Self-Help Tips From Dr Sarah Brewer

Your Eyes After 40: What’s Normal And What’s Not

eyes after 40

Even if you’ve had perfect vision all your life, when you hit 40 there are a number of things that can happen to your eyes – including health conditions such as glaucoma, cataracts and macular degeneration. Nevertheless, there are several ways you can determine whether your eyes are healthy post 40 or giving warning signs of something more serious. Check out the below for what to expect from your eyes after 40 – and read between the blurred lines to find out what’s normal and what’s not!

Dry eyes

While Dry Eye is a common condition, the amount of people who experience Dry Eye after 40 shoots up and occurs in approximately 30% of the British population. Dry eyes occur when your tear production is unstable, which can cause a whole host of irritable symptoms including itchy eyes, swelling, redness, burning sensation, light sensitive, blurry vision and a gritty feeling in the eyes.

Furthermore, dry eyes can cause watery eyes, which might come as a surprise! Despite the discomfort, these symptoms are all normal and can be managed at home with lubricating eye drops. Abnormalities arise when dry eyes are not cared for and under-lubricated. When the surface of the eye is left untreated, together with inflammation of the lid margin the eyes are left vulnerable to scratches and abrasions and therefore more susceptible to infections. It is therefore essential to keep up your eye hygiene by regularly cleaning your lids and reducing the bio load as well as maintaining regular use of the lubricating drops which should become an essential part of your daily regimen.

Reduced reading vision

If you find yourself increasingly needing to squint or push your phone further away from you in order to read text and emails, then do not fear, you’re just like the rest of us! Post 40, the eyes lens starts to lose its ability to focus on close-up objects. The need for reading glasses post 40 essentially replaces the lens function of the eye. The change is a gradual one with the prescription increasing over the next few years.

As the years pile on, expect to see changes in clarity and an increase in reading difficulty from small print on the back of medicine bottles to reasonable size print on laptops and desktops. It is all part of the eyes aging process. In addition, as it’s almost inevitable that at some point during your day you will most likely use some kind of electronic screen, it is important that we make a conscious effort to take regular breaks in between to avoid eye strain.

Vision when reading can also worsen as a consequence of a reduced blink rate when focusing on near visual tasks ie computer screens and books. A reduced blink rate allows for the tear film to evaporate off the surface of the eyes at a quicker rate than normal. Regular breaks away from screens will also help in maintaining good muscle functionality. However, if you’re unable to escape the ensnares of modern technology and limit screen time, then at least make sure your vision is at its best by wearing your accurate reading prescription.


Risk factors for the development of glaucoma include age- over 40 and a family history. The more common ‘Open’ type of glaucoma is difficult to detect in its early stages as symptoms are virtually non-existent to the individual, therefore it is important to get regular eye examinations as there are certain specific tests that can be carried out to diagnose its presence. Glaucoma is damage to the optic nerve from irregularities in fluid drainage that results in progressive field of vision loss. Pressure readings need to be monitored as there is a direct correlation between high readings and glaucoma. Sudden onset ‘Closed Angle’ glaucoma is easily recognisable with its sudden emergence, associated with light haloes, pain and nausea.

Management of glaucoma is commonly in the way of long-term treatment using drops to control eye pressure. In some cases surgical interventions are also sought. However, beware of the fact that glaucoma is irreversible, so once your vision begins to fade, there is no going back! Ultimately well established glaucoma leads to a tunnel vision affect. Unfortunately, it is difficult to self-diagnose glaucoma related symptoms and so all the more vital to make sure you pop to the optometrist for regular check-ups. In particular look out for a practice that can offer an OCT scan; at an extra cost you can pick up on early glaucomatous changes and possibly start treatment before any substantial damage occurs.


UV exposure from the sun’s rays contribute to cataract formation, eye cancers and skin tags on the whites of the eyes. It’s worth noting more aggressive forms of cataract are most prevalent in hotter countries. Sunglasses are essential in protecting your eyes from the sun’s harmful UV rays, however, the most common factor that contributes to the development of a cataract is age. It is estimated that 30% of those over the age of 65 have a visually impairing cataract in one or both eyes.

The common symptoms of a developing cataract include glare issues and visual difficulties, especially when reading. The not-so-normal is when your cataract matures enough that it affects your vision and has become a hinderance on your lifestyle. At this point vision will be checked by an optometrist and a referral for surgery obtained (by an optometrist) to remove and replace the aged lens.

Macular degeneration

Whether you have clear vision or not, kicking bad habits such as smoking, poor diet and high UV exposure should be an essential part of your healthy lifestyle. All these factors can contribute to macular degeneration, as well as a factor that can’t be controlled – age.

Your macula region, situated at the back of the eye, functions to maintain that crystal-clear vision. An unhealthy macula is not able to pick up on visual stimuli and light information in the same way.

There are 2 types of macular degeneration:

Dry macular degeneration is induced by poor metabolism of waste at the macula leading to deposits in this location. It is considered a progressive condition and currently there is no effective treatment options for dry macular degeneration. Management of progression is the only option and that can be done through diet, dark leafy greens in particular. In some cases it may be a better to opt for supplements that help to maintain macula health. As already mentioned cessation of smoking is essential if you have been diagnosed with macular degeneration and you want to prevent rapid deterioration.

Recent studies suggest that by performing light exercise 3 or 4 times a week, you can reduce your chances of developing macular degeneration by 70%. Grab your trainers and get moving!

Wet Macular degeneration is the more severe form of the condition and more often than not is preceded by the dry form. This type of macular degeneration involves bleeding at the macula region which causes a sudden onset of visual impairment, rather than a gradual one. A check you can perform at home for each eye is to make sure straight lines are appearing straight and not wonky; use a door or picture frame. If treatment is not administered immediately there will be sight threatening consequences.

Sona Thakerar is an award-winning optometrist, McOptom and Sports Vision Practitioner and founder of Aston & Woods, an optician that combines a premium approach to clinical eyecare, alongside a high-end eyewear offering. Visit astonandwoods for more information.

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