Age-Related Vision Changes: An Introduction

by Robert Wall Emerson and Catherine Wall Emerson

Ah, the halcyon days of youth, when we would laugh too loudly, drink too much, and wear inappropriate clothing (any images coming to mind?). In our youth we may have paid very little attention to our health, but as we age, one thing we begin to accept is how our bodies change. We recognize that our reflexes slow, our hearing is not as precise, and our eyesight occasionally needs a helping hand.

Eyesight is what this article will focus on. With the increasing years, we may find that newspaper print is getting blurry, menus need to be held farther away, or the world is getting dimmer. (Isn’t it funny how we often don’t think we are changing, but that other things are changing around us?)

Our eyes are made up of several main features: the cornea (the rounded bit right in front), the iris and pupil (the hole in the iris), the lens, the orbit (filled with watery stuff in front of the lens and jelly-like stuff behind), the retina, and the optic nerve. As we age, certain aspects of our vision change, irrespective of any eye diseases.

Two important changes are a reduction in pupil size and the loss of the ability to adapt to different lighting conditions. These changes mean that older folks get less light through to their retinas; it is as though they are perpetually wearing sunglasses, and so they need more light in any given situation.

Another feature that often changes as we age is the retina. The retina contains the rods (cells that specialize in seeing light and movement) and cones (cells that specialize in seeing color and detail). As our retinas get older, these cells take a little longer to reset after getting excited or are harder to get excited. This means that when walking into a dimly lit restaurant, we will not only notice our eyes taking longer to get used to the change in lighting, but we will never adapt as well as we did when we were younger.

The lens and cornea also show the effects of wear over the years. Like curtains that have been in the sun too long, the lens starts to yellow and get a little cloudy. The cornea, being right up front, gets little pockmarks or abrasions from years of dust and wind. The yellowing of the lens may lead to difficulty in distinguishing some colors and shades (often blues and greens), and other colors may appear less bright. The aging of the lens and cornea means that light is scattered more as it enters the eye, leading to a degraded visual image. This degraded image requires energy to process, so visual tasks are going to require more mental effort. The lens also gradually loses its ability to change shape as it ages. This leads to greater difficulty in refocusing between near and far.

Finally, with increasing age comes decreased lacrimation (secretion of tears). Your tear ducts slow production, and yet they may not drain the tears you do produce as efficiently. So older folks may either have drier eyes or more watery eyes, depending on which problem is predominant.

All of this may sound like we are falling apart, but these kinds of changes are normal and expected with age. In fact, it is so expected that in addition to the common eye conditions of myopia (near-sightedness) and hyperopia (far-sightedness) that can affect people of all ages, changes due to an aging eye have their own term—presbyopia.

If you already have glasses, the fact that your eyes are aging and changing might mean that you need one prescription for near and a different prescription for far (or middle distance). How do you get two prescriptions in one set of glasses? Bifocals!

For most of us, if we have never had glasses before, a visit to the local optometrist or ophthalmologist will correct the presbyopia, myopia, hyperopia, or astigmatism that is besetting (or upsetting) us. Glasses, contact lenses, or laser eye surgery can correct many of the visual disturbances a person typically develops. For others, these prescriptive aids may not offer any or enough clarity, and more involved plans may need to be considered.

While we can all expect the normal changes associated with aging eyes, some people may experience the onset of common eye conditions like glaucoma, cataracts, macular degeneration, or diabetic retinopathy. It is important to go to an eye professional and have your vision checked whenever you (or people around you) notice changes in your visual functioning.

You may just need an adjustment to your spectacle prescription, but you could be developing a serious medical condition. Regardless of the situation, there are steps we all can take to preserve our vision and to minimize difficulties.

Since a lot of the typical aging issues deal with lighting, make sure that you have adequate illumination. Go to that fancy but dimly lit restaurant when there is plenty of light (like at noon), get small or gooseneck lamps to direct more light on reading or work tasks, and make sure there is plenty of overhead light in potential trouble areas like stairs or the shower.

When increasing lighting, make sure that glare is minimized. If you increase glare when you add more light, you will only make matters worse. So convert high-gloss surfaces to matte surfaces, or cover high-gloss areas with rugs. Draw the curtains or blinds to eliminate glare from the television or move the television to a shaded area. Wear a hat with at least a three-inch brim (the brim will help to reduce the amount of light getting into your eyes), and wear sunglasses or transitional lenses to reduce the blinding effect of glare or brightness.

For those of you who don’t want to admit that you are getting older, you can help put off these (inevitable) changes by taking some preventive steps. First, protect your eyes from harmful radiation by wearing good-quality sunglasses designed to block out both UVA and UVB rays. (See also “July Is UV Safety Month!” in the July 2008 issue of the CoSozo Newsletter, now CoSozo Living.)

We will also tell you what your mother and doctor have been telling you: eat plenty of veggies and don’t smoke. Good vision requires certain vitamins and minerals that you get from vegetables (see “Vision and Blindness: Common Myths Debunked” in the October 2008 issue of CoSozo Living to learn more about the carrots and vision myth), and smoking restricts blood vessels, which can lead to macular degeneration.

When we were young we had a little leeway with our health and may not have seen much in the way of detriments. But now that we are getting older, every wrong decision has a greater consequence.

As we age, it becomes more important to eat well, be active, and take care of ourselves. In the process, we will take care of our eyes and our vision as well.