PCAP · Public education

Understanding vision loss
in older adults.

Vision loss can change how someone reads a prescription label, sees the edge of a step, or recognizes a friend. Knowing what can change in the eye helps explain why. Listening to the person tells us what it means in their life.1

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What changes as we age?

As the lens becomes less flexible, close-up tasks like reading a menu or sorting mail can become harder. Older adults may also take longer to adjust when moving from bright sunlight into a dim room. Reading glasses or better lighting can help with some of these changes. The risk of certain eye diseases also rises with age, and an eye exam can help identify what’s causing a change in vision.12

Four conditions that affect vision in different ways

Lens

Cataracts

The lens becomes cloudy. Things may look blurry or hazy, and glare can make details harder to see.3

Macula

Age-related macular degeneration

The macula is the part of the retina that provides sharp central vision. Changes there can make it harder to read, recognize faces, or see details while cooking.4

Optic nerve

Glaucoma

Glaucoma damages the nerve that carries visual signals to the brain. Some forms gradually reduce side vision, so objects off to one side may be harder to notice.3

Retinal blood vessels

Diabetic retinopathy

Diabetes can damage blood vessels in the retina, the light-sensitive tissue at the back of the eye. Early changes may have no noticeable symptoms. Later, some people see dark spots or streaks like cobwebs.5

What can vision loss change in everyday life?

Two people with the same diagnosis can have different experiences. Someone may read large print in good light and still struggle to see a step at dusk. Someone else may get to the mailbox independently and use text-to-speech to read their letters privately. What helps depends on the person, the activity, and the surroundings.12

Vision loss can increase the risk of falls and make it harder to stay connected. Some people worry about giving up driving, losing touch with friends, or having less privacy when they need help. Others have used tools and routines that work for them for years. Ask what matters to the person and what already works for them.6

Ask the person. “How do you describe your vision?” Then ask, “What works for you here, and is there anything you’d like me to do differently?” Give them time to answer and let them decide what help they want.

Sources

  1. National Eye Institute, Low Vision
  2. National Institute on Aging, Aging and Your Eyes
  3. National Eye Institute, Get Your Eyes Checked to Protect Your Vision (PDF)
  4. National Eye Institute, Age-Related Macular Degeneration
  5. National Eye Institute, Diabetic Retinopathy
  6. CDC, Vision Impairment and Falls Among Older Adults and Vision Loss and Mental Health