Aging and Vision Problems


Alice Pomidor & John Reynolds

Palmer MH high(8) res

Alice Pomidor, MD, MPH, AGSF
Florida State University School of Medicine

Mary Palmer, PhD, RN, FAAN, AGSF
Helen W. and Thomas L. Umphlet Distinguished Professor in Aging
UNC School of Nursing

Your eyes are your windows on the world, so it’s wise to protect your vision, especially as you age. Although not all older adults will experience vision problems, many people will experience age-related changes. While many vision problems are easy to correct with prescription lenses or brighter lighting, other problems require medical treatment. These include:

Cataracts. This age-related vision problem occurs when the lens in one or both of your eyes becomes cloudy. By age 80, more than half of all Americans will either have a cataract or will have had surgery to correct a cataract. Symptoms include dullness, blurriness, or a brownish tint to your vision. As cataracts gradually get worse, vision problems become more noticeable. Although complete healing takes about a month, cataract surgery can immediately and dramatically improve your vision. During the procedure, the surgeon will implant a clear, plastic lens—like a permanent contact lens. Cataract surgery is safe and effective for most people, no matter what their age, health, or mental status. Medicare and most insurance plans cover the costs of the procedure.

Age-related macular degeneration (ARMD). The macula is a very small structure within the eye that helps you see fine details. When it begins to degenerate (fail), your central (straight ahead) vision can become distorted. People with ARMD will keep their peripheral (side) vision, and training can help them make the most of their lowered ability to see. There are a number of aids that can help people with ARMD, including magnifying lenses, large print items, speech software for computers, and computer and video enlargement systems.

Glaucoma. When the pressure of the fluid inside your eye becomes too high, it causes chronic glaucoma, a disease that slowly causes vision loss. In its early stages, glaucoma causes the loss of peripheral (side) vision that eventually can lead to blindness. In its early stages, glaucoma can be treated with eye drops, which you must take for the rest of your life. Unfortunately, once vision is completely lost, nothing can restore it. Early detection is the best protection against glaucoma. Your eye doctor will perform one or more tests to detect glaucoma. These may include:

  • Tonometry: Using a special machine that applies a puff of air to each eye, the eye specialist will then measure the inner pressure of your eyes.
  • Opthalmoscopy: Special eye drops that dilate your pupil allow the eye specialist to examine your optic nerve for damage.

Acute glaucoma is rare, but treatable. It occurs when pressure in the eye rises suddenly. You might experience pain and redness in the eye, severe headaches, nausea, vomiting, and blurred vision. You might even see halos around lights. If you experience these symptoms, consider it an emergency that needs immediate attention by an eye specialist.

Diabetic retinopathy. Diabetes damages blood vessels throughout the body, including the tiny ones in the back of your eyes.  This makes diabetes the leading cause of blindness in this country. If you have diabetes, make sure to regularly check your blood sugar and see your eye specialist. According to a recent study, keeping up good blood sugar control may prevent or slow the beginning of diabetes-related eye problems, and may lower the need for laser treatments. Once the problem has developed, laser treatments and other types of surgery can improve vision and prevent further loss.

When treating vision problems, it’s important to know the different types of eye specialists available.

Handy Guide to Eye Specialists

Ophthalmologists: Medical doctors (MDs) who are additionally trained to specialize and treat eyes and vision problems. They perform eye examinations, prescribe and fit glasses and contact lenses, prescribe medications, and can perform surgery. Some ophthalmologists may opt for additional training to specialize in specific eye diseases or conditions.

Optometrists:  Medical specialists with a doctor of optometry (OD) degree. These practitioners are licensed to perform eye exams, vision tests, prescribe and fit corrective lenses, can diagnose some eye problems, and can prescribe medications for some eye diseases.

Opticians: Technicians who fit prescription lenses and eyeglasses, using prescriptions from ophthalmologists or opticians. They do not test vision or treat or diagnose eye diseases.

Now that you know what kinds of vision problems that may happen with age, look out for our next blog post about steps you can take if you have changes in your vision.

Drs. Pomidor and Palmer are the Chair and Vice Chair, respectively, of the American Geriatrics Society’s Public Education Committee.