May 22, 2020

Are Vision Changes After 40 Normal?

And six warning signs for when they're not

Reader glasses placed on a book

Once an idealistic 20-something, you thought this day would never come. But here you are at your local pharmacy, trying on — gasp! — your first pair of reading glasses. Has it really come to this?


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

The medical term for this seemingly inevitable rite of passage is presbyopia, and it describes how our vision changes as we age. But is there any way to avoid it?

“Nothing escapes time,” says ophthalmologist Claudia Perez-Straziota, MD. “Our hair doesn’t. Our joints don’t. And our eyes don’t. But there are things you can do to lessen the impact.”

Why does near vision change after 40?

Our eyes are like a camera — the lenses inside automatically focus on whatever we need to see. “That process works through the contraction and relaxation of certain muscles that move our lens forward or backward,” explains Dr. Perez-Straziota. “When we’re young, our eyes can ‘accommodate,’ or focus at different distances, without the help of glasses or other aids.”

But as we age, our body gets less firm — and not just our waistline. Those eye muscles also experience a middle-age spread and start losing their ability to adjust and accommodate. The dominoes keep falling, eventually affecting your ability to see things up close.

“This is called presbyopia. It’s not just common — it’s a given. And it starts happening at around age 40,” reports Dr. Perez-Straziota.

Aging eyes don’t pull any punches either. So as your lens muscles weaken, the crystalline lens’ proteins change as well. This affects the shape and transparency of the lens, which is called a cataract and is another normal process of the aging of our eyes. “It eventually becomes too cloudy to see clearly,” notes Dr. Perez-Straziota. “At that point, cataracts are an issue.”


Vision changes with age: What’s normal?

What are the signs of presbyopia — other than being over 40? “It’s variable,” says Dr. Perez-Straziota. “Presbyopia and cataracts are like white hair. Everybody gets them at some point, but the question is when and how fast.”

Some signs that you may be experiencing cataracts include:

  • Cloudy vision.
  • Difficulty reading in normal light.
  • More frequent eyeglass and contact lens prescription changes.
  • Vision difficulty when driving at night (may include glares and halos around lights).

Some signs that you may be experiencing presbyopia include:

  • Difficulty focusing up close.
  • Slower focusing ability.

“For instance, you are focusing in the distance and then look down to read your phone. When you try to look at that distance again, your vision is blurry at first and eventually comes back into focus,” says Dr. Perez-Straziota.

These signs come on slowly (think a drippy faucet versus a burst pipe). “You will not wake up and say, ‘Today, I can’t see,’ ” explains Dr. Perez-Straziota. “More likely, you’ll start realizing that you’ve been experiencing these things, and you can’t pin down exactly when it all started.”

When should you see a doctor about age-related vision changes?

Dr. Perez-Straziota says that a routine eye exam is a must. The American Optometric Association recommends this appointment schedule for healthy adults:

  • Ages 18-39: At least one eye exam every two years.
  • Ages 40-64: One eye exam per year.
  • Ages 65 and older: Two eye exams per year.

“If you have a personal or family history of medical eye conditions or diabetes, go every year,” says Dr. Perez-Straziota. “If you have other medical conditions, or have already been diagnosed with an eye condition, follow the schedule that your healthcare provider recommends.”

If you notice a change in your vision between eye exams, Dr. Perez-Straziota recommends making an appointment with your optometrist or ophthalmologist. They will not only check your prescription and vision, but they’ll also rule out anything else that could be going on. “If you think you may have presbyopia, you can first try your pharmacy to see if reading glasses help.”

When it’s NOT just aging eyes

Some vision changes can’t be blamed on presbyopia. See your doctor if you notice:

  • Changes in your color perception.
  • Constriction in your peripheral vision or parts of your vision that is missing.
  • Double vision.
  • A significant decline in your vision.
  • Sudden vision changes.
  • Vision that does not improve at all with any reading glasses from the pharmacy.

Rest assured, presbyopia and other eye conditions are treatable. From glasses and contacts to implants and surgery, there is a wide range of options to help you see clearly again.

Related Articles

aspirin and its effect on eyes
November 3, 2020
Can Using Too Much Aspirin Hurt Your Eyes?

Weighing benefits against age-related macular degeneration risk

Notes taped to window of possible new year's resolutions with hand in foreground holding marker.
December 1, 2023
How To Keep Your New Year’s Resolutions

Pick specific, measurable goals, but also be open to changing them if need be

person holding a thermometer with stress thought bubbles above head
December 1, 2023
Yes, There Is Such a Thing as Stress Sickness

From nausea, weight gain and eczema, stress can affect your immune system in many ways

bowl of soy-based cubes with hand
November 30, 2023
Can Soy Cause Breast Cancer?

Research consistently shows that soy-based foods do not increase cancer risk

person scratching neck that has eczema
November 29, 2023
How Lifestyle Changes and Self-Care Can Improve Your Atopic Dermatitis

Changing your wardrobe or environment won’t eliminate eczema, but it can help reduce flares

person stressing, with clock and books
November 29, 2023
6 Ways To Feel Less Anxious in the Mornings

Breathwork, sleep mediatation and avoiding screens can help fight back morning anxiety

covid toe
November 28, 2023
Are COVID Toes and Rashes Common Symptoms of the Coronavirus?

Chilblain-like skin lesions and rashes probably aren’t COVID related

magnesium pills out of container spelling out MG
November 28, 2023
Magnesium for Anxiety: Does It Help?

This supplement may help with regulating cortisol levels, which may help with stress

Trending Topics

group of hands holding different beverages
November 14, 2023
10 Myths About Drinking Alcohol You Should Stop Repeating

Coffee won’t cure a hangover and you definitely shouldn’t mix your cocktail with an energy drink

Person applies moisturizer as part of their skin care routine after a shower.
November 10, 2023
Korean Skin Care Routines: What You Need To Know

Focus on the philosophy — replenishing and respecting your skin — not necessarily the steps

glass of cherry juice with cherries on table
November 8, 2023
Sleepy Girl Mocktail: What’s in It and Does It Really Make You Sleep Better?

This social media sleep hack with tart cherry juice and magnesium could be worth a try