Vision changes occur as you get older, but these changes don't have to affect your lifestyle. Knowing what to expect and when to seek professional care can help you safeguard your vision. As you reach your 60s and beyond, you need to be aware of the warning signs of age-related eye health problems that could cause vision loss.

Many eye diseases have no early symptoms. They may develop painlessly, and you may not notice the changes to your vision until the condition is quite advanced. Wise lifestyle choices, regular eye exams and early detection of disease can significantly improve your chances of maintaining good eye health and vision as you age.

You may not realize that health problems affecting other parts of your body can affect your vision as well. People with diabetes or hypertension (high blood pressure), or who are taking medications that have eye-related side effects, are at greatest risk for developing vision problems. Regular eye exams are even more important as you reach your senior years. The American Optometric Association recommends annual eye examinations for everyone over age 60. See your doctor of optometry immediately if you notice any changes in your vision.

Age-related eye and vision changes and problems

In the years after you turn 60, a number of eye diseases may develop that can change your vision permanently. The earlier these problems are detected and treated, the more likely you can retain good vision. The following are some vision disorders to be aware of:

• Age-related macular degeneration (AMD) is an eye disease that affects the macula (the center of the light-sensitive retina at the back of the eye) and causes central vision loss. Although small, the macula is the part of the retina that allows us to see fine detail and colors. Activities like reading, driving, watching TV and recognizing faces all require good central vision provided by the macula. While macular degeneration decreases central vision, peripheral or side vision remains unaffected. 
• Cataracts are cloudy or opaque areas in the normally clear lens of the eye. Depending upon their size and location, they can interfere with normal vision. Usually, cataracts develop in both eyes, but one may be worse than the other. Cataracts can cause blurry vision, decreased contrast sensitivity, decreased ability to see under low light level conditions (such as when driving at night), dulling of colors and increased sensitivity to glare.
• Diabetic retinopathy is a condition that occurs in people with diabetes. It is the result of progressive damage to the tiny blood vessels that nourish the retina. These damaged blood vessels leak blood and other fluids that cause retinal tissue to swell and cloud vision. The condition usually affects both eyes. The longer a person has diabetes, the greater the risk of developing diabetic retinopathy. In addition, the instability of a person's glucose measurements over time can impact the development and/or severity of the condition. At its most severe, diabetic retinopathy can cause blindness.
• Dry eye  is a condition in which a person produces too few or poor-quality tears. Tears maintain the health of the front surface of the eye and provide clear vision. Dry eye is a common and often chronic problem, particularly in older adults.
• Glaucoma is a group of eye diseases characterized by damage to the optic nerve resulting in loss of peripheral (side) vision. It often affects both eyes, typically one eye before the other. If left untreated, glaucoma can lead to total blindness. People with a family history of glaucoma, African Americans and older adults have a higher risk of developing the disease. Glaucoma is often painless and can have no obvious symptoms until there is a significant loss of side vision.
• Retinal detachment is a tearing or separation of the retina from the underlying tissue. Retinal detachment most often occurs spontaneously due to changes to the gel-like vitreous fluid that fills the back of the eye. Other causes include trauma to the eye or head, health problems like advanced diabetes, and inflammatory eye disorders. If not treated promptly, it can cause permanent vision loss.

Driving safely after 60

If you are 60 or older, driving a car may be increasingly difficult. Age-related vision changes and eye diseases can negatively affect your driving abilities, even before you are aware of symptoms. Some age-related vision changes that commonly affect seniors' driving are:

• Not being able to see road signs as clearly.
• Difficulty seeing objects up close, like the car instrument panel or road maps.
• Difficulty judging distances and speed.
• Changes in color perception.
• Problems seeing in low light or at night.
• Difficulty adapting to bright sunlight or glare from headlights.
• Experiencing a loss of side vision.

These tips can help you stay safe when driving, especially at night:

• Use extra caution at intersections. Many collisions involving older drivers occur at intersections due to a failure to yield, especially when taking a left turn. Look carefully in both directions before proceeding into an intersection. Turn your head frequently when driving to compensate for any decreased peripheral vision.
• Reduce your speed and limit yourself to daytime driving. If you are having trouble seeing at night or your eyes have difficulty recovering from the glare of oncoming headlights, slow down and avoid driving at night.
• Avoid wearing eyeglasses and sunglasses with wide frames or temples. Glasses with wide temples (side arms) may restrict your side vision.
• Take a driving course for seniors. Participate in a program for older drivers in your community, such as those offered by the American Association of Retired Persons (AARP). This can help you learn how to compensate for the physical changes that may affect your driving ability, and may even lower your insurance premium.
• Have an annual eye examination. Yearly eye exams can ensure your eyeglass or contact lens prescription is up to date. It can also ensure early detection and treatment of any developing eye health problem.

Dealing with vision loss

Unfortunately, some people over 60 lose sight beyond the normal, age-related vision changes. Macular degeneration, glaucoma, and diabetic retinopathy are among the eye health conditions that can lead to permanent vision loss in varying degrees and forms.

Visual acuity alone is not a good predictor of a person's degree of visual difficulty. Someone with relatively good acuity (e.g., 20/40) can have difficulty functioning, while someone with worse acuity (e.g., 20/100) might not experience any significant functional problems. Other visual factors, such as poor depth perception, limited side vision, extreme sensitivity to lights and glare, and reduced color perception, can also limit a person's ability to do everyday tasks.

Low-vision rehabilitative services can provide people with the help and resources they need to regain their independence. These services can teach people with low vision a variety of techniques that allow them to perform daily activities with their remaining vision.

A doctor of optometry can help plan a rehabilitation program so that you can live an independent life within your condition's limitations. A wide variety of rehabilitation options are available to help people with low vision live and work more effectively, efficiently and safely. Most people benefit from one or more low-vision treatment options.

The more commonly prescribed devices are:

• Spectacle-mounted magnifiers. A magnifying lens is mounted in spectacles (this type of system is called a microscope) or on a special headband. This allows you to use both hands to complete a close-up task, such as writing a letter.
• Handheld or spectacle-mounted telescopes. These miniature telescopes help people see at longer distances, such as across the room to watch television. They can also be modified for near (reading) tasks.
• Handheld and stand magnifiers. These are often portable and convenient for short-term reading tasks, such as viewing price tags, labels and instrument dials. Both types can include lights.
• Video magnification. Table-top (closed-circuit television) or head-mounted systems enlarge reading material on a video display. Some systems can be used for distance viewing. Some are portable systems, and some can be used with a computer or monitor. Users can customize image brightness, image size, contrast, foreground/background color, and illumination.

In addition, numerous other products can assist those with a vision impairment, such as large-type books, magazines, and newspapers; books on tape; talking wristwatches; self-threading needles; and more. Talk with a doctor of optometry to learn more about available options.