40's and 50's Eyes

You may also notice that just about everyone in your age group uses some type of vision correction, like spectacles or multifocal contact lenses. Beyond corrective lenses, there are other options to consider. If you’re short-sighted (myopic), long-sighted (hyperopic) or you have astigmatism and you’d like to reduce your reliance on vision correction, laser surgery and ortho-k are two safe and effective alternatives.

Be sure to visit the optometrist regularly – and learn about all the potential eye concerns related to your particular age group. By being well-informed, you can learn to recognise signs of trouble – and possibly cure or slow a sight-threatening disease. In between eye exams, if you notice a change in your vision – or if your eye becomes injured in any way – contact your optometrist.

Getting the right amount of rest, regular exercise, and proper nutrition are vital for your long-term eye health. Studies have shown that antioxidant minerals and other vitamins may help defend against free radicals and help prevent related diseases^1^. Free radicals are unstable molecules – unchecked, they can damage cells in the eye, which may lead to serious vision problems, such as cataracts and age-related macular degeneration.

It’s helpful to know how the eyes work, to understand how the eye’s parts function together to bring clear images to your brain – and how these parts change over time.

One thing you might notice is that just about everyone in your age group wears some kind of vision correction, like spectacles or contact lenses. Here are some reasons why:

The eye’s lens becomes less elastic^2^

Are printed words not as clear as they used to be? This is, in part, because the lens within your eye becomes less elastic with time. This makes it tougher for your eyes to focus with the same agility you experienced in younger years. Reading glasses, bifocals or multifocal contact lenses will help you see more clearly. Beyond that, using a vision accessory like a magnifying glass will bring the smallest print into focus – like the words on maps or numbers in crossword puzzles.

The eye’s lens may become cloudy^3^

The lens within your eye may start to become cloudy, making it harder to see colours with the same vibrancy you once enjoyed. You may also notice additional glare from headlights at night, or from the sun hitting the pavement during the day. Polarised sunglasses can help prevent this from happening during the day by filtering out the glare. You may also find it more difficult to drive at night. Contact lenses that correct for spherical aberration may help with this condition.

Eyes may feel drier

You may have noticed that your eyes feel drier than normal^4^. This is because your tear glands have lost some ability to produce moisture and keep your eyes properly lubricated. Artificial-tear eye drops that work like real tears will help to moisturise and alleviate the discomfort of dry eye.  If your job involves using a computer for hours at a time, you may be increasing the dryness through a condition called digital eye strain. Making some small changes in your work habits can provide some relief for this problem. This includes:

• Keep your computer screen within 50-60cm of your eyes
• Keep the top of your computer screen slightly below eye level
• Minimise the distance between your computer screen and any documents you need to reference while working
• Use the 20-20-20 rule and take a break every 20 minutes to focus on an object over 20 feet away for 20 seconds
• Blink frequently to restabilise the tear film
• Adjusting the light to minimise glare on the screen
• Seeing bright pinpoints of light or floating black dots

Are you seeing occasional bright pinpoints of light, or floating black dots that seem to last a long time? These come into your field of vision because your vitreous, the part of the eye that connects to the retina, begins to shrink as you reach your 40s^5^. The floaters and flashers are a nuisance, but you can learn to ignore them without much effort. If you see a sudden increase in the number of dots and flashes, contact your eye care professional.

Regular eye exams become more important as you reach your 40's and 50's. Not only do you need to keep pace with the changes in your vision by updating your prescription for glasses or contact lenses, but you also want to be certain there’s no vision problem beginning to develop. Many of these problems have no physical symptoms until they’re quite advanced. You should have eye exams as advised by your optometrist once you’ve reached 40 – and these exams are even more important if you have high blood pressure, diabetes or a family history of eye disease.

What can you expect at your eye exam?

Each optometrist has a routine, but most eye exams follow a similar pattern. First, your optometrist will explore any concerns you have and review your personal and family health history as you may be at special risk for eye problems if you have a family history of eye disease, diabetes, high blood pressure, or poor vision.Then, your optometrist will conduct tests to check your:

• Vision - The optometrist can check for short-sightedness (myopia), long-sightedness (hyperopia), astigmatism and presbyopia. While you look at an eye chart, the optometrist will assess your vision for distance and reading, and, if necessary, determine a prescription for corrective lenses.
• Coordination of eye muscles - The optometrist will assess how well your eyes work together by asking to you to look at different objects while they cover and uncover your eyes.
• Visual fields test - The optometrist will use a piece of equipment called the visual field screener to assess the full horizontal and vertical range and sensitivity of your vision, which can be a good indicator to the health of your visual system.
• Pupil response to light - The optometrist will shine a light in your eyes and watch the pupil's reaction.
• The health of the front and the back of your eyes - The optometrist will use either a handheld torch called an ophthalmoscope or a table-mounted microscope called a slit lamp to look for any abnormalities.
• Measurement of eye pressure - The optometrist will release a puff of air onto your eye using an instrument called a tonometer.  This tests the pressure inside the eye, an early indicator of glaucoma.

Generally, changes in your vision now are just a factor of ageing. If you experience any of the issues below, you may have the early warning signs of a more serious problem. In all cases, early detection and treatment can keep your vision strong—so see your eye care professional to be sure that your eyes are healthy, or to begin treatment and to check for developing conditions.

• Loss of peripheral vision

If you’ve noticed that you don’t have the side-to-side vision you’re used to, this may be an early sign of glaucoma^6^. This condition is caused by abnormally high pressure inside your eye – and it often does not show symptoms until damage to your vision has begun. Your eye care professional will test your eyes for glaucoma during your eye exam. Early detection, treatment and management can save your vision.

• Cloudy or distorted vision

If your vision seems dim or you’re having trouble reading, watching television, or just seeing what’s around you – even when you’re wearing your glasses or contact lenses – you may have cataracts in one or both eyes^3^. Most of us will develop cataracts as we age because the lenses in our eyes become more opaque as we get older. Cataracts can be corrected by your ophthalmologist, who can replace the cloudy lens with a clear plastic implant known as an intraocular lens (IOL).The effects of Age-Related Macular Degeneration (AMD) in its early stages often go unnoticed. In AMD, the macula, the part of your retina that’s responsible for central vision, deteriorates and creates distortion or a blind spot in the middle of your field of vision^7^. AMD is the leading cause of blindness in people over 50, but its progress is often slow. Your optometrist will check for this disease during your annual eye examination. 

• Floating spots and flashes of light

We all see spots, specks, and other things that look like dark bits of string floating in our eyes on occasion. These are actually cells and fibres in the vitreous, the gel-like part of your eye. Generally, these floaters are infrequent and just a normal part of vision^5^. If you experience a sudden increase in the number of floaters or notice that existing floaters have become more noticeable, and if they’re accompanied by bright, flashes of light and/or a curtain or shadow at the edge of your vision, this may be a warning sign of impending retinal detachment – a tear between the vitreous part of the eye and the retina. If left untreated, this tear can expand and lead to a serious loss of vision. See your eye care professional immediately if you experience any of these symptoms. Retinal detachment can be treated successfully with surgery.

• Low vision/vision loss

While regular eye examinations and early diagnosis of eye disease can save much of your vision, in some cases, you may already have incurred some vision loss that cannot be treated and so you may be left with some permanent reduction in your vision before you have seen your optometrist and can begin treatment. This is commonly called low vision^8^, a condition that can’t be corrected with eye glasses, contact lenses, or surgery. There are many products and devices such as magnifiers that can help people with low vision continue to live normal lives. In addition, some eye care professionals specialise in rehabilitation for low vision, so ask your optometrist for recommendations.

• Diabetes and your eyes

If you have type-1 or type-2 diabetes, it’s important to have your eyes examined every year to check for a complication called diabetic retinopathy^9^. High blood sugar and hypertension (high blood pressure) can damage the tiny blood vessels within your retina. This painless condition has no symptoms – until it’s serious. Regular visits to your eye care professional can detect it in its early stages. Diabetic retinopathy can be controlled and treated, and its progress slowed significantly if detected before you experience vision loss.

A regular eye exam is the best way to protect your eyesight – and an easy precaution to take. Many sight-threatening diseases can be cured or slowed if caught early enough.

How important is nutrition to eye health?

Research indicates proper nutrition is critical to maintaining and preserving eye health for both men and women. As part of a healthy diet, choose foods rich in antioxidants; including foods like dark leafy, green vegetables; and fish^1^.

An inadequate intake of antioxidants and consumption of alcohol and saturated fats may create free-radical reactions that can harm the macula. High-fat diets can also cause deposits that constrict blood flow in the arteries. The eyes are especially sensitive to this, given the small size of the blood vessels that feed them.

Don't smoke

Smoking exposes your eyes to high levels of oxidative stress and it is a known risk factor for developing AMD, with smokers up to four times more likely of developing AMD than non-smokers^13^. To help you quit, visit the NHS smoking cessation website NHS Stop Smoking.

Exercise

Exercise improves blood circulation, which increases oxygen levels to the eyes and helps remove toxins and may help protect the retina^10^.

Wear sunglasses

Being outdoors in the sun can feel wonderful – but it can be tough on your eyes. Fortunately, there's an easy solution: sunglasses. Be sure to choose a pair that can block harmful ultraviolet (UV) rays. Also, a hat with a wide brim will reduce the amount of UV radiation exposure from above or around the periphery of your sunglass lenses.

Computer use

Computer images are created from thousands of tiny dots – so there is no distinct image for your eye to focus on. You have to focus and refocus to keep the images sharp – and after two hours you can end up with the same kind of repetitive stress in your eye muscles that the keyboard causes in your wrists^11^. You can reduce the impact of computer eyestrain by following a few simple rules:

• Keep your computer screen within 50-60cm of your eyes
• Keep the top of your computer screen slightly below eye level
• Minimise the distance between your computer screen and any documents you need to reference while working
• Use the 20-20-20 rule and take a break every 20 minutes to focus on an object over 20 feet away for 20 seconds
• Blink frequently to restabilise your tear film
• Adjusting the light to minimise glare on the screen

Eye Injuries

If your eye is injured, it is tempting to think that you can just flush it out with some cold water and it will be fine. However, it is not easy to judge the extent or severity of any eye injury, so you should always get immediate, professional medical attention. It is the best way to safeguard your vision.

Here are some symptoms that may signal serious eye injury:

• Obvious eye pain or vision problems
• Cut or torn eyelid
• One eye that does not move as completely as the other
• One eye that protrudes more than the other
• Abnormal pupil size or shape
• Blood in the white of the eye
• Something imbedded in the eye
• Something under the eyelid that cannot be easily removed

Even if you’ve never worn spectacles or corrective lenses, chances are you know about short-sightedness (myopia), long -ightedness (hyperopia), and astigmatism. You may have even developed one of these vision correction conditions. But there’s one other condition that commonly develops in people around the age of 40 you may not have heard of: presbyopia.

• What is presbyopia?

It’s not a disease or an illness. Presbyopia is a normal, natural part of our eyes’ aging process, and it happens to just about everyone^12^; even if you’ve had laser eye surgery. Presbyopia is simply the result of your lens becoming less flexible. As you age, the lens in each of your eyes begins to lose its ability to change shape easily – which allows your eyes to focus quickly on a single object or a page of text. The less elastic your lenses become, the harder it is to focus. That’s when spectacles or contact lenses come into play. While presbyopia can’t be corrected with laser eye surgery or ortho-k, you still have several options that will help keep your vision at 20/20 – both near and far.

• What are multifocal contact lenses?

Multifocal contact lenses – including Ultra for Presbyopia Contact Lenses – can correct presbyopia so you can see comfortably up close and at a distance while enjoying the benefits and freedom of wearing contact lenses instead of reading glasses or bifocals.

• What about magnifiers and vision accessories

Embroidering, building models, reading maps, and seeing the numbers on small technical instruments can become challenging as we move into presbyopia and experience other changes in vision. Brighter lighting can help with close-up work, but sometimes you need additional help. Magnifiers bring fine print and needlework into focus, and they come in many sizes to help match the level of magnification you need for your task. And if you need both hands to perform delicate work, you can use a hands free magnifier.