Dr Ajay Shah explains vision changes after 60: What is normal and what needs a check-up?

People start to experience issues with their vision as they grow old, but not all such change should be considered as normal part of ageing, shares Dr Shah.

It is common knowledge that when an individual grows old, their vision deteriorates. However, not all signs of vision trouble can be chalked up to normal ageing.

In an interaction with HT Lifestyle, Dr Ajay Shah explained that a person turning 60 does not automatically mean that they should experience blurred vision, difficulty reading or increasing dependence on brighter light.

“Some changes are part of normal ageing, but others may be the earliest signs of cataract, glaucoma, age-related macular degeneration (AMD) or retinal disease. The key is knowing which pattern requires investigation,” he stated.

Vision changes that need to be corrected

According to Dr Shah, one of the common age-related problems of the eye is presbyopia, which is the gradual loss of the eye’s ability to focus on near objects.

“Older adults may also take longer to adjust when moving from bright to dim environments and may notice reduced contrast or difficulty distinguishing certain colours,” he stated. “These changes can often be corrected with appropriate lenses and lighting.”

“Reading may become difficult because of cataract, but new distortions such as straight lines appearing bent or wavy can point towards macular disease,” he shared.

“AMD may remain symptom-free in its early stages, which is why relying only on how clearly a person feels they can see can be misleading.”

For older people, an eye test is a lot more than reading off a chart.

Diagnosing age-related vision issues

From a diagnostic standpoint, a useful eye assessment for a person above the age of 60 is not limited to whether someone can read an eye chart, pointed out Dr Shah.

“Visual acuity should be assessed separately in each eye, followed by refraction, intraocular pressure measurement, retinal and optic-nerve examination and, where indicated, visual-field testing,” he stated.

“Importantly, normal eye pressure alone does not rule out glaucoma; diagnosis requires assessment of the optic nerve and visual function.”

Dr Shah further highlighted that chronic conditions like diabetes, hypertension and vascular disease can affect the retina, sometimes before a person notices substantial visual symptoms.

“Finally, sudden, painless loss of vision in one eye, a new curtain-like shadow, sudden increase in flashes or floaters, or abrupt visual-field loss is not a routine ageing change. These symptoms require urgent medical evaluation because some retinal and vascular conditions are time-sensitive emergencies,” he added.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Ajay Shah, MBBS, MD, is the managing director of Neuberg Ajay Shah Laboratory in Mumbai and has over four decades of clinical experience.