMD is unknown, but it has been linked to smoking, high blood pressure, being overweight, and having a family history of the condition.
AMD affects the central part of your vision, not the edges, and it can occur in one or both eyes. It can make activities like watching TV or driving difficult or even impossible. Other symptoms include seeing straight lines as wavy or crooked, objects appearing smaller than usual, colors seeming less bright, or seeing things that aren’t there (hallucinations).
Unlike other eye conditions, AMD is not painful and does not affect the appearance of your eyes. Sometimes, AMD is detected during a routine eye test before any symptoms are noticed.
When you visit the optician, they will use a magnifying glass with a light to examine the back of your eyes and check your vision. They may also use eye drops to make it easier to detect any issues. However, these drops can temporarily blur your vision for a couple of hours. If your optician spots a problem, they will refer you to an eye clinic where a consultant will discuss further treatment options.
For dry AMD, there is no specific treatment. You will be advised on vision aids to help manage the condition, such as using a magnifying lens for reading, installing brighter lighting in your home, and utilizing computer software or mobile apps to make tasks easier.
Wet AMD requires regular injections, and occasionally a light treatment called photodynamic therapy is used to prevent further vision loss.
Since AMD is often linked to an unhealthy lifestyle, adopting healthier habits can help manage the condition. Try to eat a balanced diet, exercise regularly, lose weight if necessary, and stop smoking if you do.
AMD can make it unsafe to drive. Your optician or consultant will advise you on whether it is safe for you to continue driving. By law, you are required to inform the DVLA about your condition if it affects both eyes or if your vision in one eye is below the minimum standard required for driving.