Even if you’ve had a twenty-twenty vision all your life, as the birthdays pile up post-40, you might suddenly find yourself squinting or coping with other vision-related troubles for the first time. After your fortieth birthday, it’s time to get to know an eye doctor and sign up for a yearly checkup even if you’ve never worn glasses or contact lenses.
“Diseases like glaucoma and macular degeneration–while normally older person’s diseases–can start in your forties,” Not all age-related eye problems are serious enough to threaten your vision, but they can be uncomfortable and downright annoying daily. Here’s what to expect from your eyes after 40–and what you can to do to help ensure that you keep seeing clearly for many years to come.
DRY EYES
Dry eye syndrome, also called dry eye disease (DED), is a condition in which the eyes do not make enough tears. DED can also occur when your eyes don’t create the correct type of tears. The condition is extremely common.The chances of having DED increase with each decade of life, but it can affect people of any age. DED becomes even more common after age 50. People often experience DED in both eyes. It’s possible to have dry eye symptoms in one eye only, but this is uncommon.DED can be temporary or chronic. Examples of temporary dry eyes include dryness that you may experience when on vacation in a dry climate or when you’ve had too much screen time. Temporary dry eye is usually treated easily, and results are seen quickly. However, temporary symptoms that occur regularly and go untreated can lead to chronic DED.
WHAT’S CAUSING IT: Dry eyes can be a problem for both men and women, but women will often find that all of their mucous membranes–including their eyes–start to dry out sometime after age 35, thanks to hormone shifts. In the years leading up to and after menopause, estrogen and progesterone levels drop, and that is a leading cause of dryness. Living in a dry climate can exacerbate the condition, as can dry indoor air. “And staring at the computer screen for hours increases eye strain and makes eyes more dry. “Normally people blink about 30 times a minute, but when you’re staring at a computer, you only blink about half that much.”
- Natural causes
- Some contributing factors to chronic dry eyes are out of your control. These factors include ageing, being female and experiencing hormone changes.
- Although DED can occur at any age, it becomes more common after age 50. As you get older, the eyes naturally produce fewer tears. This often leads to dry, gritty eyes.
- Environmental causes
- Eye dryness can occur due to environmental factors, such as dry climate or high winds. This can be the case both indoors and outdoors.
- Regarding indoor environments, air conditioning, ceiling fans and forced air heating systems can decrease indoor humidity. An example of this is in the cabins of aeroplanes. This extremely dry air can lead to dry eye problems, especially among frequent flyers.
- Habit-related causes
- There are some cases of DED that can be traced back to certain habits. For example, frequent and prolonged computer use can dry the eyes out. This is because we tend to blink our eyes less fully and less frequently when using a computer, smartphone or other portable digital device. This leads to greater tear evaporation and increased risk of dry eye symptoms.
- Health-related causes
- Underlying health conditions can affect the eyes’ ability to produce tears. Certain diseases, such as diabetes, thyroid-associated conditions, lupus, rheumatoid arthritis and Sjogren’s syndrome, can contribute to dry eye problems.
- A condition that directly causes DED is called lagophthalmos. It’s characterized by incomplete closure of the eyelids when blinking or sleeping. Lagophthalmos has many causes, including natural aging, eye infections and nerve damage from trauma or cosmetic blepharoplasty.
- Not only can certain conditions cause DED, but the medications you take for a condition may cause it as well. Many prescription and nonprescription medicines increase the risk of dry eye symptoms. Some of these include antihistamines, antidepressants, anxiety medication, blood pressure medications such as beta-blockers or diuretics, and birth control pills.
- Eye dryness is common after eye surgeries like LASIK and other corneal refractive procedures. In most cases, dry eye discomfort after eye surgery is temporary and resolves within a few weeks of the procedure.
- Wearing masks, such as those worn with CPAP machines or to protect against the spread of infectious disease like COVID-19, can also dry the eyes. Ill-fitting or improperly worn masks can force the air out the top of the mask and over the surface of the eyes. Wearing glasses with a mask can direct the air over the eyes even more.
WHAT CAN HELP: See your primary care provider or your eye doctor for relief, especially if you wear contacts (you’ll feel the effects of the dryness more when your lenses are in). Prescription eyedrops can help rebuild your tears to normal levels. Over-the-counter lubricating drops can also help cope with discomfort, redness, itchiness, and burning. cautions patients to skip redness-relieving eyedrops, however. “That just deals with redness by constricting the blood vessels, but will do nothing to help with dryness.” Instead, she recommends a lubricant that you can use first thing in the morning and throughout the day as needed.
- Your diet can also play a role in lubricating chronic dry eyes. Anything that keeps your body well hydrated will also help your eyes–so drink plenty of water and avoid dehydrating things like alcohol (especially red wine). intake of omega-3s because those good fats help increase lubrication throughout the body. Eat more cold-water fish like salmon and halibut and supplement your diet by taking 1,000 mg of fish oil twice a day.
- Nasal spray for dry eye :Tyrvaya (teer-VI-uh) is a prescription nasal spray that can relieve symptoms of DED. It works through your nasal passage to naturally activate the production of tear film. Rather than relying on artificial tears, Tyrvaya helps users create natural tears of their own. Common side effects include nose and throat irritation, sneezing and coughing.For the best results, spray Tyrvaya once into each nostril twice per day.Be sure to follow your eye doctor’s directions concerning which eye drops to use and how often you use them. Using a different brand or multiple brands of artificial tears will make it difficult to assess the success of the dry eye treatment your doctor recommended.
- Eye drops and nasal sprays: Mild cases of dry eyes resulting from situational causes may be treated with frequent use of artificial tears or other lubricating eye drops. In fact, artificial tears are usually the first step in dry eye treatment.Many brands of artificial tears are available over the counter (OTC) without a prescription. They come in a wide variety of ingredients and viscosity (thickness).If your eye doctor determines that prescription relief is needed for your symptoms, they may recommend one or more medicated eye drops.The recommended application time for warm compresses is between five and 10 minutes. The length of time that the compresses should be heated in the microwave will be indicated in the instructions. It is important to make sure that the compresses are comfortably hot and do not burn the eyelids. The more often the warm compresses are applied the better, but twice a day is most practical for many patients.
REDUCED READING VISION
What’s causing it: If you suddenly seem to need more light to see what you’re reading, or find yourself holding your smartphone further and further away in order to read an email or text message, you’re in good company. After age 40, it’s common for your vision to change so that you require reading glasses. “As we age, the lens inside the eye becomes less flexible, so we have a harder time viewing things clearly when they are up close,”
What can help: The only solution here (other than growing longer arms!) is to see your eye doctor for an eye exam. Depending on your prescription, you may be able to get away with buying inexpensive reading glasses at the drugstore, or you may need something customized. Luckily, these days the options are much less obvious than they used to be. Instead of the old-fashioned bifocal glasses, you can now get glasses with progressive lenses. They work virtually the same way as the old bifocals, but without the telltale line. Multifocal contact lenses serve the same purpose, enabling you to see at all distances without having to pull out reading glasses to read the menu.
DIFFICULTY SEEING AFTER DARK
What’s causing it: Reduced night vision is another common symptom of ageing eyes. It’s caused by the ageing of the photoreceptors in the eyes, which results in a reduced ability to see clearly in dark situations, such as driving at night.
What can help: Unfortunately, there’s not much that can be done to really improve your night vision. Your best defense is to see your eye doctor annually to ensure that your glasses or contacts prescription is up to date to help keep your vision as sharp as possible in all conditions.
GLAUCOMA
What’s causing it: A buildup of pressure in the eye can cause damage to the optic nerve. Without treatment, vision loss–starting with the peripheral vision–is common.
What can help: Everyone over 40 should get a full eye exam every year during which your doctor tests the pressure in your eyes, examines the optic nerve, and dilates and examines the pupil. When diagnosed early enough, glaucoma can be treated.
CATARACTS
What’s causing it: The lens of the eye is made up primarily of water and protein. As we age, the proteins can clump together and become a cataracts. The result is that the lens of the eye gets clouded, making vision blurry, reducing night vision, and possibly creating the illusion of halos when you look at lights.
What can help: Wear anti-glare sunglasses whenever you’re outdoors because prolonged exposure to UV rays can exacerbate the problem. If a cataract is found early enough, non-surgical solutions, like a new glasses prescription, may be adequate. More advanced cases require surgery to remove the clouded lens and replace it with an artificial one.
MACULAR DEGENERATION
What’s causing it: The macula is located at the back of the retina and is made up of millions of light-sensing cells that work to provide you with sharp, central vision. When the macula breaks down, the layers start to separate and leak. Gradually, your central vision begins to get blurry.
What can help: A diet rich in antioxidants may be helpful as part of an overall preventive approach. Again, you need to see your eye doctor annually to be examined for any early signs of macular degeneration. When left untreated, it will lead to vision loss.
