Ageing and your eyes

Ageing can affect eyesight and cause some eye conditions to worsen. This page will outline common issues that people experience as part of the normal eye ageing process and how to know if changes are due to age or something more serious.

We’ll explore how ageing affects the eyes, whether age contributes to eye conditions such as cataract and glaucoma, and which eye tests and eye surgery are suitable for age-related vision problems.

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Common conditions of ageing eyes

Ageing eyes can develop eye conditions, including cataracts, glaucoma and age-related macular degeneration. Early detection of these problems can help slow deterioration and maintain sight, so it’s important to attend regular eye tests to maintain good vision as you age.

Most cataracts are caused by changes in the eye due to ageing (Source: RNIB). Over time, the protein in the lens of the eye can break down, causing clouding and low vision. However, cataracts are not just an old-age eye problem and can occur in children and young adults too. Symptoms of cataracts include light sensitivity, blurred vision and double vision.
Eye pressure is measured using a process called tonometry. An optometrist numbs the eye with eye drops before using a tonometer, a small device placed onto the eye’s surface to measure the pressure within the eye. As we age eye pressure tends to increase (Source: NIH).

An eye pressure of between 10 and 21mmHg is considered normal. Your ophthalmologist will decide on your normal eye pressure range by age, general eye health and medical history.

An eye pressure of 22mmHg or above is considered high and requires close monitoring. Increased eye pressure is the main risk factor for glaucoma, so timely detection and treatment are vital.
Age-related macular degeneration (AMD) typically affects people aged 55 and over and is a common cause of vision loss for ageing eyes. The macula, a part of the eye used for central vision, becomes thinner over time, causing vision changes. Age-related macular degeneration is progressive, meaning that it gets worse over time. Taking vitamin supplements (Source: RNIB), avoiding high cholesterol (Source: NIH) and reducing exposure to ultraviolet light can help slow AMD progression (Source: Eye & Contact Lens).
High blood sugars from diabetes affect the delicate blood vessels at the back of the eye, causing damage and permanent vision loss in a condition called diabetic retinopathy. Diabetic retinopathy is a leading cause of blindness in adults aged 20-74 years (Source: Eye and Vision). People with diabetes can experience eye problems at any age, but the risk increases over time as damage to the eye builds up. High blood glucose levels, pregnancy and high blood pressure, can all accelerate disease progression.
As we age, changes in the jelly-like vitreous fluid within the eye can affect the retina, causing it to loosen and detach (Source: Frontiers). Symptoms include vision changes, such as seeing dots, a shadow across the vision or lines. A detached retina needs urgent attention, so if you experience any of these symptoms, contact your ophthalmologist immediately to avoid permanent damage to sight.

Signs of ageing eyes

As part of normal ageing, the natural lenses in our eyes become more rigid over time, in a condition known as presbyopia. As a result, many older adults have difficulty focusing on close objects and need reading glasses as they age.

Other eye issues are more common as we age, including dry or watery eyes.

Dry eyes are very common as we age, and some people over 65 experience symptoms including redness, stinging and watery eyes. Dry eyes occur when the eyes produce too few tears or when the tears are of poor quality. Prolonged dryness can damage the surface of the eye, so your optometrist or doctor may suggest artificial tear eye drops to keep the eyes moist.
Floaters look like little strings or specks that drift around in your field of vision and move away as you attempt to look directly at them. Floaters become more common over the age of 50 as the jelly-like vitreous fluid in the eye becomes thinner, and the fibres start to stick together, causing the floating specks in your vision. Floaters can be a sign of a more serious eye problem, like a retinal tear, so always get them checked out.
Tearing or watery eyes typically occur as a result of irritation. As you age, dry eyes and other eye conditions can cause the eyes to be more sensitive and prone to irritation. In response, your tear glands create more tears to keep the eyeball moist and wash away any irritant. Occasionally, watery eyes can require treatment. If you have any lumps, pain or signs of infection, or your eyelid is turning inwards or outwards, seek advice from your optometrist.

At what age do you get a free eye test?

You can get a free NHS eye test if:

You're 60 or over
You're 40 or above and have a close family history of glaucoma
You're under 16
You're 16, 17 or 18 and in full-time education
You've been diagnosed with glaucoma
You have diabetes

People with diabetes are eligible for free regular eye exams at any age as part of the Diabetic Screening Programme. You also qualify for free eye examinations if you have vision loss of any kind, including glaucoma.

Does eye colour change with age?

In most cases, eye colour does not change due to age. However, some age-related conditions, change the appearance of the eyes. For example, cataracts involve clouding of the lens which can make the pupil appear whiter. A true eye colour change can indicate a more serious problem, so it’s always best to get it checked out by an eye doctor.

Do eyes grow with age?

Once we reach adulthood, our eyes do not grow bigger with age, but the crystalline lens inside the eye does keep on growing and as a result becomes more dense. This alters its ability to change shape and focus (presbyopia) and also contributes to cataract formation.

The size and growth of an eyeball vary depending upon age:

Newborn baby – 16.5mm diameter.
Birth to two years – the eyes start to grow.
During puberty – the eyes continue to grow.
By age 20 – the eyes are fully grown at 24mm diameter.
Old age – the eyes remain the same size.

Frequently asked questions

Conclusion

Eye changes, including dry eyes and floaters, can be due to normal ageing. Mild visual impairment like presbyopia is also common as we age and is easy to correct with glasses.

Advancing age is one of the risk factors for developing more severe eye conditions such as glaucoma, cataracts and macular degeneration. See your doctor or optometrist if you experience changes to your central or peripheral vision, flashes of light, pain, or anything else that concerns you.

Regular comprehensive eye exams and good healthcare and eye care throughout life can all help you maintain healthy eyes as you age.

Explore more topics in our eye health hub

Medically reviewed by: The Royal College of Ophthalmologists on 06/09/2022

Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
LSHTM

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.