If you are over 40 years of age, you’ve probably noticed changes in your vision. Difficulty seeing clearly for reading and close work is among the most common problems adults develop between ages 41 to 60. However, this is also the time when other changes in your eyes can start to affect your work and enjoyment of life.

Beginning in the early to mid-forties, most adults may start to experience problems with

Many people in middle age begin to experience difficulty with their vision.

their ability to see clearly at close distances, especially for reading and computer tasks. This normal aging change in the eye’s focusing ability, called presbyopia, will continue to progress over time.

Initially, you may find you need to hold reading materials farther away to see them clearly. Print in the newspaper or on a restaurant menu may appear blurred, especially under dim lighting. If you already wear prescription glasses or contact lenses to see clearly in the distance, the near vision changes caused by presbyopia can bring about the need to use bifocal or multifocal lenses. If you are nearsighted, you may have discovered that you now need to remove you glasses to see better up close. Fortunately, people with presbyopia now have many options to improve their ability to see well.

Along with the onset of presbyopia, an increase in the incidence of eye health problems occurs during these years. Whether or not there is a need for eyeglasses, adults should be examined for signs of developing eye and vision problems. A comprehensive eye examination is recommended at least every two years. Don’t rely on an insufficient substitute like the limited driver’s license vision test or other vision screenings to determine if you have an eye or vision problem.

Adults over 40 may be particularly at risk for the development of eye and vision problems if any of the following exist:

• Chronic, systemic conditions such as diabetes or high blood pressure.
• A family history of glaucoma or macular degeneration.
• A highly visually demanding job or work in an eye-hazardous occupation.
• Health conditions like high cholesterol, thyroid conditions, anxiety or depression, and arthritis for which you take medications. Many medications, even antihistamines, have ocular side-effects.

Understanding Age-related Vision Changes

Just like your body, your eyes and vision change over time. Aging changes in various parts of the eye can result in a number of noticeable differences in how well you see. While not everyone will experience the same level of symptoms, the following are common age-related vision changes:

• Need for More Light

As you age, you need more light to see as well as you did in years past. Brighter lights in your work area or next to your reading chair will help make reading and other near tasks easier.

• Difficulty Reading and Doing Close Work

Printed materials are not as clear as before, in part because the lens in your eye becomes less flexible with time. This makes it harder for your eyes to focus near objects with the same ability you had when you were younger.

• Problems with Glare

You may notice additional glare from headlights at night or sun reflecting off of windshields or pavement during the day, making it more difficult to drive. Changes within the lens in your eye cause light entering the eye to be scattered rather than focused precisely on the retina, thus creating more glare.

• Changes in Color Perception

The normally clear lens located inside your eye may start to discolor making it harder to see and distinguish between certain shades of colors.

• Reduced Tear Production

With age, the tear glands in your eyes will produce fewer tears. This is particularly true for women after menopause. As a result, your eyes may feel dry and irritated. Having an adequate amount of tears is an essential element in keeping your eyes healthy and maintaining clear sight.

Encountering Problems with Near Vision after 40

If you have enjoyed relatively good vision throughout your life and haven’t needed eyeglasses or contact lenses to correct distance vision, then the development of near vision problems after age 40 can be somewhat of a concern and a frustration. Losing the ability to read the newspaper or see the cell phone numbers may seem to have occurred abruptly. Actually, these changes have been occurring gradually since childhood. But up until now, your eyes have had adequate focusing power to allow you to see clearly for reading and close work. Now your eyes no longer have enough focusing power for clear and comfortable near vision tasks.

This loss of focusing ability for near vision, called presbyopia, is simply the result of the

Persons with presbyopia have several options available to regain clear near vision.

lens inside the eye becoming less flexible. This flexibility allows the eye to change focus from objects are far to objects that are close. Persons with presbyopia have several options available to regain clear near vision. They include:

• Eyeglasses, including single vision reading glasses and multifocal lenses
• Contact lenses, including monovision and bifocal lenses
• Laser surgery and other refractive surgery procedures

As you continue to age through your 50s and beyond, presbyopia becomes more advanced. You may notice the need for more frequent changes in eyeglass or contact lens prescriptions. Around age 60, these changes in near vision should stop and prescription changes should occur less frequently.

Presbyopia can’t be prevented or cured, but many options are available to help compensate for the loss of near focusing ability. Most individuals should be able to obtain clear, comfortable near vision for all of their lifestyle needs.

Warning Signs of Eye Health Problems

This is also the time in life when your risk for developing a number of eye and vision problems increases. If you experience any of the following symptoms, you may have the early warning signs of a serious eye health problem:

• Fluctuating Vision

If you experience frequent changes in how clearly you can see, it may be a sign of diabetes or hypertension (high blood pressure). These chronic conditions can damage the tiny blood vessels in the retina, the light sensitive layer at the back of the eye, causing vision loss that can sometimes be permanent.

• Seeing Floaters and Flashes

Occasionally, you may see spots or floaters in your eyes. In most cases, these are actually shadowy images of particles floating in the fluid that fills the inside of the eye. Although they can be bothersome, spots and floaters are usually harmless and typically do not risk vision. They are a natural part of the eye’s aging process. But if you suddenly see more floaters than normal, and they are accompanied by bright, flashing lights, they may be a warning sign of impending retinal detachment—a tear of the retina. Treat Retinal Detachment immediately to avoid serious vision loss!

• Loss of Side Vision

If it seems that you are losing peripheral or side vision, this may be a sign of glaucoma. Glaucoma occurs when the optic nerve is damaged and no longer transmits all visual images to the brain. It often has no symptoms until damage to sections of your vision has begun. (Link to glaucoma)

• Seeing Distorted Images

  If straight lines appear distorted or wavy or there appears to be a blind spot or empty area in the center of your vision, you may have the signs of age-related macular degeneration (AMD). The disease affects the macula, the part of your retina that is responsible for central vision where the eye’s acuity is sharpest. The disease causes a blind spot that’s right in the middle of your field of vision. (Link to age-related macular degeneration)

Regular eye examinations and early diagnosis and treatment of eye diseases can help you continue to preserve good vision throughout life.