Introduction

• For most people, eyesight is the most treasured of the senses.
• The eyes undergo many changes with aging. Between the ages of 40 and 50, most people notice that seeing close objects becomes difficult.
• In addition, many eye disorders become more common with aging, so many people experience visual impairment as they get older.

Sign & Symptoms

• Eyes become sunken due to loss of fat around the eye.
• Focusing on near objects become more difficult (presbyopia) because the lens becomes less elastic.
• A gray-white ring (arcus senilis) may appear on the surface of the eye but it does not affect vision.
• Adaptation to dark is affected because the pupils tend to be small and slow to react to light.
• For reading, brighter light is needed because the lens tends to become denser and less light enters the eye. Also, the retina, which contains the cells that sense light, becomes less sensitive. On average, 60 year-olds need 3 times more light to read than 20 year-olds.
• The way depth is perceived and judging distances becomes more difficult because the ability to see differences in shades and tones and to see fine details decreases. This change probably occurs because the number of nerve cells that transmit visual signals from the eyes to the brain decreases.
• Entropion (in-turned eye lashes) is common and causes irritation to the cornea.
• Ectropion (out-turned eye lashes) is common and the most frequent cause of watery eye (epiphora).
• Dry eyes occurs because the number of cells that produce fluids to lubricate the eyes decreases and tear production decreases.

Disease

• The serious eye problems that occur during old age are caused by a disorder but not by aging itself. For examples: glaucoma, retinopathy, macular degeneration, and cataracts
• Whatever the reason for vision loss, any vision change can compromise an older person’s quality of life and, indirectly, health. For example, poor eyesight may contribute to a motor vehicle accident or fall.
• Loss of vision can be especially devastating to older people coping with other problems as well, such as poor balance and hearing loss.
• In such cases, vision loss can contribute to significant injury and can impair a person’s ability to perform daily activities.

Treatment

• Many people try to ignore presbyopia for as long as they can.
• Ultimately, almost everyone with presbyopia will have to wear reading glasses.
• People who need glasses to see distant objects may need to wear bifocals/multifocal glasses or 2 sets of glasses (one for near and one for long distant objects).