The Aging Eye

Of your five senses, which one are you most afraid of losing? If you’re like most people, the answer is your ability to see. Despite this, many people are not conscientious about caring for their eyes, and often neglect to visit an ophthalmologist for routine eye exams as they get older.

This report focuses on four disorders that pose the greatest threats to vision after age 40: cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy. It will help you determine your risk of developing these disorders, describe their symptoms, and discuss diagnosis and treatment.

This report also describes other common eye disorders including presbyopia, dry eye, floaters and flashes, retinal detachment, and eyelid problems such as drooping upper or lower lids. You’ll also learn why you should have regular eye exams, especially if you have diabetes or a family history of glaucoma; how to recognize the risk factors and symptoms of specific eye diseases; and what steps you can take to prevent or treat them before your vision deteriorates further.

Prepared by the editors of Harvard Health Publishing in consultation with Laura C. Fine, M.D., Clinical Instructor in Ophthalmology, Harvard Medical School; and Jeffrey S. Heier, M.D., Clinical Instructor in Ophthalmology, Harvard Medical School. 53 pages. (2022)

Faulty optics: When your vision isn’t perfect

When the eye sees normally, light focuses directly on the retina, producing a clear image. But in some people, images appear blurred because the eye focuses light rays either in front of or behind the retina. These problems are not eye diseases, but common conditions known as refractive errors of the eye. Although laser surgery procedures such as LASIK have become increasingly popular as a way to correct refractive errors, these techniques are usually most appropriate for people younger than 50. For that reason, refractive errors in older adults are most often corrected with eyeglasses or contact lenses.

Myopia (nearsightedness). A nearsighted person has difficulty seeing objects at a distance because the light rays converge and focus before reaching the retina. The cause is usually an elongated eyeball (which requires light rays to travel farther than they would in a normal eye) or a lens or cornea that is too strong (which bends the light rays so much that they focus before reaching the retina).

Hyperopia (farsightedness). A farsighted person sees objects better at a distance than up close. In this case, the eyeball is usually too short, and light rays reach the retina before they are focused. Hyperopia can also be caused by weaknesses in the refractive power of the lens and cornea. You may not notice farsightedness for years, but because your eye’s corrective ability diminishes with age, you will probably need glasses by midlife.

Astigmatism. A person with astigmatism has irregularities in the curvature of the cornea’s surface that cause distorted vision. Light rays do not meet at a single point. For some people, vertical lines appear blurry; for others, horizontal or diagonal lines look out of focus. Astigmatism develops early and is usually well established after the first few years of life. It often occurs together with nearsightedness or farsightedness.

• How the eye works
• Common changes in the aging eye
  • Presbyopia: Hello, reading glasses
  • Double vision
  • Eyelid problems
  • Dry eye syndrome
  • Watery eyes
  • Corneal edema
  • Conjunctivitis
  • Floaters
  • Flashes
  • Retinal tear or detachment
• SPECIAL SECTION: Safeguarding your sight
• Cataracts
  • Preventing cataracts
  • Coping with early cataracts
  • Do you need cataract surgery?
  • Types of cataract surgery
  • Replacement lenses
  • Preparing for cataract surgery
  • During and after surgery
  • Possible complications
• Glaucoma
• What causes glaucoma?
  • Types of glaucoma
  • Symptoms of glaucoma
  • Diagnosing glaucoma
  • Treating glaucoma
• Age-related macular degeneration
  • Types of AMD
  • Causes and risk factors
  • Diagnosing AMD
  • Monitoring AMD
• Treating dry AMD
  • Treating wet AMD
• Diabetic retinopathy
  • Preventing diabetic retinopathy
  • Detecting diabetic retinopathy
  • Treating diabetic retinopathy
• Living with low vision
• Resources
• Glossary

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