When it comes to preserving your sight, you have more power than meets the eye.
Some things, like your priorities and sense of self, become clearer with age. Your eyesight is not usually one of them.
Even if you’ve enjoyed 20/20 vision your whole life, you may suddenly find yourself struggling. The good news: If you educate yourself, control some risk factors, and quickly get help for any problems that arise, you’ll have a much better shot of preserving your eyesight for the years to come.
Here are six common eye issues affecting older adults—and what you can do about each.
Problem #1: Farsightedness
If you spent much of your life with normal vision—or only needed glasses to watch a movie—you might be surprised to now have trouble seeing things up close. Presbyopia, or farsightedness (because you can see better from a distance), happens when the lens of your eye becomes less flexible, making it harder to change focus.
Presbyopia may first become noticeable as early as your mid-40s, according to the American Optometric Association, but it usually worsens in the decades that follow. A pair of drugstore readers—or a prescription for progressive glasses or contacts—can make reading restaurant menus, books, and text messages a lot easier.
Problem #2: Dry Eye
As you get older, the quality and quantity of tear production decreases, which makes it harder to keep your peepers moist and comfortable. The result: Your eyes feel scratchy, as if something is stuck in them. You might also have redness, stinging, or burning.
“Dry eyes become much more common after age 40, with a markedly increased prevalence in seniors,” says Alan D. Mendelsohn, M.D., an ophthalmologist in Miami.
This condition is especially common in women over 50 who’ve gone through menopause, according to the National Eye Institute (NEI). Over-the-counter treatments like artificial tears and ointments may help, but prescription medication and procedures like punctal plugs sometimes work better.
As always, talk to your doctor about the best solution for you, and check with your health plan for benefits and estimated costs.
Problem #3: Macular Degeneration
“Macular degeneration is the number-one cause of blindness in the United States for people 50 years of age and older,” says Dr. Mendelsohn, “and the incidence is rising.”
You can reduce your risk in a number of ways. For starters, don’t smoke, as it damages your eyes (along with many other body parts). Dr. Mendelsohn also urges patients to wear polarized sunglasses with UV 400 protection when outdoors and blue-blocker glasses inside while using digital devices to ease eye strain.
Meanwhile, eat plenty of fatty fish like wild salmon, since they’re rich in omega-3s that may help keep your eyes healthy. Taking AREDS or AREDS2 supplements—which contain high levels of zinc and antioxidants—may also be worthwhile, but check with your doctor before trying them to avoid any possible interactions with meds you’re already taking.
Problem #4: Cataracts
The older you are, the higher your risk: By age 80, more than half of Americans have had at least one cataract, according to the NEI. Cataracts happen when protein that’s naturally found in the eye starts to clump together, making the lens cloudy and obscuring vision. You might first notice that you’re having more trouble driving at night, Dr. Mendelsohn says. “Oncoming headlights begin to become bothersome,” he says.
If you get to the point where cataracts are interfering with your ability to do everyday tasks, it may be time for surgery. But don’t panic: These days many patients simply need a five-minute outpatient procedure.
Problem #5: Glaucoma
“Two percent of the U.S. population develops glaucoma, but the incidence rises to greater than 10 percent for those 65 and older,” Dr. Mendelsohn says. “Glaucoma is called the ‘sneak thief’ in that vision is gradually lost, permanently, and the patient typically has no symptoms nor any idea that damage is occurring.”
In other words, if you’re not getting regular eye exams, you might not catch this problem until it’s too late. Glaucoma itself—caused by increased pressure within the eyeball—isn’t preventable, but loss of vision from it is, provided an eye doctor can detect and treat it promptly.
Problem #6: Diabetic Eye Disease
More than 25 percent of Americans ages 65 and up have diabetes, and the condition can take quite a toll on your body, including your eyes. “Diabetic eye disease is the second most common cause of blindness in the U.S. behind macular degeneration,” Dr. Mendelsohn says.
As you get older, your risk of diabetic retinopathy (damaged blood vessels in the retina caused by high blood sugar) and maculopathy (swelling in the area that controls your central vision) increases substantially.
If you have diabetes, work with your doctor to control blood sugar with quarterly A1C tests and at-home testing, if recommended, Dr. Mendelsohn says. Plus, see your eye doctor twice a year, he adds.
If you don’t have diabetes or any known optical disorder, see your eye doctor annually, Dr. Mendelsohn says. A comprehensive exam should include dilation and an evaluation of the optic nerve, macula, and retina using optical coherence tomography (OCT).
“The OCT will detect problems at their inception, and almost always before you develop symptoms,” Dr. Mendelsohn says. If your eye doctor suspects that you have glaucoma, you might also need a visual field test to check your peripheral vision.
Whether you’re visiting the eye doctor, general practitioner, or any other specialist, get the most out of your appointment by following this four-step guide to planning and preparation.