Needing reading glasses is the eye change everyone expects. Less obvious are the conditions that can take vision slowly, often before you notice anything wrong. Glaucoma, age-related macular degeneration and cataracts all become more common after 50, and for each one, finding it early changes what can be done.

The main tool is a dilated eye exam, in which drops widen the pupils so an eye doctor can see the retina and optic nerve. The National Eye Institute explains what the exam involves.

Glaucoma: the quiet one

Glaucoma is a group of diseases that damage the optic nerve. According to the NEI, it usually has no early symptoms, and side vision tends to go first, so slowly that many people do not notice. There is no cure, but treatment with eye drops, laser or surgery can often stop further damage. Vision already lost does not come back, which is the argument for finding it early.

The NEI lists higher risk for:

  • People over 60, especially Hispanic or Latino adults
  • African American adults over 40
  • Anyone with a family history of glaucoma

For people at higher risk, the NEI recommends a dilated eye exam every 1 to 2 years.

Macular degeneration: central vision

Age-related macular degeneration, or AMD, affects the macula, the part of the retina responsible for sharp, straight-ahead vision. The NEI notes it is a leading cause of vision loss in older adults, though it does not cause complete blindness. Risk is higher after 55, with a family history, in white adults, and in people who smoke.

Early AMD usually causes no symptoms. Later, straight lines may look wavy, a blurry or blank spot may appear in the center of vision, and colors may look duller. The NEI calls wavy lines a warning sign of late AMD and advises seeing an eye doctor right away if it happens.

There are two forms. The dry form is more common and progresses slowly. For people with intermediate dry AMD, a specific combination of vitamins and minerals studied by the NEI may help slow progression to late AMD. The supplements are meant for people who already have AMD. The wet form is less common but can cause faster vision loss, and it is treated with injections into the eye.

The NEI’s advice for lowering risk will sound familiar: do not smoke, stay active, keep blood pressure and cholesterol in a healthy range, and eat leafy greens and fish.

Cataracts: clouding of the lens

A cataract is a cloudy area in the eye’s lens. By age 80, the NEI reports, more than half of Americans either have cataracts or have had surgery for them. Common signs are blurry or faded vision, glare, halos around lights, and trouble seeing at night, which matters a great deal for night driving.

Risk factors include age, diabetes, smoking, heavy drinking, steroid medicines and a lot of sun exposure. In Florida, that last one deserves attention: the NEI recommends sunglasses and a brimmed hat outdoors. Surgery replaces the cloudy lens with an artificial one, and the NEI describes it as very safe, with about 9 in 10 people seeing better afterward. It is usually timed for when cataracts start to interfere with daily life.

How often to be checked, and when not to wait

The NEI advises a dilated exam every 1 to 2 years from age 60, and for people at higher risk of glaucoma. People with diabetes need one at least once a year to check for diabetic retinopathy.

Some eye symptoms are emergencies. Go to an emergency room or call your eye doctor right away for:

  • A sudden shower of new floaters, flashes of light, or a dark shadow or curtain across part of your vision. These can signal a retinal detachment.
  • Sudden severe eye pain with redness, blurred vision and nausea, which can be a form of glaucoma called angle-closure.
  • Sudden loss of vision in one eye, or sudden double vision. Call 911 if it comes with weakness, numbness or trouble speaking, since these can be signs of stroke.

Eye health ties into the rest of your care. Blood sugar, blood pressure and smoking all affect the eyes, and our articles on prediabetes and the A1c test and protecting your skin in the Florida sun cover related ground.

At Legacy Medical, Dr. Shtern keeps track of when your last eye exam was, makes sure your eye doctor knows about conditions such as diabetes, and reviews medicines like steroids that can affect the eyes. She coordinates with specialists so results come back to one place. To meet her, the first visit is a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.