Reviewed by: Dr. Matthew Miller, OD on Dec 17, 2020

I have to laugh with some of my patients when they sit down in my chair, look at me with a rueful smile and announce: “Well doc, I’ve got ‘old people eyes!”.

It’s definitely true that as we age we go through a lot of changes physically. Our eyes are no exception to this. Aging eyes still experience the common vision problems many of us are accustomed to at younger ages. Those problems being: nearsightedness, farsightedness, astigmatism and, at slightly less young age, presbyopia. But, in addition to these common vision problems, seniors can also experience other vision problems brought about by natural changes to their eye physiology and other health related eye changes.

The first impairment due to “old” age that we all experience is presbyopia, or a gradual loss of our ability to focus on near objects. This is a completely normal, and annoying, change that occurs in adults typically starting in their mid forties. While most of us continue to be in denial for at least a few years, eventually we all have to give in and get some sort of reading help. In many cases a simple pair of reading glasses or a type of bifocal lens fixes things right up.

Following presbyopia, cataracts become a major issue in our sixties and older. Cataracts are the most common impairment of vision due to old age. Cataracts form when the internal lens of the eye starts to thicken and becomes cloudy. This too is a normal aging change, but can be hastened by UV light exposure, and certain health conditions, such as diabetes. Because of its location directly behind the pupil, as the lens clouds over it prevents light from reaching the retina properly. Initially this may start out as trouble with glare and gradually moves on to blurred vision and eventual loss of vision if the cataract is not removed. Thankfully, in the vast majority of cases, good vision can be restored even in the worst cases of cataracts after surgery.

Another more serious problem associated with the aging eye is macular degeneration. Macular degeneration is the most common retina problem in the elderly population. It occurs when the blood vessels in the retina don’t function properly and the retina becomes starved for oxygen and nutrients. In more severe cases, new, poorly functioning, blood vessels form to try to compensate for this. Unfortunately, these “bad” blood vessels end up doing more harm than good. In the most severe forms of macular degeneration central vision can be damaged to the point of complete central blindness. Thankfully, only about 10-15% of patients develop the more severe form, and studies have shown that taking supplements, classified as AREDs vitamins, can help slow the progression of the disease.

It’s always a good idea to have regular eye check ups with your eye doctor. But, it’s especially recommended after the age of 40 and older. Having a routine eye exam can uncover a lot of information about your vision and general well being, and this is an important part of maintaining our overall health, not just our eye health, as we age.