Your eyes after 40

You're not the only who can't read your iPhone, a speedometer, or a menu. A look at six common vision problems of midlife--and what to do about them.
© Prevention // © Prevention

We must care for our eyes

At the end of a two-year intensive writing project, Stephanie Smith, 44, noticed her near vision going south. When she opened her laptop to start her next assignment, her eyesight was even worse. "I went to the optometrist and was told I needed bifocals," says Smith, an artist, writer, and teacher in Bethlehem, PA, who has been wearing glasses since she was 4. "Jeez," I thought. "Bifocals? Bury me now, please." To women like Smith, bifocals, along with gray hairs and skirted swimsuits, are visible evidence that they've crossed the threshold into middle age. "All I could think of was the old ladies in the library with glasses around their necks," Smith says. "That's just not how I see myself."

But like any other body part with lots of mileage, eyes wear out. And whether we've been happy with our glasses or contacts or never had vision problems, eye changes often feel as if they've come along overnight.

9 Solutions For Dry Eyes

-- By Sarah Mahoney, Prevention

1 of 6 A close up of a woman's eye (© CMSP/Getty Images)

Problem: You have burning, scratchy eyes

IT COULD BE: Dry eye, caused by hormonal changes (especially a drop in androgen, a sex hormone) or an autoimmune disease. One, called Sjogren's syndrome, mostly affects women over 40.

WHY IT HAPPENS: Blinking usually distributes an even flow of tears around the eyes, keeping them moist and comfy. When the eyes don't produce enough or the right kind of tears, they can itch and burn.

WHO'S AT RISK: Everyone, but especially women in midlife. (And hormone replacement therapy won't help: Women taking estrogen are actually 70% more likely to have dry eye.) Overall, 52% of American women say they deal with dry eye symptoms on a regular basis.

WHAT HELPS: Artificial tears, gels, and ointments. Doctors can also slip small silicone plugs into the drainage holes in the inner corners of the eyelids to help keep tears (artificial or your own) on your eyes longer.

Remedies include a broad array of over-the-counter drops, gels, and ointments. Anne sumners, MD, an ophthalmologist in Ridgewood, NJ, and a clinical correspondent for the American Academy of OphthalmologySumers is also a big fan of lenses formulated for patients with dry eye. "They really are comfortable," she says. Ask about scleral lenses, which cover the white of the eye and have been found to help even in severe cases.

While the evidence isn't conclusive, some research suggests that a diet rich in omega-3 fatty acids, such as those in salmon and other fish, may reduce or help prevent dry eye. "Personally, I get my omega-3s from flaxseed oil, and I think it helps," says Dr. Sumers.

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2 of 6 A man rubbing his eyes (© Stockbyte/Getty Images)

Problem: You see floaters and flashes

IT COULD BE: Totally normal. But sudden changes could signal the start of a tear in your retina, which can lead to vision loss.

WHY IT HAPPENS: Eyes are filled with a clear, gel-like substance that slowly shrinks as we age, releasing tiny clumps of cells and debris. These drifting cells and debris cast shadows inside the eye, making it seem as if things are floating into view. Floaters can look like dots, circles, lines, clouds, or cobwebs. As the gel shrinks, it can also pull on the retina, creating what appear to be lightning streaks or flashes. These flashes can appear on and off for weeks or months.

WHO'S AT RISK: While their appearance increases as we age and can happen to anyone, floaters are more common among those who are nearsighted or have had eye surgery or any inflammation or injury to the eye.

WHAT HELPS: You may need urgent care. See your eye doctor right away if you notice abrupt changes.

Why It Goes Dark When You Stand Up

3 of 6 A flash of light (© Glow Images/Getty Images)

Problem: You hold papers far away, like you're playing the trombone

IT COULD BE: Presbyopia, which sounds way better than what it really means. It's Latin for "old man eyes."

WHY IT HAPPENS: In your early 40s, the lens of the eye begins to get stiff and less able to focus. Reading type at a normal distance becomes more difficult and eventually impossible.

WHO'S AT RISK: Anyone who remembers Jimmy Carter in the White House or saw Saturday Night Fever in a theater.

WHAT HELPS: OTC reading glasses. When they no longer work, or if you already have prescription lenses, see your eye doctor.

Minor environmental changes can be helpful too. "Add more light in your house, and explore e-readers, like a Kindle, that allow you to adjust font type and size," Dr. Sumers says.

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4 of 6 A woman reading (© Paul Bradbury/Getty Images)

Problem: You have trouble driving at night

IT COULD BE: A cataract.

WHY IT HAPPENS: Proteins within the lens start to clump, clouding vision. Gradually they turn the lens a yellowish color, creating a brownish tint in vision.

WHO'S AT RISK: Aging is the main factor (and more than 50% of people over 80 have cataracts) . Family history, high blood pressure, diabetes, smoking, obesity, and extensive exposure to sunlight have also been linked.

WHAT HELPS: Wearing sunglasses and brimmed hats may help prevent the problem; once you have a cataract, prescription glasses can help you live with it. But as vision becomes more severely affected, surgery, including the insertion of an artificial lens, may be required.

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5 of 6 An elderly couple driving at night (© Johannes Kroemer/Getty Images)