Common age-related eye conditions to look out for

Published November 2024 | 5 min read 
Expert contributor Nabill Jacob, Orthoptist at Vision Australia 
Words by Alana Wulff 
 
While many of us will experience a range of common age-related eye conditions, there are steps we can take to make sure our vision remains strong and clear.
 
As we age, so do our eyes – and while many of the changes may be inevitable or hereditary, some can be managed with a commitment to regular eye checks, a healthy lifestyle and an understanding of what to expect.  
 
From as early as our 40s, we may start to experience slight changes to our vision, such as difficulty focusing on close objects and with reading.  
 
However, recent studies have shown that lifestyle factors including diet and maintaining a healthy weight can help prevent diseases like age-related macular degeneration and diabetic retinopathy.  

Understanding normal levels of vision loss 

Although we may assume loss of vision is a natural part of life, orthoptist and clinical relationship manager of Vision Australia, Nabill Jacob, says while some decrease in vision sensitivity is to be expected, we shouldn’t just assume that “slowly going blind” as we age is inevitable.  
 
“While our vision will decrease somewhat with age, at 45 less than 1% of people are likely to have low vision (vision problems making it hard to do everyday activities and not correctable with glasses or surgery), by the age of 75 that jumps to 5% and by the age of 85, it’s 15%,” he says.  
 
To catch any changes early on, Nabill recommends getting an eye check roughly every 18 months after the age of 50. 

Macular degeneration

Macular disease is the leading cause of blindness and severe vision loss for those aged over 40 in Australia. Around 8.5 million people over the age of 50 are at risk of macular disease and over 1.7 million Australians have some evidence of the disease.  
 
These conditions occur at the back of the eye where the retina is, says Nabill.  
 
"Think of it like a film camera where your eye is the camera and the film is the retina,” says Nabill. “It’s very fragile tissue at the back of the eye that absorbs the light and transmits this to the brain.”  
 
While painless, macular diseases can include a range of symptoms like:  

• dark patches in your central vision 
• distortion (where straight lines may look bent or wavy) 
• problems recognising faces 
• difficulty with activities that need detailed central vision.

While one of the risk factors for macular degeneration is age (being over 50) and almost 15% of Australians aged over 80 have vision loss or blindness from age-related macular degeneration, it’s important to note macular diseases are largely hereditary, says Nabill. 
 
“If it’s in your family, just remember you’re never too young to get your eyes checked [by an optometrist or ophthalmologist],” he says.  
 
The most common macular disease is age-related macular degeneration. There are two types of macular degeneration, ‘wet’ and ‘dry’. ‘Dry’ is the most common kind and it develops slowly. ‘Wet’ develops quickly and is considered the more serious kind, however you can treat (not cure) this type with treatment, including regular eye injections.  
 
“You can have injections now and that seems to be successful in halting the progression of [‘wet’ macular degeneration], however the ‘dry’ version isn’t as easily treated at this stage,” says Nabill.  
 
“If you’ve seen your eye doctor and they’re telling you that you’re at the beginning stages [of this condition], [your doctor may recommend you] take a macular health vitamin,” he says. “They’re concentrated with the antioxidants that are most helpful within the context of macular degeneration.”  

Glaucoma

According to Glaucoma Australia, one in 50 Australians will develop glaucoma in their lifetime. A predominantly age-related condition, glaucoma can cause vision loss due to damage of the optic nerve caused by increased fluid pressure. If left untreated, it can lead to blindness.  
 
“Essentially we have a pump mechanism at the front part of the eye where [clear fluid] is continuously pumped in and out of the eye,” says Nabill. “That pump can malfunction and increase pressure inside the eye, meaning water doesn’t drain as well as it should.”  
 
Symptoms may include:  

• loss of peripheral vision 
• painless, blurred vision 
• difficulty adjusting to low light. 

Vision loss caused by glaucoma tends to happen gradually, and the loss of peripheral vision (side vision) can be fairly significant before you even notice there’s a problem. In Australia, 300,000 people currently have the condition, yet it’s estimated that around half of them don’t realise. Although it can occur at any age, it's more common in older Australians over the age of 60. Early-onset glaucoma is when the disorder appears before the age of 40. 
 
Glaucoma can be treated with the use of drops or, for more severe cases, with laser or keyhole eye surgery to help with drainage within the eye.  

Dry eyes

The condition of dry eye occurs when there's a change in how the eyes produce tears, so essentially the lack of sufficient lubrication causes irritation and red, sore or itchy eyes. Dry eyes can occur at any age, but it tends to occur after the age of 50 (most common over the age of 65) as we tend to produce less tears naturally as we age. Those with glaucoma are at a higher risk of dry eye.  
 
While dry eye can’t be cured, there are ways you can manage the symptoms. To help keep your eyes moist and protect them against dust particles, pollution, smoke and even prolonged air conditioning use, Nabill suggests using a basic lubricate or eye drops that can be purchased at your local pharmacy without a prescription.  
 
“This, plus your own tears, will help to keep your eyes moist, and will flush out any potential harmful debris,” he says. “If you’re in an air-conditioned office all day or you’re driving a lot with the window open, make sure you have drops on hand.” 
 
You can also reduce your screen time (as we tend to blink less while using them), use a warm compress, keep your eye lids clean, use a humidifier, and avoid smokers and smoking.

Cataracts

A cataract is when there’s a clouding of the lens of the eye. Normally this part of the eye is clear, so when cataracts occur, a person’s vision is affected quite substantially. Cataracts can be frustrating, but they’re relatively easily treated with cataract surgery. 
 
“If we lived long enough, we’d all eventually get cataracts,” says Nabill. “Think of them as a natural blurriness and hardness of the lens inside the eye that eventually needs to be removed and replaced with a plastic one.”  
 
Symptoms may include:  

• sensitivity to glare 
• reduced night vision 
• blurred vision 
• seeing ‘double’ 
• fading or 'yellowing' of colours. 

While cataracts can occur in younger people (and even in newborn babies), they’re predominantly part of a natural ageing process. By the age of 70, most of us will have some form of cataracts in our eyes. Certain factors however can bring cataracts about earlier in life, including excessive exposure to UV (wraparound sunglasses can help), smoking and diabetes.

Diabetic retinopathy

Diabetes occurs when your body loses the ability to produce insulin or stops producing or using it efficiently. This causes blood glucose levels to rise. Over time, high blood glucose levels damage your blood vessels, which can lead to heart attack, stroke and problems with the kidneys, gums, feet and nerves. High blood glucose levels can also negatively affect your eyes in several ways.  
 
To begin with, they can trigger changes in the shape of the lens, consequently blurring your vision. Persistently high glucose levels increase the risk of developing cataracts, macular oedema, glaucoma and dry eyes. 
 
Ongoing management and tight control of diabetes are essential to eye health, especially as diabetic retinopathy is the leading cause of blindness in Australians aged 20 to 65. If you have diabetes or a family history of diabetes, Nabill recommends having your eyes checked as a priority.  
 
“Diabetes can affect the eyes and when it does, it affects the retina, which is when it becomes diabetic retinopathy,” he says. “We want to make sure it’s not causing issues like leakages or the growth of new blood vessels that start to leak. All of these things can damage your vision quite severely.” 

Keeping your eyes in check 

The best way to look after your eyes is a few simple lifestyle changes, says Nabill.  
 
Firstly, maintain a healthy diet and regularly exercise. Nabill suggests a diet high in antioxidants and vitamin A can help protect your eyes, and new research suggests a low protein diet may offer benefits for general eye health. 
 
During the middle of the day and on high-UV days, make sure you’re wearing a hat and wraparound sunglasses. Avoid smoking and drinking too much alcohol, and if you have diabetes or pre-diabetes, monitor your eye health closely. 
 
And lastly, maintain a regular schedule of eye checks, but visit more often if you notice any changes to your vision. A visit to your local optometrist will give you the insight you need to manage your vision going forward.  
 
“Getting your eyes checked regularly can head these issues off at the pass if you’re aware of them,” explains Nabill. “If your vision isn’t letting you do things you used to be able to do very comfortably, then it might be a good time to see someone.” 

Supporting your eye health  

Eligible members can get 100% back* on a range of prescription glasses (excluding add-ons like high index material, coatings and tinting). You can also get free digital retinal imaging with your eye test through HCF Eyecare Centres, Specsavers or Dresden.