En español | Maybe you're having a hard time reading this article. Or perhaps you have stopped driving at night because you just can't see as well then. Don't worry: Chances are, you're not going blind. But you might be experiencing some age-related eye issues.
Here's a list of the most common symptoms that affect your eyesight as you get older, why they happen, what to do about them — and when to see your eye doctor immediately.
Why it happens: As you age, your eye's lens becomes less flexible, which means it has a harder time changing its focal point from far to near. That makes it difficult to focus on close-up objects.
How to Fix it: You know you can get reading glasses or bifocals, but sexier options include bifocal contacts, multifocal contacts, or monovision, where one eye is fitted with a contact lens to see distance and the other eye is fitted with a lens to see close up.
"Monovision is a great option for many, but not everyone's brain accepts it," says Nancy A. Tanchel, M.D., an ophthalmologist and owner of Liberty Laser Eye Center in Tysons Corner, Virginia. You're a good candidate for bifocal, multifocal, or monovision contacts if you're willing to trade off supersharp vision at a distance for better close-up vision.
Red Flag: An abrupt decline in vision could be associated with several conditions, including macular degeneration, a disorder in which central vision is damaged; a vitreous hemorrhage, sometimes from an aneurysm in the eye, often associated with diabetes; or a retinal detachment. "Any abrupt change warrants an immediate evaluation," Tanchel says.
Why it happens: When you're young, your tears have the right components to coat the eye completely. As you get older, your tears may lose their ability to fully lubricate the eye.
"Tears have three layers: a protein layer, a fat layer, and a water layer," says Tanchel. "If any of those layers are not working as well as they should, we call that dry eye."
Eyes may feel dry and scratchy, or they may water excessively to compensate for a tear imbalance. Blood pressure medicines, antihistamines, diuretics, hormone replacement therapy, and some antidepressants could be to blame, as could the use of a ceiling fan.
Postmenopausal women also tend to develop meibomian gland dysfunction. The meibomian glands, located in the eyelids, create the oily, fat layer of tears. If that oil is diminished, the patient experiences dry eyes.
"It's pretty common for women past 40 to have dysfunction of the meibomian glands or blepharitis — inflammation of the eyelids," says Jen Galbraith, O.D., an optometrist in Harrisburg, Pennsylvania. "Another kind of dry eye I see misdiagnosed is lagophthalmos, which happens when the patient doesn't blink completely." These patients often sleep with their eyes cracked slightly open, so the eyes dry out. "It's often missed," says Galbraith, " but easy to treat."
How to Fix it: Experiment with over-the-counter artificial tears. If that doesn't work, consider Restasis, a prescription drop that helps you make your own tears. If your dry eye is caused by medication, switching meds may help. Tetracycline-based antibiotics can also be used to treat dry eyes, says Cory M. Lessner, M.D., medical director and owner of Millennium Laser Eye Center in Sunrise, Florida. A final option is punctal occlusion, which involves placing tiny plugs in the tear duct, so tears drain more slowly.
Red Flag: Sudden dry eyes might signify a damaged tear gland or blocked tear duct, which can be caused by an infection, a tumor, or scarring or swelling from a blow to the eye. Treatments range from massaging the area (your eye doctor can show you how), to a probe procedure that opens the duct, to surgery.
Why it happens: Being nearsighted, farsighted, or astigmatic — having an irregular curve in the cornea that causes blurriness — are the chief reasons you see glare or halos at night, especially around headlights and traffic signals.
How to Fix it: Get your prescription checked. If new glasses don't help, make sure the lens is aligned with the visual center of the eye (to reduce distortion).
Red Flag: A posterior subcapsular cataract can cause a loss in night vision or bothersome nighttime glare. It's more common in diabetics, people who've been on steroids, and those who have experienced eye trauma. If you can't see well at night, ask your doctor to rule out this type of cataract.
Why it Happens: Floaters are tiny threads or specks floating across your field of vision. "They're nothing more than shadows cast by small strands and bits of protein in the jelly of the eye," says Lessner. As you age, that jelly liquefies and separates from the retina.
How to Fix it: Floaters by themselves are not harmful, and usually no treatment is necessary.
Red Flag: Dozens or hundreds of new floaters can signify a retinal tear or detachment, which can lead to blindness if not corrected immediately. You will likely need surgery that same day to repair the damage.
Why it happens: Glaucoma, a disease that causes optic nerve damage, has no symptoms until much of the optic nerve is dead. After that, the first symptom is often the loss of peripheral vision.
How to Fix it: Once an optic nerve fiber dies, there is no way to bring it back. "The goal of glaucoma treatment is to prevent the loss of additional nerve fibers," says Galbraith. Glaucoma is actually a family of diseases, so treatment will depend on the type and may include medication or surgery.
Red Flag: Because glaucoma has no symptoms until it is fairly advanced, don't neglect a glaucoma screening at your next eye exam.
Why it happens: Blame it again on the lens, which gets cloudy with age (a clouded lens is a cataract). "A lot of people don't realize it because it's a gradual process. Things may turn more yellow or brown than they really are," says Brian Bonanni, M.D., medical director of Gotham Lasik Vision in New York City.
How to Fix it: A surgeon can remove the cataract and replace it with a permanent, plastic lens. Cataracts are typically repaired one eye at a time, several weeks apart, to allow the surgical eye to heal. If you're not ready for surgery but notice a color change, your doctor may suggest yellow-tinted glasses, which can help brighten your surroundings.
Red Flag: If left untreated, cataracts can lead to blindness, so see your doctor.
You may also like: 10 foods to protect your vision.