Dealing with the prospect of declining eyesight begins with a vision test, which will identify your need for corrective lenses.

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Advancing age tends to make almost every part of the body a bit weaker and slower. Unfortunately your eyes are no exception. Aging can affect the shape of the eye and/or the functionality of its components. Refractive errors occur when the anatomy, or shape, of the eye prevents light from properly focusing on the retina, affecting your vision. An eye test, of course, will provide the prescription you need for corrective lenses. Age also affects the eye’s ability to produce tears.

The most common forms of refractive errors are nearsightedness, farsightedness, and astigmatism, each of which can be diagnosed with a simple eye test. The most common age-related vision problem is presbyopia, where the eye begins to lose its ability to focus due to loss of lens flexibility. It’s a gradual process that happens to everyone who lives long enough, and it usually requires corrective lenses beginning at some point in your 40s. Chronic dry eye is another common condition of aging eyes.

Causes of Declining Eyesight

Vision issues relate to a number of conditions:

• Nearsightedness (myopia) occurs when the eye is too long from front to back, causing distant images to fall short of the retina. A nearsighted person has trouble focusing on distant objects but can see close-up objects clearly.
• Farsightedness (hyperopia) is when a person can clearly see distant objects, but close objects are fuzzy. Shorter-than-average eyes cause hyperopia, or farsightedness, where the focal point of close objects falls behind the retina.
• Astigmatism occurs when the cornea is oblong rather than round. This inhibits focus for both near and far objects, leading to distorted vision.
• Presbyopia is the loss of lens flexibility, and thus clear vision, brought on by aging.
• Dry eye syndrome occurs when the eyes don’t produce enough tears, or tears lack the consistency to lubricate the eye. Hormonal changes can trigger dry eye syndrome.

Risk Factors

Although there are no specific risk factors for refractive errors brought on by aging, there are a few for chronic dry eye syndrome. Menopausal women are at greatest risk as hormonal changes affect tear production and increase eye inflammation.

Declining male hormone levels increase risk for men due to deterioration of the tear film, which provides moisture to the cornea. Overuse of the eyes (using a computer or driving a lot), smoking, LASIK surgery, and long-term use of contact lenses are also risk factors for chronic dry eye syndrome.

Treatment

Glasses or contact lenses compensate for distortions by bending light before it enters the eye, so the image focuses correctly and sharply on the retina. The focusing ability of the lens decreases with age, which is why eyeglass prescriptions grow stronger as we get older. An eye test will tell you which type of corrective lens and treatment to pursue:

• Bifocals: These glasses correct both distance and reading vision. Typically, a horizontal line across the middle divides the lens into correction for distance, through the upper lens, and for close-up vision, through the lower portion. Progressive bifocals accomplish this without a line.
• Trifocals: These lenses correct for distance, middle-distance (for looking at your computer screen, for example), and close-up vision.
• Monovision correction: This type of correction uses a contact lens for distance vision in one eye and a lens for close-up work in the other.
• Laser surgery to implant a multifocal lens: This lens can function like a younger eye, adjusting between near and far objects to provide clear vision at all distances. During surgery, the natural lens of the eye is removed and then replaced with the artificial lens.
• LASIK eye surgery or PRK surgery: Laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) reshape the cornea to improve near vision.

Most cases of dry eye syndrome are easily treated with over-the-counter artificial tears. You may need to try different formulations to see which one works best. Eye drops containing omega-3 fatty acids might help reduce inflammation.

Severe dry eye may be treated with tiny plugs inserted into the eye’s drainage system. The plugs force tears to back up into the eye, helping maintain moisture.

Prevention

You cannot prevent your eyes from aging, of course, but you can give them the best possible care. The American Academy of Ophthalmology recommends a baseline eye exam at age 40. Your ophthalmologist will schedule exams after that, based on your risk factors.

For further reading on eye-related conditions, click on these links:

• “Eye Infections: Symptoms and Treatments“
• “Cataract Symptoms: What You Should Know To Correct Clouded Vision“
• “Glaucoma: Symptoms, Treatment, and Prevention of a Serious Eye Disease“
• “Detached Retina: Symptoms and Treatment“

Originally posted on May 2016 and updated.