Vision Loss - What’s Normal and What’s Not?

All our bodies change as we age, and our eyes are no different.

But what’s normal ‘wear and tear’ due to age, and what’s something more serious? If you notice vision changes over the years, it’s all a matter of noting the changes, addressing the symptoms, and understanding the causes.

Is your vision abnormal for your age? Are you experiencing typical changes, and is there anything you should be doing?

For Black people especially, conditions like glaucoma, diabetic retinopathy, and cataracts are all more common than in other races. So without further ado, let’s get right into it…

Here’s What’s Normal

If you’re having trouble focusing on things close to your face, this is mostly normal. This happens as we age, and it’s called presbyopia. You can expect to notice this starting around age 40 and sometimes, you’ll just hold things farther from your face to see them. The best way to treat this is with bifocals and good lighting when doing things close-up.

Another age-related eye issue is dryness. This happens because aging causes the production of tears to wane, and may be particularly prevalent in women post-menopause. Fortunately, eye drops and some menopause medication can help.

A third issue is pupil responsiveness. As we age, our pupils often decrease in size and may be less responsive. In other words, they may not change quickly or efficiently as we change from dark to light, or light to dark, environments. This can be mostly treated by keeping rooms, especially work areas, well-lit. Also, look into sunglasses to keep your eyes safe from glare and UVs.

Finally, there is a loss of peripheral vision, meaning you don’t see ‘out the sides’ as well as you used to. This causes your field of vision to narrow, but is usually nothing to be worried about unless it impairs activities like moving or driving. Just be careful if you’re entering new areas, especially driving.

Your eye doctor will check your eyes routinely to stay on top of these issues.

Now let’s get into what is not normal…

Here’s What’s Abnormal

While the previous issues are mostly normal (unless they come out of nowhere when you’re young), the following issues are not just typical aging. They typically require significant lifestyle changes, medication, or surgery.

One is glaucoma, which as you might know, affects the Black community disproportionately. Glaucoma is a cluster of conditions that hurts your optic nerve. When not addressed, glaucoma may result in serious vision loss.

So look out for trouble seeing peripherally, seeing halos, or tunnel vision. Be sure to visit an eye doctor regularly, and take any professional opinions seriously.

Also, be sure to look out for diabetic retinopathy. Because Black folks are more likely to have diabetes, they’re also at a greater risk of developing diabetic retinopathy. If you have diabetes and you’re experiencing things like blurred vision, floaters, or trouble with color perception, check your blood sugar.

Meet with your eye doctor and personal doctor about a plan for both your eyes and diabetes.

Another condition to look out for is cataracts, which are the clouding of your lens. Poor night vision, blurriness, and problems seeing with glare are all symptoms to recognize. Because cataracts usually come on slowly, start with using brighter lighting and wearing sunglasses.

In time, surgery is a good option and is very well tolerated.

And then there’s retinal detachment. Because this involves your retina leaving its typical position, RD is no joke. It’s considered a medical emergency and will usually occur with weird flashes of light, shadowed visual fields, and abrupt floaters.

Don’t play with this one, as surgery is usually necessary.

Finally, is what’s called age-related macular degeneration (AMD). While “age-related” is in the name, this issue can get pretty serious since it affects your central vision. If problems with central vision get too severe, you may struggle to drive, see faces, or even read.

In some cases, if regular eye exams and supplements don’t help, you may need medicine. Injections and laser procedures are also an option.

So there you have it.

If you’re unsure if your issue is related to age or something more serious, don’t guess. Meet with a doctor and tell all. Be specific about the symptoms. Try to chart down when they occur, how often, and how severe.

Also, be sure to ask about potential causes. With these, you’ll learn potential treatments as well. And once you’ve learned potential treatments, you’ll be way more likely to address the problems early on before they get bad!

And what’s better than that?

By Evan Bollinger | Published December 6, 2024

Medically Reviewed By:

Joseph M. Coney, MD, FACS, FASRS

Dr. Coney received his Bachelor of Science in biology from the University of Illinois and his medical degree from Loyola Stritch School of Medicine. After completing his ophthalmology residency at University Hospitals/Case Western Reserve University, where he is now a Senior Clinical Instructor.