Common vision problems

Slide show: Age-related vision problems

Previous Next 1 of 8 Cataracts and other age-related vision problems As you age, so do your eyes. You might find that you have difficulty reading small print or that you need brighter lighting at your desk. Eye conditions that could lead to more-serious vision problems also become more common with age.
Consider cataracts. A cataract is a clouding of the normally clear lens of the eye. Most cataracts develop slowly and don't disturb eyesight early on. At first, stronger lighting and eyeglasses can help you deal with cataracts. Eventually cataracts can interfere with your vision and, left untreated, cause blindness. However, even with advanced cataracts, vision can usually be restored with surgery.

• Cataracts and other age-related vision problems
• Vision with cataracts
• Glaucoma
• Vision with glaucoma
• Macular degeneration
• Vision with macular degeneration
• Eye floaters
• Vision with eye floaters

 

The most common vision problems are refractive errors, more commonly known as nearsightedness, farsightedness, astigmatism and presbyopia. Refractive errors occur when the shape of the eye prevents light from focusing directly on the retina. The length of the eyeball (either longer or shorter), changes in the shape of the cornea, or aging of the lens can cause refractive errors. Most people have one or more of these conditions.


The cornea and lens bend (refract) incoming light rays so they focus precisely on the retina at the back of the eye.

What is refraction?

Refraction is the bending of light as it passes through one object to another. Vision occurs when light rays are bent (refracted) as they pass through the cornea and the lens. The light is then focused on the retina. The retina converts the light-rays into messages that are sent through the optic nerve to the brain. The brain interprets these messages into the images we see.

What are the different types of refractive errors?

The most common types of refractive errors are nearsightedness, farsightedness, astigmatism and presbyopia.
Nearsightedness (also called myopia) is a condition where objects up close appear clearly, while objects far away appear blurry. With nearsightedness, light comes to focus in front of the retina instead of on the retina. Learn more about nearsightedness.
Farsightedness (also called hyperopia) is a common type of refractive error where distant objects may be seen more clearly than objects that are near. However, people experience farsightedness differently. Some people may not notice any problems with their vision, especially when they are young. For people with significant farsightedness, vision can be blurry for objects at any distance, near or far. Learn more about farsightedness.
Astigmatism is a condition in which the eye does not focus light evenly onto the retina, the light-sensitive tissue at the back of the eye. This can cause images to appear blurry and stretched out. Learn more about astigmatism.
Presbyopia is an age-related condition in which the ability to focus up close becomes more difficult. As the eye ages, the lens can no longer change shape enough to allow the eye to focus close objects clearly. Learn more about presbyopia.

Who is at risk for refractive errors?

Presbyopia affects most adults over age 35. Other refractive errors can affect both children and adults. Individuals that have parents with certain refractive errors may be more likely to get one or more refractive errors.

What are the signs and symptoms of refractive errors?

Blurred vision is the most common symptom of refractive errors. Other symptoms may include:

• Double vision
• Haziness
• Glare or halos around bright lights
• Squinting
• Headaches
• Eye strain

How are refractive errors diagnosed?

An eye care professional can diagnose refractive errors during a comprehensive dilated eye examination. People with a refractive error often visit their eye care professional with complaints of visual discomfort or blurred vision. However, some people don’t know they aren’t seeing as clearly as they could.

How are refractive errors corrected?

Refractive errors can be corrected with eyeglasses, contact lenses, or surgery.

Types of Vision Problems

Most Common Adult Vision Problems

• Blurred vision (called refractive errors)
• Age-related macular degeneration
• Glaucoma
• Cataract
• Diabetic retinopathy

Most Common Childhood Vision Problems

• Blurred vision (called refractive errors)
• Crossed eyes (called strabismus)
• Lazy eye (called amblyopia)

Blurred vision (refractive errors)

• Nearsightedness (called myopia) is when you can see clearly up close but blurry in the distance.
• Farsightedness (called hyperopia) is when you can see clearly in the distance but blurry up close.
• If you are older than 40 and have trouble reading small print or focusing up close, this is usually due to a condition called presbyopia. One in every three people 40 years or older in the U.S. will need glasses to read smaller print.
• Astigmatism is another condition that causes blurred vision, but it is because of the shape of the cornea.

These conditions affect the shape of the eye and, in turn, how the eye sees.  They can be corrected by eyeglasses, contact lenses, and in some cases surgery.

What are the risk factors for developing refractive errors?

• Family history – parent(s) who have one or more refractive errors
• Advancing age - presbyopia affects most adults over age 35

Crossed Eyes (strabismus)

Strabismus occurs when the eyes do not line up or they are crossed. One eye, however, usually remains straight at any given time. Common forms of strabismus include:

• Esotropia – one or both eyes turn inward toward the nose
• Exotropia – one or both eyes turn out; also called wall-eyed 
• Hypertropia – one or both eyes turn up
• Hypotropia – one or both eyes turn down

If detected early in life, strabismus can be treated and even reversed.
If left untreated strabismus can cause amblyopia.

What are the risk factors for strabismus?

• Family history of strabismus
• Having a significant amount of uncorrected farsightedness (hyperopia)
• Disabilities such as Down syndrome and cerebral palsy
• Stroke or head injury

Lazy Eye (amblyopia)

Amblyopia — often called lazy eye — is a problem that is common in children.
Amblyopia is a result of the brain and the eyes not working together. The brain ignores visual information from one eye, which causes problems with vision development.
Treatment for amblyopia works well if the condition is found early. If untreated, amblyopia causes permanent vision loss.

What are the risk factors for amblyopia?

• Premature birth
• Low birth weight
• Retinopathy of prematurity diagnosis
• Cerebral palsy diagnosis
• Intellectual disability diagnosis
• Family history of certain eye conditions
• Maternal smoking, drug or alcohol use
• Surgery on eye muscles for esotropia (eyes turn in toward nose)

Diabetic Retinopathy (DR)

All people with diabetes, both type 1 and type 2, are at risk for DR.  It is caused by damage to blood vessels in the back of the eye (retina).  The longer someone has diabetes, the more likely he or she will get DR.
People with this condition may not notice any changes to their vision until the damage to the eyes is severe.  This is why it is so important for people with diabetes to have a comprehensive eye exam every year.
There are four stages of DR.  During the first three stages of DR, treatment is usually not needed.  To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.  For the fourth stage of DR, called proliferative retinopathy, there are treatments that reduce vision loss, but are not a cure for DR.
Warning signs of diabetic retinopathy includes blurred vision, gradual vision loss, floaters, shadows or missing areas of vision, and difficulty seeing at nighttime.
People with diabetes are at greater risk for cataract and glaucoma as well.

What are the risk factors for diabetic retinopathy?

• Type 1 or 2 diabetes
• Poor control of blood sugar level
• High blood pressure
• High cholesterol
• Pregnancy
• Being African American or Hispanic
• Smoking

Normal vision	Vision with diabetic retinopathy

Photos courtesy of the National Eye Institute, National Institutes of Health

Age-Related Macular Degeneration (AMD)

AMD is a disease that blurs the sharp, central vision needed to see straight-ahead.  It affects the part of the eye called the macula that is found in the center of the retina. The macula lets a person see fine detail and is needed for things like reading and driving.
The more common dry form of AMD can be treated in the early stages to delay vision loss and possibly prevent the disease from progressing to the advanced stage. Taking certain vitamins and minerals may reduce the risk of developing advanced AMD.
The less common wet form of AMD may respond to treatment, if diagnosed and treated early.

What are the risk factors for AMD?

• Type 1 or 2 diabetes
• Poor control of blood sugar level
• High blood pressure
• High cholesterol
• Pregnancy
• Being African American or Hispanic
• Smoking

Normal vision	Vision with AMD

Photos courtesy of the National Eye Institute, National Institutes of Health

Glaucoma

There are different types of glaucoma, but all of them cause vision loss by damaging the optic nerve.  Glaucoma is called the “sneak thief of sight” because people don’t usually notice a problem until some vision is lost.
The most common type of glaucoma happens because of slowly increasing fluid pressure inside the eyes.
Vision loss from glaucoma cannot be corrected.  But if it is found early, vision loss can be slowed or stopped. A comprehensive eye exam is important so glaucoma can be found early.

What are the risk factors for glaucoma?  Anyone can have glaucoma, but some people are at higher risk of developing the disease.

• African Americans over age 40
• Everyone over age 60, especially Mexican Americans
• Those with a family history of glaucoma

Normal vision	Vision with glaucoma

Photos courtesy of the National Eye Institute, National Institutes of Health

Cataract

A cataract is a clouding of the lens of the eye.  It often leads to poor vision at night, especially while driving, due to glare from bright lights.
Cataracts are most common in older people, but can also occur in young adults and children.
Cataract treatment is very successful and widely available.

What are the risk factors for cataracts?

• Age, cataracts are more common after age 60
• Certain diseases such as diabetes
• Smoking and alcohol use
• Too much exposure to sunlight

Normal vision	Vision with cataract

Photos courtesy of the National Eye Institute, National Institutes of Health

Types of Eye Problems

Eye Health

The eyes are complex organs, with many parts that must work together to produce clear vision. Here is a basic overview of eye anatomy.
Find an ophthalmologist near you »

Cornea

Cornea

The cornea is a layer of clear tissue at the front of the eye that helps focus light.

Tear Ducts

Tear Ducts

Located at the corner of each eye, tear ducts drain tears secreted by the lacrimal gland to the surface of the eye. Tears keep the cornea lubricated and clear of debris.

Iris/Pupil

Iris and Pupil

The colored part of the eye is the iris. It is a muscle that controls the pupil, the opening in the middle of the eye that controls the amount of light coming in.

Lens/Retina

Lens and Retina

The lens is behind the pupil and focuses light onto the retina, the light-sensitive cells on the back of the eyeball. Acting much like the film in a camera, the retina converts images into electrical signals that are sent to the optic nerve.

Optic Nerve

Optic Nerve

The optic nerve is a thick bundle of nerve fibers attached to the back of the eye that transmits visual information from the retina to the brain.

Complications

When Things Go Wrong

Problems or malfunctions in any of eye parts cause many common eye conditions.

Refractive Errors

When light is not focused properly, it causes blurry vision. Refractive errors can usually be corrected with glasses, contacts, or surgery. They include:

• myopia (nearsightedness), which is when far-away objects look blurry
• hyperopia (farsightedness), which is when close-up objects look blurry
• astigmatism, which can result in blurry vision because the cornea is not perfectly shaped to direct light into the eye
• presbyopia, which is farsightedness caused by the loss of elasticity of the eye’s lens due to aging

Glaucoma

Glaucoma is increased pressure of the fluid inside the eye, which can cause optic nerve damage. Glaucoma is a common cause of blindness, particularly in diabetic patients.

Cataract

Cataract is a clouding of the lens, causing blurry or color-tinted vision. People with cataracts often report “haloes” surrounding objects that they are looking at, particularly at night. It is most common in older people, and cataracts can be removed by surgery that replaces the lens with an artificial lens.

Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is gradual damage to the cells of the macula. This condition is most common in people over 60 years old. It causes blurry vision, especially in the center of the field of view. According to the Foundation Fighting Blindness, AMD is the leading cause of blindness among people over age 55 in the United States.

Amblyopia

Commonly referred to a "lazy eye," amblyopia occurs when one eye has worse vision than the other, and the brain begins to favor the better eye. This will occur if one of the eyes is blocked from producing clear images during the critical years from ages 0 to 6. One eye may be inhibited by problems such as a lid droop, tumor, or crossed eyes (strabismus) that are not fixed when a child is young. It is crucial to have young children evaluated by an eye doctor in order to ensure that subtle signs of amblyopia are not present.

Diabetic Retinopathy

Diabetic retinopathy is damage to the blood vessels of the retina caused by diabetes. It causes blurred or dark spots in the field of vision and will eventually lead to blindness. The best way to avoid these vision problems is to keep your blood sugars under control and see your eye doctor every year for a dilated eye exam.

Retinal Detachment or Tear

A tear in or detachment of the retina causes blurry vision or partial loss of vision.

Dry Eye Syndrome

Dry eye is a lack of proper tears, usually due to a problem with the tear ducts or eyelids, or a problem with certain medications. This condition can cause pain and blurry vision.

Eye Conditions: Macular Degeneration. (n.d.). Foundation Fighting Blindness. Retrieved November 5, 20