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Common Vision Changes in the Middle Years of Life

    The middle years of life, also known as middle age or midlife is the period between young adulthood and old age. It is usually pegged anywhere between 35 and 65 years, but in most cases, from 40 to 60 years.

    During this period, the eyes, like other parts of the body, undergo changes that interfere with how they see. While many of these changes are normal, some are not.

    So, what is normal and what is not? Read on to learn more.

    Normal vision changes are alterations in vision that are occur as a result of the normal physiological processes the eyes undergo with age. They include:

    #1. Difficulty seeing small prints or performing other near tasks

    This is one of the first changes in vision that people observe in their middle years. The condition is known as presbyopia, and it is caused by the gradual and natural hardening of the crystalline lens with age.

    Coping with difficulty seeing small prints often involves making lifestyle adjustments and using visual aids like glasses and contact lenses to improve vision and relieve eye discomfort. You can learn more about this vision change and how to cope/manage it from my Guide to Managing Difficulties with Seeing Small Prints. Click here to read it.

    #2. Needing more light to see

    This vision change may start early or later in middle age depending on how the structures in the eyes change. It is caused by factors such as:

    • The hardening of the crystalline lens which becomes denser and less transparent
    • The weakening of the muscles that control the pupil responsible for letting light into the eye.
    • A decrease in the number of light-sensitive cells at the back of the eye (retina)

    These factors either decrease the amount of light entering the eye or makes the eyes less responsive to light. To cope with this visual change, ensure that you read in a well-lit environment.

    #3. Taking a longer time to adjust to a dark environment

    When moving from a bright room to a dark one, it usually takes the eyes a few minutes to adjust and see things in the dark room. This is known as dark adaptation. 

    Dark adaptation occurs because, in dim light, the pupil widens to let in more light and the light-sensitive cells in the back of the eye respond adequately to the light.

    With age, however, the pupil responds slowly and the number of light-sensitive cells in the back of the eye decrease. This affects the ability of the eyes to adjust from seeing in a bright room to seeing in a dark one.  Hence, it takes a longer time to adjust to a dark environment.

    #4. Increased light and glare sensitivity

    There is increased sensitivity to light and glare with age because changes in the lens cause light entering the eye to scatter instead of forming a single focus on the retina.

    #5. The eyes feel drier and irritated

    With age, the tears produced by the tear glands decreases. This makes the eyes feel drier. This condition which can cause a lot of eye discomfort is known as dry eye syndrome. Click here to learn more about dry eye syndrome. 

    #6. Changes in colour perception 

    This occurs more in old age, but some people begin to experience it in the later part of their middle years. It is caused by the age-related yellowing of the normally clear lens in the eye. With these changes, colours may look dull, and people may find it difficult to distinguish between different shades of the same colour. For instance, it may be hard to differentiate between navy blue and grey or burgundy and maroon. These changes are not drastic and usually do not cause any harm.

    Sudden or drastic changes in colour perception are a cause for concern and should be evaluated by an eye doctor.

    #7. Decreased contrast sensitivity

    This is another vision change that is common in old age but starts in some people in the latter part of their middle years.

    Contrast sensitivity is the ability to notice subtle differences in outlines or patterns of different objects or substances in an environment. The reason for this decrease has been attributed partly to the reduction in the amount of light that gets to the retina after hitting the aging lens and partly to the age-related reduction in the number of nerve fibres in the eye.

    Decreased contrast sensitivity can make it hard to perform tasks like:

    • Driving when the visibility is poor, such as driving at night or in the rain.
    • Climbing or going down the stairs without missing a step or tripping.
    • Identifying objects on a background with similar colours. For instance, identifying a white book on a bed covered with a white sheet.
    • Reading materials with poor contrast, like books printed with newsprint paper.

    Abnormal vision changes are alterations in vision that are not due to normal physiological processes in the eye. While the risk of developing these changes increases with age, they are not necessarily caused by aging. They often occur as a result of a disease process in the eyes and can lead to vision loss and blindness. 

    Examples of these changes include:

    • Sudden blurry vision
    • Fluctuating vision
    • Double vision
    • Sudden/severe eye pain
    • Persistent red eye
    • Seeing rings around light
    • Seeing dark spots or patches in your field of view
    • Flashes of light
    • Persistent red eye
    • Blood in the eyes

    These changes are often warning signs that something abnormal is happening in the eyes.

    Note that many sight-threatening diseases like do not show warning signs early enough. If you develop any of these, it may be a sign of an advanced disease. So, you should take it seriously and consult your eye doctor immediately.