Your Eyes After 40: What’s Normal and What’s Not

Aging Eyes

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Even if you’ve had twenty-twenty vision all your life, as the birthdays pile up post-40, you might suddenly find yourself squinting or coping with other vision-related troubles for the first time. After your fortieth birthday, it’s time to get to know an eye doctor and sign up for a yearly checkup even if you’ve never worn glasses or contact lenses.

“Diseases like glaucoma and macular degeneration–while normally older person’s diseases–can start in your forties,” warns Liz Erley, an ophthalmologist at Wink Optical, Boulder, CO. “But if they are caught early, your vision can usually be saved.”

Not all age-related eye problems are serious enough to threaten your vision, but they can be uncomfortable and downright annoying on a daily basis. Here’s what to expect from your eyes after 40–and what you can to do to help ensure that you keep seeing clearly for many years to come.

Dry Eyes

What’s causing it: Dry eyes can be a problem for both men and women, but women will often find that all of their mucous membranes–including their eyes–start to dry out sometime after age 35, thanks to shifts in hormones. In the years leading up to and after menopause, estrogen and progesterone levels drop, and that is a leading cause of dryness. Living in a dry climate can exacerbate the condition, as can dry indoor air. “And staring at the computer screen for hours increases eye strain and makes eyes more dry,” says Erley. “Normally people blink about 30 times a minute, but when you’re staring at a computer, you only blink about half that much.”

What can help: See your primary care provider or your eye doctor for relief, especially if you wear contacts (you’ll feel the effects of the dryness more when your lenses are in). Prescription eyedrops can help rebuild your tears to normal levels. You can also help cope with the discomfort, redness, itchiness, and burning with over-the-counter lubricating drops. Erley cautions patients to skip redness-relieving eyedrops, however. “That just deals with redness by constricting the blood vessels, but will do nothing to help with dryness.” Instead, she recommends a lubricant that you can use first thing in the morning and throughout the day as needed.

Your diet can also play a role in lubricating chronic dry eyes. Anything that keeps your body well hydrated will help your eyes as well–so drink plenty of water and avoid dehydrating things like alcohol (especially red wine). Erley also recommends upping your intake of omega-3s because those good fats are helpful for increasing lubrication throughout the body. Eat more cold-water fish like salmon and halibut and supplement your diet by taking 1,000 mg of fish oil twice a day.

Reduced Reading Vision

What’s causing it: If you suddenly seem to need more light to see what you’re reading, or find yourself holding your smartphone further and further away in order to read an email or text message, you’re in good company. After age 40, it’s common for your vision to change so that you require reading glasses. “As we age, the lens inside the eye becomes less flexible, so we have a harder time viewing things clearly when they are up close,” says Erley.

What can help: The only solution here (other than growing longer arms!) is to see your eye doctor for an eye exam. Depending on your prescription, you may be able to get away with buying inexpensive reading glasses at the drugstore, or you may need something customized. Luckily, these days the options are much less obvious than they used to be. Instead of the old-fashioned bifocal glasses, you can now get glasses with progressive lenses. They work virtually the same way as the old bifocals, but without the telltale line. Multifocal contact lenses serve the same purpose, enabling you to see at all distances without having to pull out reading glasses to read the menu.

Difficulty Seeing After Dark

What’s causing it: Reduced night vision is another common symptom of aging eyes. It’s caused by the aging of the photo receptors in the eyes, which results in a reduced ability to see clearly in dark situations, such as driving at night.

What can help: Unfortunately, there’s not much that can be done to really improve your night vision. Your best defense is to see your eye doctor annually to ensure that your glasses or contacts prescription is up to date to help keep your vision as sharp as possible in all conditions.

Glaucoma

What’s causing it: A buildup of pressure in the eye can cause damage to the optic nerve. Without treatment, vision loss–starting with the peripheral vision–is common.

What can help: Everyone over 40 should get a full eye exam every year during which your doctor tests the pressure in your eyes, examines the optic nerve, and dilates and examines the pupil. When diagnosed early enough, glaucoma can be treated.

Cataracts

What’s causing it: The lens of the eye is made up primarily of water and protein. As we age, the proteins can clump together and become a cataract. The result is that the lens of the eye gets clouded, making vision blurry, reducing night vision, and possibly creating the illusion of halos when you look at lights.

What can help: Wear anti-glare sunglasses whenever you’re outdoors because prolonged exposure to UV rays can exacerbate the problem. If a cataract is found early enough, non-surgical solutions, like a new glasses prescription, may be adequate. More advanced cases require surgery to remove the clouded lens and replace it with an artificial one.

Macular Degeneration

What’s causing it: The macula is located at the back of the retina and is made up of millions of light-sensing cells that work to provide you with sharp, central vision. When the macula breaks down, the layers start to separate and leak. Gradually, your central vision begins to get blurry.

What can help: A diet rich in antioxidants may be helpful as part of an overall preventive approach. Again, you need to see your eye doctor annually to be examined for any early signs of macular degeneration. When left untreated, it will lead to vision loss.

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The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.

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