Your eyes change as you get older, and many people notice the first signs in their forties. Some of these changes are a normal part of ageing, while others are worth having checked by a professional. This guide explains the common changes, the eye conditions that become more frequent with age, the warning signs that need prompt attention and the everyday habits that are associated with good eye health. It is general education only and is not a substitute for advice from an optometrist, ophthalmologist or doctor.
Common eye changes after 40
Several changes tend to appear gradually from around the early to mid forties. None of them mean something is seriously wrong, but they are good reasons to book an eye examination if you have not had one recently.
Trouble focusing up close
The lens inside the eye slowly becomes less flexible, which makes it harder to focus on near objects. This is called presbyopia. It is why many people start holding menus and phones further away or find that they need reading glasses. An optometrist can test your vision and discuss options such as reading glasses, multifocal lenses or contact lenses.
Needing more light
With age, the pupils tend to become slightly smaller and the lens can yellow a little, so less light reaches the back of the eye. Many people notice that they need brighter light for reading and that glare from headlights makes night driving more tiring.
Drier, more tired eyes
Tear production and quality can change with age, and hormonal changes, some medicines and long periods of screen use can add to the feeling of dryness or grittiness. If your eyes are persistently uncomfortable, an eye professional can look for the cause and suggest suitable options.
Floaters
Small specks or threads drifting across your vision are common and are usually harmless. A sudden increase in floaters, however, is one of the signs that should be checked promptly, as described below.
Eye conditions that become more common with age
The conditions below are more common in older adults. Many develop slowly and can be present without obvious symptoms in the early stages, which is one reason regular examinations are recommended. This section describes what each condition is; it does not replace an examination or diagnosis.
Cataracts
A cataract is a clouding of the lens inside the eye. It tends to develop slowly and can cause blurred or hazy vision, increased glare and colours that look faded. Age is the most common factor. Other factors associated with cataracts include smoking, a lot of unprotected sunlight exposure over the years, diabetes and long-term use of some medicines such as corticosteroids. If a cataract affects daily life, an eye specialist can explain the available options.
Age-related macular degeneration
The macula is the small central part of the retina that gives sharp, detailed vision for tasks such as reading and recognising faces. Age-related macular degeneration, often shortened to AMD, affects this area. It tends to affect central vision first, while side vision usually remains. It exists in a slower “dry” form and a less common “wet” form. Because changes can begin before you notice anything, examinations that look at the retina are important. Age and smoking are among the best-established risk factors.
Glaucoma
Glaucoma is a group of conditions that damage the optic nerve, often in association with raised pressure inside the eye. It frequently causes no symptoms at first and tends to affect side vision gradually, so many people do not notice it until it is advanced. This is why eye pressure checks and examination of the optic nerve are part of a comprehensive eye examination. A family history of glaucoma, older age and some medical conditions are associated with a higher chance of developing it.
Diabetic eye disease
Diabetes can affect the small blood vessels in the retina. People with diabetes are generally advised to have regular eye examinations, including a look at the retina, even when their vision seems fine. Your doctor or diabetes care team can tell you how often is right for you, and managing diabetes overall is part of looking after your eyes.
Warning signs that need prompt attention
Some eye symptoms should not wait for a routine appointment. Contact an eye professional, your doctor or an emergency service promptly if you notice any of the following:
- sudden loss of vision, or sudden blurring in one eye
- a sudden shower of new floaters, or flashes of light
- a shadow or curtain spreading across part of your vision
- straight lines that suddenly look wavy or distorted
- eye pain, especially with redness, headache or nausea
- double vision that is new
Even if you are not sure the symptom is serious, it is better to have it checked.
Why regular eye examinations matter
A comprehensive eye examination looks at much more than whether you need glasses. Depending on your age and circumstances, it can include measuring eye pressure, checking the health of the optic nerve and the retina, and, sometimes, widening the pupils with drops so the back of the eye can be seen clearly. Quick screening tests, such as those offered in some retail settings, are not a replacement for this kind of examination.
How often you should be examined depends on your age, your family history and any health conditions such as diabetes. Recommendations differ between countries and professional bodies, so the best approach is to ask your optometrist or eye doctor how often is right for you, and to book earlier if you notice any changes.
Everyday habits associated with good eye health
No habit can guarantee healthy eyes, but a number of everyday choices are associated with better eye health, and most are also good for general health.
Protect your eyes from ultraviolet light
Long-term exposure to ultraviolet light is associated with an increased chance of cataracts and other eye problems. Wearing a hat and sunglasses that carry a recognised UV protection standard in your country is a simple way to reduce exposure, particularly in strong sun and around water or snow.
Do not smoke
Smoking is one of the best-established modifiable risk factors for both cataracts and age-related macular degeneration. If you smoke, a doctor or a quit-smoking service can help you plan to stop.
Eat a varied, colourful diet
Studies of eating patterns have linked diets rich in vegetables, fruit, fish and whole foods with better eye and general health. Leafy green vegetables, orange and yellow vegetables, eggs, nuts and oily fish are all part of that picture. Food is generally a better starting point than pills, and a doctor or accredited dietitian can advise on what suits you.
Be physically active
Regular physical activity supports circulation and is associated with better general health, including conditions such as diabetes and high blood pressure that can affect the eyes. Public health guidelines commonly suggest around 150 minutes of moderate activity a week for adults, adjusted for your own health and ability.
Look after your eyes at the screen
Long periods of close-up work can leave eyes feeling tired and dry. A commonly recommended routine is the 20-20-20 rule: every 20 minutes, look at something about 20 feet (six metres) away for around 20 seconds. Blinking fully, adjusting the screen distance and keeping the room well lit can also help comfort. Screen use is not known to cause permanent damage to the eyes, but it can cause temporary discomfort.
Take care with contact lenses
Wash and dry your hands before handling lenses, follow the wearing and replacement schedule from your eye professional, and see someone promptly if an eye becomes red, painful or sensitive to light.
What about supplements?
You may have heard of the AREDS and AREDS2 studies, large trials run in the United States by the National Eye Institute. They tested particular combinations of vitamins and minerals in people who already had intermediate-stage age-related macular degeneration. Because those studies involved people with an existing eye condition under supervision, and because high-dose supplements can interact with medicines and may have side effects, they are not a general recommendation for everyone. If you are wondering whether a supplement is right for you, please discuss it with your doctor or eye specialist rather than starting one on your own.
Questions readers ask
Do eye exercises improve vision as we age?
There is no good evidence that eye exercises reverse presbyopia or other age-related changes. Relaxation and regular breaks from close work can make eyes feel more comfortable, but they are not a substitute for glasses or examination.
Do blue-light glasses help?
A 2023 Cochrane review of the evidence found no clear benefit from blue-light-filtering lenses for reducing eye strain from screens. If your eyes are uncomfortable, a proper examination and good screen habits are a better first step.
Is it normal for my vision to change slowly?
Gradual changes in near focus and light sensitivity are common. Any sudden change, or a gradual change that is noticeable in one eye only, should be checked.
How often should I have my eyes checked?
It depends on your age, health and family history. Your optometrist or eye doctor can give you a recommendation that fits your situation.
The bottom line
Some changes in vision after 40 are a normal part of ageing, and glasses often solve them. Other conditions can develop quietly, which is why regular comprehensive examinations, prompt attention to warning signs and general healthy habits all play a part. This article offers general information only; please speak with a qualified eye care professional or doctor about your own eyes.
Sources and further reading (plain text): National Eye Institute (United States), information on AREDS and AREDS2 and on common eye conditions; the Royal Australian and New Zealand College of Ophthalmologists; the American Academy of Ophthalmology; the World Health Organization physical activity guidelines of 2020; the Cochrane Library review on blue-light-filtering spectacle lenses (2023).