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The Aging Eye

As the body ages, some components may become stiffer, losing youthful agility. The body also tends to become drier and to shrink, losing its youthful shapeliness. Overall, the changes of aging make the body more fragile and more prone to dysfunction. The eyes are not immune to these aging tendencies.


After we reach mid-life, the eyes start to become presbyopic and we may need reading glasses. Causes of presbyopia are not fully understood, although it is known to involve age-related changes in the lens. There are several effective treatments for presbyopia that counteract blurry near vision, and new treatments are under testing by the FDA (Food and Drug Administration). Presbyopia is a progressive condition and may need further treatment after a few years.

Starting in mid-life, various eye diseases may also develop, impairing vision for different reasons. Some of them will cause blindness if they are not treated.


Cataracts are an impairment of the eye’s lens, where its transparency becomes clouded by tiny clumps of protein molecules. They block some of the incoming light and as they slowly expand over the years, vision becomes dimmer. When it becomes dim enough to interfere with daily activities, your eye doctor will recommend replacing the natural lens with an artificial lens called an intraocular lens. This will restore clear vision and since an artificial lens cannot develop cataracts, the problem is usually solved.


Glaucoma is a problem with optic nerve damage. Each eye has a large nerve leaving the retina which carries data from the retinal cells to the brain’s vision center. Without the optic nerve, we would have no vision. In glaucoma, optic nerve damage slowly destroys peripheral vision first, and progressively also destroys central vision until total blindness will result if nothing is done. Usually the optic nerve is damaged by higher-than-normal intraocular pressure (IOP); but there are also cases of glaucoma where IOP is normal. There is no cure for glaucoma but typically it can be well managed with eyedrops that lower IOP.

Age-Related Macular Degeneration (AMD)

AMD is a problem with the retina. The macula is the central retinal area that provides our clearest direct vision and when it starts to deteriorate, we lose that central vision. We retain peripheral vision however, which is the opposite vision loss from that of glaucoma, where peripheral vision is lost first. There are wet and dry forms of AMD. Dry AMD is the early stage and will lead to wet AMD in about ten percent of cases. Wet AMD causes more severe vision loss. Blood vessels under the retina leak blood and fluid, damaging retinal cells and causing blind spots in central vision.

Dry Eye Syndrome

Anyone can have dry eyes temporarily if they have been out in the wind or on the computer for too long. Dry Eye Syndrome is a chronic condition that affects more women than men, usually in mid-life. It is caused by a problem with tear production. There are a number of dry eye treatments, including surgical modifications to the tear drainage ducts, some medications, and procedures you can do at home.

Read about some Sight Saving Tests for Older Eyes and learn about When Age Related Vision Changes Start to Occur.

If you are approaching age 40, it would be best to visit your ophthalmologist for a thorough eye exam. Treatment results are always better when the problem is diagnosed early and with just one pair of eyes, you would not want to put your vision at any unnecessary risk.

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