Article Medically Reviewed by Dr. Valerie Sheety-Pilon
If you’re over 40, life certainly has its perks: wisdom, confidence, better taste in TV shows and wine (hopefully). But getting older also brings some unexpected changes that literally happen right before your eyes. Vision issues like presbyopia and diseases like glaucoma become real possibilities. In fact, there’s a whole lineup of eye changes we’ve broken down below. It’s not always easy to admit that things aren’t as sharp as they used to be... but knowing what eye conditions to watch for—and what you can do about it—might just be your smartest move yet. Here are five common eye conditions, symptoms, and treatments to be aware of as you turn 40.
1) Presbyopia
Have you noticed that life after 40 feels a little less… limber? Your knees start to crack, your back talks back, and—surprise—your eyes are in on it, too. Your ability to quickly shift focus from one thing to the next is starting to stiffen up, and it’s a little annoying. Sound familiar? It might be presbyopia.
What is presbyopia?
Despite being a word you probably don’t hear every day, presbyopia is the most common physiological change occurring in the adult eye. It’s where your eye’s normally flexible, gel-like lens (the one that helps you focus from near to far—and back again) loses its elasticity with age. Then, before you know it, fine print is difficult to see.
But for everything presbyopia is, the one thing it isn’t is a disease. Annoying? Yes. But a disease? Hardly. It’s simply a normal part of aging that happens to everyone, and fortunately, there’s an incredibly simple fix for presbyopia: glasses. Prescription lenses that compensate for your presbyopia are by far the easiest way to resolve your presbyopia. But minimally invasive surgeries also exist, which aim to bypass or replace the eye’s lens to fix any issues.
What are the symptoms of presbyopia?
- Holding reading material further away to see clearly
- Blurred vision at normal reading distances
- Eye strain or headaches after close-up work
How is presbyopia treated?
- Corrective lenses (reading glasses, bifocals, multifocal contact lenses)
- Refractive surgery
2) Diabetic retinopathy
Who knew too much sugar could be bad for your eyes? Seriously! Most of us think of diabetes in terms of blood sugar and insulin, but high blood sugar doesn’t just affect your pancreas; it can do a number on your retinas, too.
What is diabetic retinopathy?
Diabetic retinopathy occurs when high blood sugar levels slowly damage the blood vessels keeping your retinas healthy. If this happens for long enough, blood vessels can swell, leak fluid, bleed, or even close off entirely. Abnormal blood vessels may try to grow in their place, but that isn’t really as helpful as it sounds. It can lead to distorted or blurred vision, and even permanent vision loss in some advanced cases.
What are the symptoms of diabetic retinopathy?
Diabetic retinopathy progresses quietly in the background. This makes regular eye exams with your eye doctor extremely important when diagnosing diabetic retinopathy, especially if you’re over 40 years old and have diabetes. In fact, nearly one-third of diabetic American adults over 40 are affected by this condition.
But before you start thinking it’s all doom and gloom, there’s good news, too: If you catch diabetic retinopathy early, there are treatments that can slow its progression and help preserve your sight.
Here are several symptoms of diabetic retinopathy:
- Blurred or distorted vision
- Floaters
- Difficulty seeing colors (especially at night)
- Sudden vision loss (in more advanced cases)
How is diabetic retinopathy treated?
- Blood sugar management
- Injections that can reduce swelling and abnormal vessel growth
- Laser therapy
- Regular eye exams
3) Cataracts
Imagine getting ready for the day in front of a fogged-up mirror—you can still see (sort of), but good luck styling your hair with any confidence. That’s kind of what it’s like to have cataracts… only the issue here isn’t steam, it’s protein, specifically the protein that makes up your eye’s lens.
What are cataracts?
Over time, protein can start clumping together, forming cloudy patches that are hard to see through. That’s what we call a cataract. It doesn’t usually happen overnight though, just little by little as we age. Cataracts can also be congenital, but that’s a bit more rare—as are cataracts resulting from eye injuries or other conditions like diabetes.
And while there’s no way to prevent cataracts entirely, you can slow their onset by wearing sunglasses or quitting smoking. Once they start creeping into your field of view, however, the National Eye Institute is pretty blunt about your options: “No matter what type of cataract you have, the treatment is always surgery.”
The silver lining here is that cataract surgery is relatively simple, and one of the most common (and successful) procedures in the United States.
What are the symptoms of cataracts?
- Blurry or cloudy vision
- Glare or light sensitivity (sunlight, lamps, headlights)
- Seeing halos around lights
- Poor night vision
- Colors looking faded or yellowed
- Double vision in one eye
How are cataracts treated?
- Wearing sunglasses (preventative)
- Quitting smoking (preventative)
- Maintaining a healthy diet (preventative)
- Cataract surgery (removes the cloudy lens and replaces it with a clear artificial one)
4) Age-Related Macular Degeneration (AMD)
AMD is quite literally the degeneration of your macula—the small, central part of your retina—due to age. And that can be a bit problematic, because the macula is what helps you focus on what’s straight ahead of you. If the macula starts degenerating, so will your ability to focus on anything in your central vision. And in later stages of AMD, that central area of vision just... disappears altogether. How quickly this happens, though, depends on which version of AMD you have—wet or dry AMD:
• Wet AMD is less common, but more severe. It’s caused by abnormal blood cell vessels growing under the retina. These vessels can sometimes leak fluid and blood (never a great combo), damaging the macula more quickly.
• Dry AMD is the slower of the two and is more common. It happens when light-sensitive cells in the retina break down gradually. And, unlike wet AMD, there is no abnormal blood vessel growth, nor fluid leakage (hence the name).
What puts someone at risk for AMD?
The biggest culprit by far is age. Most people who develop AMD are over 60, and your odds only go up from there. Genetics can also play a big role. So, if AMD runs in your family, you’ve got a higher chance of developing it yourself. And, for reasons that are still being studied, Caucasians are more likely to develop AMD than other racial groups.
But it’s not just how you’re born, it’s also how you live. Lifestyle choices, like smoking, poor diet, and lack of exercise, can all raise your risk of developing AMD. Smoking alone can double it. And anything not good for your heart (high blood pressure, high cholesterol, etc.) isn’t good for your eyes either. But here’s the good news: While AMD might sound intimidating, smart lifestyle choices can actually help slow its progression. Your everyday habits matter more than you think.
What are the symptoms of AMD?
- Blurred or distorted central vision
- Shadows or fuzzy areas, especially in the center of your vision
- Wavy lines (straight lines may appear bent or distorted)
- Difficulty seeing in low light
- Loss of color vibrancy
How is AMD treated?
There’s no cure for wet or dry AMD, but progression can be slowed with treatment and lifestyle changes:
- Quitting smoking (preventative)
- Healthy diet and exercise (preventative)
- Anti-VEGF injections for wet AMD can reduce abnormal blood vessel growth and leakage
- Lifestyle changes and nutritional supplements can delay progression of dry AMD
- Laser therapy (in some cases of wet AMD)
- Regular eye exams for early detection and monitoring
5) Glaucoma
By the time you hit 40, you’ve probably dealt with your fair share of clogged drains. When water can’t flow properly, things get backed up, causing trouble... which is usually when you realize something’s off. Well, glaucoma is the same way, except instead of water in sinks, it’s fluids in your eye. A clogged eye can lead to a buildup of pressure that quietly puts strain on your optic nerve. And just like with your sink, you might not notice anything wrong with your vision until the damage has been done.
What causes glaucoma?
What causes this “clogging” and ocular pressure in your eyes? Well, there’s a fluid in your eyes called aqueous humor that’s constantly being produced—and just as constantly drained. If your eyes are healthy, this inflow/outflow stays balanced. But if you have glaucoma, usually one of two things are happening that throw the whole system off (and your optic nerve takes the hit):
- Open-angle glaucoma is the most common form of glaucoma. It develops slowly as drainage gradually becomes less efficient. So, most people don’t even notice any symptoms until their vision starts to fade noticeably.
- Angle-closure glaucoma is less common but more abrupt and intense. Here, the drainage angle suddenly gets blocked, causing a rapid rise in eye pressure. Angle-closure glaucoma is a medical emergency and can cause vision loss fast if not treated immediately.
Are there glaucoma risk factors?
Anyone can develop glaucoma, but there are certain risk factors that definitely raise your odds. Age is the big one, especially if you’re over 60. But family history, certain medical conditions like diabetes, and high blood pressure can all increase your risk as well. Even long-term steroid use can play a role. And like with AMD, race and ethnicity matter, too—African American, Asian, and Hispanic populations are statistically at higher risk. And yes, smoking, poor diet, and a sedentary lifestyle don’t do you any favors either.
While there’s no cure for glaucoma, it’s very much a manageable condition. Catching it early through regular eye exams is the key, as early detection and proper treatment can slow or even stop its progression. Protect the vision you still have by keeping an eye out for these symptoms and treatments:
What are the symptoms of glaucoma?
(Remember, many people won’t notice anything until it’s advanced.)
- Gradual loss of peripheral (side) vision
- Blurry or hazy vision
- Seeing halos around lights
- Eye pain or pressure (occurs mostly in angle-closure glaucoma)
- Redness in the eye
- Sudden vision loss (this is a medical emergency)
How is glaucoma treated?
- Staying active (preventative)
- Managing blood pressure (preventative)
- Prescription eye drops
- Oral medications
- Laser therapy
- Surgery
- Ongoing monitoring
What’s your plan for seeing clearly beyond 40?
Eye health after 40 is about so much more than just keeping your prescription up to date. It’s about catching vision problems early, adjusting your lifestyle to preserve healthy sight, and knowing which conditions to watch for (and what treatments are available). In other words, good vision requires you to be proactive, not just enjoy the view!
An annual eye exam is hands down the best tool for early detection. Your eye doctor will be able to detect issues before they become problems and advise you on ways you can preserve your healthy sight for many years to come.
And if you’re looking for ways you can comfortably fit eye care and all it entails into your budget, consider a vision plan from VSP® Individual Vision Plans. Aside from being full-service coverage you can buy on your own, you’ll benefit from covered annual eye exams, receive a healthy frame allowance, and save on the specialty lenses you need to see your best.
Compare vision plans to find the one that best fits you.
Information received through VSP Individual Vision Plans’ social media channels is for informational purposes only and does not constitute medical advice, medical recommendations, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Reviewed by Dr. Valerie Sheety-Pilon:
Dr. Valerie Sheety-Pilon is Vice President of Clinical and Medical Affairs at VSP Vison Care where she helps drive strategic initiatives aimed at raising awareness about vision, eye health and its connection to overall wellness, while providing insight into medical advancements that seek to benefit patient care. She also provides oversight of VSP programs to address gaps in care for some of the most high-risk populations, including those living with diabetes.
With more than two decades of experience as a Doctor of Optometry, Dr. Sheety-Pilon has dedicated much of her time to clinical research across numerous ophthalmic subspecialties and has an established history of helping patients through novel therapeutic agents and clinical adoption of transformative technology in the areas of digital health, pharmaceuticals, and medical devices.
Prior to joining VSP Vision in 2019, Dr. Sheety-Pilon served as Adjunct Clinical Professor at Illinois College of Optometry, held various executive positions within the eye health industry, and has extensive experience managing and practicing within an ophthalmology and optometry practice.
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