Your eyes change as you age. That is a fact. But not every change is harmless, and not every change is a crisis. The trouble is knowing which is which.
After 60, your risk for serious eye diseases climbs sharply. Glaucoma, macular degeneration, cataracts, and diabetic eye disease all become more common with each passing decade. Early detection makes a major difference in outcomes for every one of these conditions.
Here is a clear guide to what is normal, what is not, and when you should call your eye doctor.
Normal Changes After 60
These changes are part of aging. They can be annoying, but they do not threaten your vision:
Needing more light to read. By age 60, you need about three times as much light to read comfortably as you did at 20. Your pupils shrink with age, letting less light in. The lens inside your eye also yellows, filtering out more light.
What to do: Use brighter bulbs for reading. A 100-watt equivalent LED desk lamp aimed directly at your book or screen makes a big difference. Avoid reading in dim rooms.
Trouble with glare. The yellowing lens scatters incoming light, making headlights, wet roads, and sunlit surfaces more bothersome. Night driving becomes harder.
What to do: Keep your windshield clean (inside and out). Use anti-glare lenses in your glasses. Avoid looking directly at oncoming headlights. If night driving feels unsafe, limit it.
Difficulty focusing on close objects (presbyopia). This actually starts around age 40, but it continues to worsen into your 60s and 70s. The lens becomes stiffer and cannot change shape to focus on near objects.
What to do: Update your reading glasses or bifocal prescription as needed. Progressive lenses give you a smooth transition between near and far vision.
Dry eyes. Tear production decreases with age, especially in women after menopause. Eyes may feel gritty, itchy, or tired.
What to do: Use preservative-free artificial tears two to four times a day. A humidifier in your bedroom helps during dry winter months. If drops are not enough, your eye doctor can prescribe stronger treatments.
Smaller pupil size. Your pupils respond more slowly to changes in light. Walking from a bright room into a dim hallway can leave you momentarily unable to see well.
What to do: Pause for a moment when moving between bright and dark spaces. Keep hallways and transition areas well-lit.
Warning Signs That Need Prompt Attention
These symptoms could mean something serious. Do not wait for your next scheduled appointment.
Sudden Flashes of Light or a Shower of Floaters
A few floaters (tiny specks or threads drifting across your vision) are normal at any age. But a sudden increase in floaters, especially combined with flashes of light or a dark shadow in your side vision, can mean a retinal detachment.
Why it matters: The retina is the light-sensitive layer at the back of your eye. If it detaches, you can lose vision permanently. But if caught within 24 to 48 hours, surgery can often reattach it and save your sight.
Action: Call your eye doctor or go to the emergency room the same day. This is urgent.
Gradual Loss of Central Vision
If straight lines look wavy, or if the center of your vision has a blurry or dark spot, this may be age-related macular degeneration (AMD). AMD is the leading cause of vision loss in Americans over 60.
There are two types:
- Dry AMD progresses slowly over years. It accounts for about 80 percent of cases. There is no cure yet, but AREDS2 supplements (a specific combination of vitamins C, E, zinc, copper, lutein, and zeaxanthin) can slow progression by about 25 percent.
- Wet AMD progresses rapidly and can cause severe vision loss in weeks. Abnormal blood vessels grow under the retina and leak fluid. Injections (anti-VEGF drugs) can stop the damage and sometimes restore lost vision, but only if treatment starts early.
Action: If you notice any distortion or blank spots in your central vision, see your eye doctor within a few days. Use an Amsler grid (a simple grid of straight lines you can print or find online) to test yourself weekly. Cover one eye at a time and look at the center dot. If any lines look wavy or missing, make an appointment.
Gradual Loss of Side Vision
You may not notice peripheral vision loss until it is significant. This is the hallmark of glaucoma, which affects about 3 million Americans, half of whom do not know they have it.
Glaucoma damages the optic nerve, usually (but not always) because of high pressure inside the eye. The damage is permanent, but treatment with eye drops, laser, or surgery can stop further loss.
Risk factors: Age over 60, family history of glaucoma, African American or Hispanic heritage, high eye pressure, thin corneas, and nearsightedness.
Action: Get a comprehensive dilated eye exam every one to two years. This is the only way to catch glaucoma early, because the disease is painless and the vision loss happens so gradually that most people do not notice until it is advanced.
Cloudy or Blurred Vision That Worsens Over Months
This is often cataracts. The lens inside your eye gradually becomes cloudy, making everything look hazy, faded, or like you are looking through a dirty window.
Cataracts are extremely common. By age 75, about half of Americans have cataracts or have had surgery to remove them. Cataract surgery is one of the safest and most successful operations in medicine. It takes about 15 minutes, and most people notice clearer vision within days.
When to have surgery: There is no medical emergency. The decision depends on how much the cataract affects your daily life. If you cannot read, drive, or do activities you enjoy because of blurred vision, it is time to discuss surgery with your doctor.
Action: Mention increasing blurriness at your next eye exam. Your doctor will monitor the cataract and discuss surgery when the time is right.
Eye Pain, Redness, and Nausea Together
Sudden eye pain combined with redness, blurred vision, halos around lights, and nausea can be acute angle-closure glaucoma. This is a medical emergency.
Unlike the more common open-angle glaucoma (which develops slowly), angle-closure glaucoma happens when the drainage angle in the eye suddenly closes, causing eye pressure to spike rapidly. Without treatment within hours, permanent vision loss can result.
Action: Go to the emergency room immediately. Treatment involves medications to lower eye pressure, followed by a laser procedure to open the drainage angle.
Double Vision
Seeing double can have many causes, some minor (like eye muscle fatigue) and some serious (like a stroke, brain tumor, or nerve problem). New-onset double vision always needs medical evaluation.
Action: If double vision comes on suddenly, especially with headache, dizziness, weakness, or difficulty speaking, call 911. These could be signs of a stroke. If it comes on gradually, schedule an appointment with your eye doctor within a week.
How Often to Get Your Eyes Checked
The American Academy of Ophthalmology recommends:
- Ages 55 to 64: A complete eye exam every one to two years.
- Ages 65 and older: Every one to two years, or as recommended by your eye doctor.
- More often if you have diabetes, a family history of glaucoma or AMD, or are taking medications that affect vision (like corticosteroids).
A comprehensive exam includes dilation, which lets the doctor see the retina and optic nerve. A simple vision screening (the chart on the wall) is not enough to catch diseases like glaucoma, AMD, or diabetic eye disease.
Medicare covers an annual dilated eye exam for people at high risk for glaucoma. It also covers eye exams for people with diabetes. Check your plan for details.
Protecting Your Vision Every Day
You cannot prevent all age-related eye changes, but you can reduce your risk:
- Wear sunglasses that block 99 to 100 percent of UV-A and UV-B rays. UV exposure increases the risk of cataracts and AMD.
- Eat leafy greens and fish. Lutein and omega-3 fatty acids support retinal health. Spinach, kale, salmon, and sardines are the best sources.
- Do not smoke. Smokers are two to four times more likely to develop AMD. Quitting at any age reduces risk.
- Manage blood sugar and blood pressure. Both damage blood vessels in the eye. Diabetic retinopathy and hypertensive retinopathy are preventable with good control.
- Stay active. Regular exercise reduces eye pressure and improves blood flow to the retina.
The Bottom Line
Some vision changes after 60 are just your eyes aging. Others are signs of diseases that can steal your sight if not caught early. The difference between losing vision and keeping it often comes down to one thing: regular eye exams. Do not skip them.
Reported by Dr. James Patterson with additional research from the SeniorDaily editorial team. For corrections or updates, please contact us.
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