For many people, loss of vision is one of the worst things that could ever happen to them

Our eyes age just like the rest of our bodies. Like your skin and joints, eyes also undergo physical deterioration over time. Keeping eyes healthy by following the tips below can help with maintaining good sight as long as possible.

Unfortunately, eyes are delicate and don’t age particularly well. For example, the lens of your eye loses its flexibility (called presbyopia) and it then becomes discoloured and cloudy (called cataract). In addition, your corneas become dry and your retina becomes less sensitive to low light.

Diminishing eyesight can lead to eyestrain as well as falls. If vision becomes severely reduced, you may lose your ability to drive and enjoy an independent life. This can lead to social withdrawal, depression, cognitive decline, and it has even been associated with a shortened life expectancy. If you have kept your eyes as healthy as you can, your eyes will age more slowly and these problems can be delayed or avoided.

Healthy eyes slow down the most common age-related eye problems

The most common age-related eye problems are cataract, age-related macular degeneration, glaucoma, diabetic retinopathy and dry eye. These issues aren’t only found in the elderly, but your risk of developing these certainly increases as you get older. Although some of these conditions can lead to blindness, the good news is that excellent treatments are available.

Cataract

Just behind your pupil there is a soft, flexible, transparent lens. It’s about the size and shape of a Smartie and it is responsible for focusing incoming light onto your retina, to give you clear vision.

As you age, the proteins of the lens begin to clump together and opacify. This blocks and scrambles the light entering your pupil, causing the image you see to appear dimmed and blurred.

The first symptom of cataract is usually seeing glare and starbursts around bright lights, such as the headlights of cars when driving at night. Cataract also causes colours to appear dull; however, because this change is so gradual, few people are able to recognise the reduced vibrancy of colours (until they have their cataracts treated).

Even healthy eyes will develop some cataract problems with age. However, the process of developing cataract is aggravated by spending a lot of time in the sun without eye protection, having diabetes, smoking, and taking anti-inflammatory steroid medication.

Glaucoma

Glaucoma is caused by a build-up of pressure inside your eyeball – this is called intraocular pressure. The pressure damages the optic nerve at the back of your eye, just like how water dripping on a rock will slowly wear down a rock. Your peripheral vision will typically deteriorate first, and the condition can result in total blindness if it is not treated. If you have a first-degree relative with glaucoma, you are at greater risk of glaucoma, or if you regularly take anti-inflammatory steroid medication.

Retinal disorders

Your retina is like wallpaper that lines the back of your eyeball. It is a thin layer approximately one-quarter of a millimetre thick and it contains cells that are able to detect light (rod and cone cells). These cells trigger nerve impulses that send messages to your brain via your optic nerve, enabling you to see.

Retinal diseases can affect any part of your retina, and are severely aggravated by the onset of diabetes. Healthy bodies, resulting from good nutrition and exercise, and not smoking, can delay or avoid the onset of diabetes and, as a result, you can have healthy eyes too, as noted below.

Macular degeneration

Age-related macular degeneration (AMD) is the most common retinal disorder. The macula is at the centre of the retina, and it is responsible for us seeing what is in the very centre of our vision. For example, as you read this article, the words that you look at are being focussed onto your macula.

As we age, the macula can develop “wear and tear” changes. These appear as small, pale, fatty lumps beneath the cone cells. These lumps cause your central vision to become distorted, such that straight lines may appear wavy to you. Eventually, small blind spots can form in your central vision. This process is called age-related macular degeneration. Although macular degeneration can completely remove your central vision, the good news is that your peripheral vision is expected to remain intact.

Macular hole

A macular hole is, as it sounds, is a small hole in the centre of the macular. The hole may develop spontaneously without much warning, or it can result from an eye injury.

Diabetic retinopathy

Patients suffering from diabetes are at increased risk of a number of eye conditions, including diabetic retinopathy, cataract, and glaucoma. Therefore, it’s important for diabetic patients to have their eyes examined annually.

It is estimated that 90% of blindness caused by diabetes is preventable with early detection and good control of blood sugars. Make sure that, as you age, you get your “ABCs” checked regularly with your doctor: blood sugar test (the A1c test), blood pressure and cholesterol. It is in the interests of your overall health – including avoiding heart attacks – that you avoid the development of diabetes. And keeping your eyes healthy is part of this process.  Healthy body and healthy eyes!

If you develop diabetes, you may develop an eye condition known as diabetic retinopathy. This occurs when the tiny blood vessels in the back of your eye become leaky, oozing fluid into the retina. As a result, your retina swells, distorting your vision.

Retinal tear

A retinal tear is painless, but you will know if this happens because you may suddenly see floaters (tiny specks drifting across your vision) or flashing lights. If a retinal tear is not treated promptly, the retina can peel away from the back of your eye. This is called a retinal detachment and it can result in permanent loss of vision. Therefore, if you suddenly notice new floaters and/or flashing lights in your vision, see an optometrist or ophthalmologist immediately.

Dry eyes

Many people don’t realise they suffer from dry eyes, as a common symptom is excess watering of the eyes. This watering is a reflex that occurs in response to your eyes drying out in the moments beforehand.

Tear production decreases as you age, and the tears become less oily. You might find that your eyes are more sensitive to light and that you need to blink frequently to clear your vision.

Dry eyes can be uncomfortable, felt as stinging or burning, and your eyes may appear bloodshot. There are numerous treatments available that can help to relieve these symptoms.

If you keep your eyes healthy through avoiding digital strain, sunlight and smoking, the problems of dry eyes can be diminished, if not avoided. Healthy eyes give you better sight and also make life more comfortable.

Eye floaters

The back of our eye is filled with a clear jelly-like substance called vitreous. Floaters are formed when proteins in the vitreous begin clumping together, which is a normal ageing change. Floaters are harmless, but they may be a sign of a retinal tear. Therefore, see your eye specialist if you suddenly develop a new floater.

What to do to preserve your sight

There are several things you can do to prevent or slow down the development of these problems. And these are mostly to do with keeping your eyes healthy.

Monitor any changes in your eyes

If there is a sudden increase in floaters, or the appearance of flashes of light, you may have a retinal tear.

If you start losing peripheral or side vision, this could be a sign of glaucoma.

When straight lines in the centre of your vision start appearing distorted or wavy, you could have age-related macular degeneration or some other condition of your macula (such as a macular hole or an epiretinal membrane).

Know your family’s eye health history

Knowing your family’s health history can alert you to any risk factors. Many eye diseases are somewhat hereditary. Even though you cannot alter your family’s history of glaucoma or age-related macular degeneration, there are lifestyle changes you can make that can reduce your risk of developing these problems.

How to care for your vision and have healthy eyes

It is possible to slow down the ageing of your eyes. The general healthy lifestyle choices with which you are no doubt familiar will help your eyes too: don’t smoke, don’t drink too much alcohol, eat well, use sun protection, drink enough water, and exercise regularly. Keep your body healthy, and you will have healthy eyes.

Get your eyes checked regularly

Perhaps the most important thing you can do is to get your eyes checked regularly, particularly if you are over the age of 40, which is when you should get a baseline eye examination. You will need annual check-ups if you are over 65. Eye conditions that are detected early are typically much easier to correct.

Besides identifying eye diseases, eye examinations can also help to detect diabetes, high blood pressure, high cholesterol, and increased risk of stroke.

Your optometrist will conduct a comprehensive dilated eye examination. The optometrist will refer you to ophthalmologist (medical eye doctor) if required.

Maintain healthy blood pressure for healthy eyes

High blood pressure can damage the blood vessels of your retina and optic nerve. The two eye conditions most strongly linked to high blood pressure are retinal vein occlusions and anterior ischemic optic neuropathy. These conditions are beyond the scope of this article but information about them is readily available.

Good nutrition

For overall good health, including good eye health, it is important to have a diet that is rich in fruits and vegetables, particularly dark leafy vegetables like spinach. Eating orange coloured vegetables that are full of Vitamin A, is also important, so be sure to eat carrots and pumpkin.

Remember to eat fish high in Omega-3 fatty acids, such as sardines, tuna and mackerel.

The Age-Related Eye Disease Study (AREDS) found that certain nutrients like copper, zinc, Vitamin E, Vitamin C and beta carotene can reduce a person’s risk of developing age-related macular degeneration. However, this benefit was only detectable in patients at high risk of macular degeneration, therefore, you should speak to an eye specialist before investing your time and money on these supplements.

Exercise

Exercise is good for all parts of your body, including your eyes. Exercise lowers eye pressure and it helps to control blood pressure, blood sugar and blood cholesterol.

Maintain a healthy weight

Eating well and exercising regularly are, of course, associated with maintaining a healthy weight. Being overweight affects far more than your heart, blood pressure and blood sugar control; it also affects your eyes. Overweight individuals are more likely to develop cataract, glaucoma and age-related macular degeneration.

Do not smoke if you want healthy eyes

Smoking is as bad for your eyes as it is for the rest of your body. Smoking can lead to vision loss through numerous different mechanisms.

Smoking is strongly linked to an increased risk of developing age-related macular degeneration (up to four times the risk of non-smokers). This is because the toxins in cigarette smoke dramatically increase the stress on your macula cells.

Wear protective eyewear

Protecting your eyes from foreign objects and ultra-violet (UV) light is important, whether you are working or playing. You need safety glasses or goggles, eye guards and sunglasses. Look for sunglasses that block 99 to 100 percent of both UV-A and UV-B radiation. Wraparound glasses help to protect your eyes from the side and they will also reduce your risk of skin cancer of the eyelids, which is one of the most common sites for basal cell carcinomas to form.

Prolonged UV exposure can lead to cataract and it may increase your risk of macular degeneration, although this is not conclusively proven. Excess sunlight is also the primary cause of pterygium, which is a fleshy growth on the surface of the eye. If you are welding, it is possible to burn the surface of your eye, a painful condition known as ultraviolet keratitis or welder’s flash.

Computers and your eyes

It has been widely suggested that the blue light emitted from digital screens, such as mobile phones and computers, is harmful to our eyes. Fortunately, this is almost certainly a myth. Looking at digital screens for long periods may cause eye discomfort (asthenopia) and it may reduce your sleep quality if you look at screens before bedtime; however, the light emitted by digital screens is almost certainly not truly harmful to your eyes.

If you experience eyestrain when looking at screens then try looking away from the screen into the far distance (or at least into the furthest corner of the room) every 15 minutes. You could also see an optometrist to assess whether wearing glasses may help you. It may be that your eyes are not perfectly straight when looking at your screen (which can be alleviated with exercises or with glasses). Or you may find that wearing glasses with an anti-glare coating helps you to work more comfortably.

References

1. Age-Related Eye Disease Study Research Group. (2007). The relationship of dietary carotenoid with vitamin A, E, and C intake with age-related macular degeneration in a case-control study. Archives of Ophthalmology 125(9): 1225–1232.
2. Age-Related Eye Disease Study Research Group. (2001). Risk factors associated with age-related nuclear and cortical cataract. Ophthalmology 108(8): 1400–1408.
3. U.S. Department of Health and Human Services. 2004. Office of the Surgeon General. The health consequences of smoking: a report of the Surgeon General. Washington (DC): US Govt.

More information on healthy eyes

Booth, Stephanie. WebMD. (2024). How to keep your eyes healthy.

National Eye Institute. (2024). Healthy vision tips.

US Centers for Disease control and prevention. (2024). Taking care of your eyes