Eye Health in Later Life

The honest answer is earlier than most people expect. Presbyopia begins affecting most people in their 40s, and conditions like glaucoma and AMD, while most prevalent in the over-60s, can begin developing well before symptoms become apparent. Attending regular eye tests from the age of 40 and annually from 60, gives the best chance of catching any changes before they become difficult to treat. NHS-funded eye tests are available free of charge to adults over 60 in England.

No. Once a cataract reaches the point of significantly affecting vision, surgery is the only effective treatment. Glasses can compensate for some of the early visual changes that cataracts cause. But they cannot slow or reverse the clouding of the lens itself.

Cataract surgery is one of the most routinely performed and successfully executed procedures in the NHS. With the vast majority of patients experiencing a substantial improvement in clarity and quality of vision following the operation.

Not always. AMD can affect one eye before the other, and each eye may develop differently. Patients are sometimes given an Amsler grid, a simple pattern of straight lines, to monitor changes at home. If the lines appear distorted or areas seem missing, it may indicate progression and should be reported to an optometrist or ophthalmologist promptly.

Yes, and this is more widely recognised than it once was. An unstable or insufficient tear film disrupts the smooth optical surface of the eye. This causes blurred vision, particularly during activities that reduce blink rate such as reading, screen work, or driving.

The blur typically improves briefly after blinking, which is a useful diagnostic clue. If your vision fluctuates in this pattern rather than being consistently blurry, dry eye syndrome is a likely contributor and is worth discussing at your next appointment.

Raised intraocular pressure (IOP) is the most significant known risk factor for glaucoma. This raised pressure can compress and damage the optic nerve over time.

However, some people have raised pressure without developing glaucoma. While a minority develop glaucomatous optic nerve damage despite pressure that falls within the normal range. A type known as normal-tension glaucoma.

This is why a glaucoma assessment requires more than a pressure reading. It also involves examining the optic disc and testing peripheral vision.

Until recently, there were no approved treatments for dry AMD. Only lifestyle measures (stopping smoking, dietary antioxidants, and the AREDS2 vitamin supplement formulation) to slow its progression.

New treatments aimed at slowing dry AMD are being approved in some countries and are currently being assessed in the UK. For wet AMD, anti-VEGF injections are the main treatment and can be very effective at helping to stabilise vision when started early. Regular monitoring is important for both types, as dry AMD can sometimes develop into wet AMD.