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The Crucial Years for Protecting Your Eye Health


Aging eyes bring more than crow's feet and wrinkles. It's what you can't see—the health of your eyes—that is the bigger concern, doctors say.


As people get older, "The lens of your eye gradually loses the ability to focus in and out the way it used to," said Julia Haller, ophthalmologist-in-chief at Wills Eye Institute in Philadelphia. "Some people refuse to wear reading glasses…and really fight it. They may hold out a little longer but eventually we all succumb to the inevitable."

While we can't win against Mother Nature, some strategies can minimize the damage. Avoid self-prescribing with, say, off-the-shelf reading glasses sold at drugstores, says Gary Etting, an optometrist who specializes in vision therapy in Los Angeles. People often select glasses that appear to make things clearest, he said. But this may be a stronger prescription than they need, which can encourage their loss of focus to go faster.

There are different recommendations for eye health care at different ages. ENLARGE
There are different recommendations for eye health care at different ages. Getty Images, Corbis

Turning Points

A look at what to do at what age for your eyes.

INFANTS: Eye exam at birth and again between 6 and 12 months.

PRESCHOOL: Get a visual acuity test between ages 3 and 3½. If the test shows misaligned eyes, lazy eye or refractive errors, such as nearsightedness, farsightedness or astigmatism, the child should see an eye doctor. It's important to treat these problems before age 7, when convergence, the ability of both eyes to focus on an object simultaneously, becomes more fully developed.

SCHOOL AGE: Eye screening should be done upon entering school and whenever a problem is suspected. Nearsightedness is the most common refractive error in this age group and can be corrected with eyeglasses.

TEENAGERS/20s: Vision development is complete by the time people reach their early 20s. It remains steady for several decades, and prescription lenses change only slightly or not at all. If you wear contact lenses, see your eye specialist yearly to check the prescription. Protect eyes while playing sports.

ADULTS UNDER 40: Since vision changes little, this is a good time for refractive or LASIK surgery. Get a complete eye exam once in the 20s and twice in 30s, but more often if you have family history of eye disease or wear contact lenses. Women may have vision fluctuations during pregnancy.

ADULTS 40 to 60: This is a time when symptoms of many eye diseases may begin to emerge. A comprehensive eye exam is recommended at age 40 to check for early signs of age-related macular degeneration and other problems. Most people will get presbyopia, an inability to focus on close-up objects, starting in their 40s, when the eye's lens gets less flexible.

65 AND UP: By age 65, 1 in 3 Americans will have a vision-impairing eye disease such as glaucoma and cataracts.

Source: American Academy of Ophthalmology

Also, glasses you need for reading may be different than ones you need when using a computer, he said. "So people who wear their reading glasses on the computer can also be encouraging their eyes to weaken faster."

Scientists have been studying ways to prevent vision problems in young people, which also might help protect eyes as they age. Two studies published in the May issue of Ophthalmology, the journal of the American Academy of Ophthalmology, suggest that spending time outdoors may help minimize or prevent nearsightedness, or myopia, in children. Myopia can be corrected with glasses or contact lenses. But it can also be a precursor to severe myopia in adulthood, which is linked to the later development of eye disorders such as glaucoma and retinal detachment.

One of the studies, involving 571 students in Taiwan, compared changes in eyesight over a year between a group of children that had outside recess and another that didn't require going outdoors. The other study, in Denmark, compared detailed eye measurements of 235 nearsighted children taken during periods of longer and shorter days.

Some researchers believe the effect could be related to oxygen exposure or the amount of light exposure causing the pupil to constrict. It could also result from children focusing at far distances for extended periods. "I think the conclusion we're most comfortable drawing is that the jury is still out on that," said Rachel Bishop, chief of consult services of the National Eye Institute, who wasn't affiliated with the studies. Other possible reasons, such as greater physical activity when outside or less time spent looking at screens indoors, seem less likely, she said.

Tips for All Ages

  • People who wear contacts should see an eye specialist yearly.
  • Get more frequent eye exams if you are diabetic or prediabetic.
  • Regular exercise promotes blood circulation and oxygen intake important for eye health.
  • Wear sunglasses—look for eyesun protection factor between 25 and 50—when outside in the sun.
  • Rest up: During sleep, eyes are continuously lubricated and clear out irritants such as dust, allergens and smoke that accumulate during the day

Being outdoors also presents risks. Ultraviolet-light exposure potentially causes melanoma and contributes to the development of cataracts. Damaging rays from the sun are cumulative, so experts recommend wearing protective sunglasses and hats starting at a young age. Howard Purcell, an optometrist and senior vice president of customer development at Dallas-based Essilor ESLOY -1.17 % of America, a manufacturer of optical lenses, says sunglasses should block UV light. Look for sunglasses with an eye-sun protection factor (E-SPF) between 25 and 50, he said.

Many eye-vitamin formulations currently on the market are based on research conducted by the National Institutes of Health in a project called Age-Related Eye Disease Study, or AREDS. The first phase of the clinical trial, completed in 2001, found that a specific combination of vitamins C and E, along with beta-carotene and zinc, reduced the risk of age-related macular degeneration by as much as 25%. AMD is one of the leading causes of blindness in older people.

In the second phase of AREDS, to be published in this month's Journal of the American Medical Association, researchers identified additional nutritional supplements—the carotenoids lutein and zeaxanthin, found in foods such as spinach, kale and broccoli—that further reduce the risk and progression of AMD, especially when a person's diet is already low in these nutrients. The study found a similar beneficial effect for people with cataracts who don't normally get a lot of lutein and zeaxanthin in their diet.

The latest part of the study, which involved about 4,000 participants, also looked at the effect of replacing beta-carotene in the supplements formulation with lutein and zeaxanthin because of studies that found former smokers who take beta-carotene have a higher incidence of lung cancer. Researchers found a 20% improvement in progression to advanced AMD with the replacement, said Emily Chew, deputy director of epidemiology and clinical application for the National Eye Institute, a branch of the National Institutes of Health.

Dr. Chew said the AREDS study researchers recommend replacing the beta-carotene in supplements with lutein and zeaxanthin. Benefits from the supplements have been found only in people who are at high risk for advanced AMD or already have it in one eye.

Some eye experts say omega-3s, found commonly in fish and nuts, appear to play a protective role in eye health with both the retina and cornea. This includes help with the dry eyes that many people, especially women, experience in their 50s. Anne Sumers, a spokeswoman for the American Academy of Ophthalmology and a practicing ophthalmologist in Ridgewood, N.J., said consuming flax seed, either as a pill or sprinkled on food, can help treat dry eyes.

Too much time staring at electronic screens has given rise to another problem: computer-vision syndrome. To relax the eyes, some experts recommend that for every 20 minutes spent staring at a computer, people should take a break for 20 seconds and look at least 20 feet away, ideally out a window.

The decision to go to an optometrist versus an ophthalmologist is a personal one. Ophthalmologists are medical doctors who spend most of their time managing eye diseases and performing surgeries rather than prescribing eyeglasses. Optometrists' main focus is prescribing eyeglasses, as well as screening for eye diseases. If getting an eye checkup, be sure—particularly if you're 40 and over—that the optometrist does a comprehensive dilated eye exam to observe the pupil opened up in order to see the retina.

Write to Sumathi Reddy at

Correy Smith
Correy Smith user

Oh wow Sumathi, what an interesting fact to know that people who get older tend to get eye problems. You know, this is something that my wife and I have also been experiencing with lately. We both did our eye exam so hopefully our doctor would let us know what is wrong with our eyes. 

Casey Jones
Casey Jones profilePrivateuser

Great advice on making sure you wear sunglasses.  Thanks for sharing these tips on how to keep our eyes safe.  I didn't realize you should see an optometrist yearly if you wear contacts. 

rachel benson
rachel benson profilePrivateuser

I didn't know that purchasing glasses from the drugstore could actually be bad for your eye health.  My mom regularly gets reading glasses from the drugstore by choosing the pair that helps her see the best.  It seems like it would be better for her to see an eye doctor and make sure she is getting the correct prescription for her eyes.  I would hate for her to be causing more damage to her eyes by using an incorrect pair of glasses.

Ted Smith
Ted Smith profilePrivateuser

I agree that the bigger concern with eye health is what you can't see. Although your eye may look healthy, it may have something wrong with it. That is why it is important to get an eye exam. That way the optometrist can help you detect anything wrong in its earliest stages so that it can be fixed.

James Lisbon
James Lisbon profilePrivateuser

I liked how the article mentions that those with sensitive or damaged eyes should pay special attention to their eye health.  You only get one set, so it might be important to make sure that they are taken care of.   The last thing someone would probably want is to have issues with their eyes. 

James Lisbon
James Lisbon profilePrivateuser

The part that stuck out to me was when you mentioned how computer screens are causing more problems with eyes.   It would seem that using a computer for a little bit each day is probably not bad, but overusing a computer might lead to problems.   Eyes seem like complicated things, so it is probably a wise thing to get them checked periodically to avoid potential problems. 

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