Living Well with Age-Related Vision Loss

Aging with a Disability Factsheet Series

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As you get older, you may notice changes in your vision. Sometimes you may just need a different glasses prescription, or special reading glasses. Other times, vision changes can be more serious. Some age-related eye problems, as well as conditions like multiple sclerosis (MS) or muscular dystrophy (MD), can cause you to lose some of your vision over time. Vision loss can affect how you get around, read, write, or do things around the house. With the right tools and supports, you can still live independently and continue doing the things you enjoy.

How Does Our Vision Change With Aging?

Some common age-related vision changes include:

  • Need for corrective lenses - as you age, you may need corrective lenses to read, to see distances, or both.
  • Need for more light - as you age, your pupils may lose their ability to change size quickly when lighting changes. you may need more light than you used to for reading, or have trouble driving at night. You may also be bothered by glare or bright lights.
  • Cataracts - These are cloudy formations in the lens of your eye that can make your vision blurry and can usually be treated with surgery.
  • Loss of peripheral (side) vision - You may notice that your visual field narrows, or that you need to turn your head more while driving.
  • Color vision changes - You may have trouble distinguishing shades of color, such as different shades of blue.
  • Dry eyes - You produce fewer tears as you get older. You may notice a gritty or burning sensation in your eye. This problem is easily managed with artificial tears or other drops.

What Conditions can Cause Vision Loss?

Some long-term conditions, like MS and MD can lead to vision loss. In addition, some eye conditions are more common in older people. These include:

  • Glaucoma - This occurs when fluid stops draining properly from the back of the eye. Pressure can build up, damaging your optic nerve and causing loss of peripheral (side) vision.
  • Age-related macular degeneration (AMD) - This can cause loss of central vision due to damage to the macula, the spot in the center of the retina.
  • Diabetic retinopathy - Diabetes can cause blood vessels in the retina to break down over time, leading to vision loss.

Living Well With Vision Loss

It is wise to get eye exams at least once every two years, starting when you turn 40. These exams can help spot vision problems early.

If you have permanent vision loss, you may wonder how you will continue to care for yourself or participate in your favorite activities. These worries are natural, especially at the beginning. However, with the right tools and community support, you can still remain active and self-sufficient.

Getting Around

You may need to stop driving if you have significant vision loss. Resources you can use for transportation include:

  • Public transit and paratransit - Public transportation may be an option and all public systems have scheduled information in audio format and when appropriate provide point to point paratransit.
  • Using drivers - You may wish to pay a driver or get rides from a family member or friend, or member of your church or community. You may also consider taxi or ride sharing services.
  • Walking - A white cane is a simple tool you can use to navigate safely with limited vision. The cane is held on the ground in front of you to detect steps or obstacles, protecting you from tripping or falling. With some training, you can use the cane while walking, along with a support cane, or while using a power wheelchair. Even if you have some vision, a white can can help you avoid obstacles on the ground so you can look up while walking or rolling. An orientation and mobility (O&M) instructor can provide you with a white cane and teach you how to use it. You can find an agency in your state with O&M instructors here:
    http://www.visionaware.org/directory/aspx

Reading and Writing

There are a variety of tools you can use to read and write with limited or no sight. These include:

  • Magnifiers - These are handheld devices that make print larger.
  • Closed-circuit television (CCTV) - This device consists of a movable platform that holds the reading material and is connected to a screen, like a TV displaying an enlarged image.
  • Writing guides - These guides help you stay inside the lines when you are writing a check or signing a form.
  • Audiobooks - You may qualify for the National Library Service's talking book program. This program offers recorded books and magazines at no cost, which you can receive through the mail or online. You can learn more and apply for these services here:
    https://www.loc.gov/nls/

    You may also check if your state library system offers audiobooks. Another service called Newsline provides audio recordings of newspapers and magazines for free:
    www.nfb.org/newsline/

  • Computer software - Software is available that can enlarge text on the computer screen. Other computer programs, called screen readers, will read the text aloud. Some people prefer to use a combination of screen magnification and screen reading on their computer or mobile device. Some mobile devices, like iPhones and iPads, have screen-magnification and screen-reading software built in. Most public libraries also have computers which are accessible to people with disabilities.
  • Braille - Braille is a tactile alphabet system that uses raised (embossed) dots to represent letters. Although learning braille can be challenging at first, some older adults find it useful for notetaking, labeling, or recreational reading without eye fatigue. your local center for the blind may offer braille classes, or you can take distance classes from the Hadley Institute for the Blind.

Around the House

If you have vision loss, you may still be able to live independently at home using a few simple tools. Many inexpensive tools for labeling and organizing your home are available from the resources listed below. Possible changes you might make to accommodate vision loss include:

  • Lighting and contrast - If you have some sight, you may find that you can see more clearly when using brighter lightbulbs in  your home. Natural sunlight can also be helpful. You may also add bright or contrasting colors to items in your home to make them easier to see. For example, you might place a strip of yellow tape at the top of the staircase.
  • Decluttering - Eliminating clutter will make it easier to find things you need. To stay safe and avoid tripping, keep walkways clear, clutter off the floor (including area rugs), and cabinets and drawers shut. You may need to move more slowly through your home at first, but after a while, you will likely build a "mental map" of your home so you can move about confidently without relying on vision.
  • Labeling - Some people find it helpful to label things around the house by writing the label in black ink on a white index card and attaching the card to the item. You may also use colored permanent markers to label items, create raised markings or use rubber bands or safety pins to distinguish food or medicine containers that look the same. High-contrast or tactile marks can also be placed on appliances, such as ovens and washing machines, so you can continue to use them independently.
  • Cooking and cleaning - It is possible to cook and keep house with vision loss, using your other senses. For example, when water boils, it makes a distinctive sound and the pot handles vibrate. Meat has a distinct smell and texture when it is done cooking. You can identify dirty countertops or dusty furniture by touch, and clean mirrors and windows in a grid pattern to be sure you cover the whole area. Some social services may offer housekeeping help as well.

Find Support From Other Seniors Adjusting to Vision Loss

Additional Resources

You may be able to receive low-vision tools, such as magnifiers, white canes, or appliance markers, from your local agency for the blind and visually impaired. Your state may also have an older blind independent living program with specific resources for older adults.

Low vision tools are also available for purchase from the following websites:

For additional information about vision loss causes and treatments:

Other resources for living with vision loss:

References

American Optometric Association, “Adult Vision: 41 to 60 years of age,” https://www.aoa.org/patients-and-public/good-vision-throughout-life/adult-vision-19-to-40-years-of-age/adult-vision-41-to-60-years-of-age?sso=y

Heiting, G. “How your Vision Changes as You Age,” All About Vision, http://www.allaboutvision.com/over60/vision-changes.htm

VisionAware, “For Seniors with Vision Loss,” American Foundation for the Blind, http://www.visionaware.org/info/for-seniors/1

National Federation of the Blind, “Blindness and Low Vision: Fact Sheet,” https://nfb.org/fact-sheet-blindness-and-low-vision

Authorship

"Tips for Healthy Eating & Healthy Aging" was developed by Arielle Silverman, PhD, and published by the University of Washington Aging RRTC. Content is based on research evidence and/or professional consensus.

Disclaimer

This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

Suggested attribution

University of Washington. (2017). Living well with age-related vision loss [Factsheet]. Aging Well with a Physical Disability Factsheet Series. Hleathy Aging & Physical Disability RRTC. http://agerrtc.washington.edu