Eye exams offer sharpest vision of better health after 40
Published on Thursday, December 5, 2024
By: Danny Barrett Jr., dlbarrett@umc.edu
If you’re over 40 and the words to your favorite novel, the text messages on your phone or the words to this article look like a blurry mirage, it might be a sign your eyes need a tune-up from an eye care professional.
Noticeable age-related changes in the human eye, known as presbyopia, affect nearly everyone starting in middle age. It’s a refractive error related to common nearsightedness and farsightedness, but one that’s corrected easily starting with an eye exam.
“Everyone’s eyeballs have a lens, like a camera,” said Dr. Kimberly Crowder, professor and chair of ophthalmology. “When we’re young, the lens gets rounder and flatter when needed for objects far away and up close. It can change its own focal point. But as we age, this lens loses its ability to change shape and is basically stuck in the distance position and we’re not easily able to adapt.”
Correcting the blur when reading smallish print – such as the ingredients on the backs of food labels or on prescription medication – should be practical and fit a person’s needs and budget.
“Most patients choose over-the-counter reading glasses because their distance vision is so good,” Crowder said, adding patients should keep versatility in mind if they want to step up to prescription readers.
“Progressive lenses have an advantage, if you’re a candidate,” she said. “The top part is for your distance vision and the bottom is for your reading. If you’re in a meeting and need to see a speaker, your laptop and any texts on your phone, you can manage with progressive lenses without constantly taking your glasses on and off.”
Presbyopia can also present with the same intensity in people who’ve had corrective surgeries in the past, such as LASIK, and, in many cases, haven’t had to visit an eye doctor in years.
“It’s unpredictable when exactly the lens will begin to lose flexibility despite nearsightedness being long since corrected in those cases,” she said. “There are some who have had the surgery in their 20s who need reading glasses as soon as their 30s. The range is big and unpredictable. We use a person’s 40s as the norm.”
Comprehensive eye exams after 40 offer the best chance to detect an array of other health issues beyond just having old eyes. The leading causes of vision loss – macular degeneration, diabetic retinopathy and glaucoma – are often asymptomatic in early stages.
“As we reach 50, regular comprehensive eye exams become increasingly important, much like other essential health screenings such as mammograms or colonoscopies,” said Dr. Roya Attar, associate professor of ophthalmology. “These exams offer the best chance for early detection, timely treatment and preservation of vision.”
During a comprehensive exam, an eye care provider will assess visual acuity and function, update any prescriptions, if needed, measure intraocular pressure and screen for conditions including glaucoma and cataracts. Modern tools like Optical Coherence Tomography (OCT) can detect subtle changes in the retina and optic nerve—often before they are visible during a standard exam—helping to identify potential issues early.
“These exams are particularly critical for individuals with risk factors such as diabetes, high blood pressure or a family history of eye disease,” Attar said.
Other options to help improve vision after 40 include multifocal contact lenses and monovision lenses, which allow for one eye for distance and the other for seeing up close. Prescription eye drops for those with mild to moderate presbyopia have been approved by the FDA in recent years, though provide only temporary relief. Surgical options do exist, including procedures similar to that offered to patients with cataracts, which occur when the lens develops cloudy areas due to age and various other factors. More major procedures such as intraocular lens implants are also available.
“There are some limitations with all of them, and so it’s not perfect yet,” Crowder said. “Most people choose to wait until they actually have cataracts, which at that point would be medically necessary surgery.”
Age-related vision issues and cataracts can’t be prevented necessarily, Crowder said, but certain risk factors will speed up their development, such as smoking and certain types of medications, especially any kind of steroids.
“Family history plays a part as well, in that if your parents didn’t need cataract surgery until their 80s, then chances are you won’t need it until you’re also in your 80s.”
All new patients at the Department of Ophthalmology are given a complete, comprehensive eye exam regardless of age, Crowder said.
“It’s not because I’m worried about presbyopia, or whether you want to wear basic readers or prescription glasses. It’s about what everything looks like on the inside of your eyes. For diabetics, they need an eye exam every single year, regardless of age.”
If a patient finds a simple pair of magnifiers to be best, Crowder said, they are advised to simply avoid optional tack-ons that might inflate the cost, such as anti-glare coating. “A lot of specialty boutique-type stores sell readers as well. They’re not quite as cheap as drugstore versions but still not as much as prescription lenses and still look cute.”
To make an appointment with UMMC Ophthalmology, call 601-984-5020 or visit here.
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