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From Forty On, We See Differently: What to Expect in Your 40s, 50s, 60s, and 70s

Our vision changes throughout life, but we tend to notice those changes most in our forties and fifties. Not all of them are warning signs — some are simply part of the eye’s natural ageing process. Others, however, may be the first signs of a disease that, if left untreated, could lead to vision loss. How can you tell the difference, what should you expect at different ages, and how can regular eye check-ups help keep your vision in good condition for as long as possible?

Forties: The First Signs of Eye Ageing

Around the age of forty, most people begin to notice that reading small text becomes more difficult, especially in dim light or when tired. This is a typical symptom of presbyopia — age-related farsightedness caused by the gradual loss of the eye’s ability to focus. At first, holding the text farther away may help, but over time reading glasses become necessary. For many, this is the moment that brings them to an eye doctor for the first time.

“The first signs of presbyopia should be a signal for us to start regular preventive eye check-ups. A comprehensive eye examination doesn’t just assess dioptres — it can also detect the early stages of serious diseases such as glaucoma, which can appear as early as the age of forty. The most common cause is increased intraocular pressure, which doesn’t cause pain or other symptoms on its own, yet it quietly damages the optic nerve and can lead to complete and irreversible vision loss,” warns Chief Doctor MUDr. Radan Zugar, Eye Centre Prague.

Fifties: Time for Regular Check-ups

After fifty, the natural changes in vision become more pronounced. The eye reacts more slowly when moving between light and darkness, the ability to distinguish fine details and colours decreases, and an unstable tear film often causes a feeling of dryness. In women, this issue may worsen during menopause, as hormonal changes reduce tear production and increase eye irritation.

“At the same time, the risk of serious eye diseases such as cataract, glaucoma, or age-related macular degeneration rises significantly. These diseases often develop quietly, which is why it is crucial at this age to undergo an OCT examination (retinal CT). It allows us to visualise the retina in detail and detect even the earliest stages of serious diseases,” says Chief Doctor MUDr. Radan Zugar.

This period is also ideal for those who wish to permanently resolve presbyopia and at the same time prevent future cataract development — for example, by replacing the natural lens with a multifocal intraocular lens. Today’s modern implants allow sharp vision at near, far, and intermediate distances without glasses, which for many people brings a major improvement in quality of life.

Sixties: Cataract and the Surgery That Restores Vision

After sixty, most people have at least one diagnosis related to the ageing of the eye — and the most common is cataract. It is a gradual clouding of the natural lens, leading to blurred vision, poorer visibility in dim light, glare in bright light, and changes in colour perception. People often describe it as “seeing through fog or dirty glass.” The only effective treatment is surgery, during which the cloudy lens is replaced with an artificial intraocular lens. The procedure is quick, safe, and patients usually return to normal activities within a few days.

“Thanks to modern medicine and the latest technologies, cataract surgery is one of the safest surgical procedures overall. It requires no significant restrictions before or after the operation and is fully covered by public health insurance, including a standard monofocal intraocular lens,” adds Chief Doctor MUDr. Radan Zugar from Eye Centre Prague.

During surgery, patients may also choose premium intraocular lenses, which are gentler on the eyes, provide better contrast sensitivity, and can even eliminate the need for glasses altogether.

Seventies and Beyond: Retinal Diseases and the Risk of AMD

After seventy, besides cataract, the main threat to vision becomes a retinal disease known as age-related macular degeneration (AMD). It affects the central part of the retina, called the macula, which is responsible for sharp vision needed for activities such as reading or recognising faces. The disease leads to blind spots in the centre of the visual field. Patients may notice that straight lines start to appear wavy, letters look distorted, or a grey or dark spot appears in the middle of their vision. AMD occurs in two forms — dry and wet — with the wet form progressing rapidly and, without treatment, potentially causing severe vision loss. Modern therapies, particularly biological treatment in the form of intraocular injections, can stabilise the disease and slow its progression.

“Macular degeneration cannot be completely cured, but if detected early, we can preserve functional vision for many years. Regular eye check-ups after the age of seventy are therefore absolutely essential,” emphasises Chief Doctor MUDr. Radan Zugar from Eye Centre Prague.

Prevention That Pays Off

Ageing of the eyes is inevitable, but losing good vision is not. Regular check-ups, a healthy lifestyle, and timely treatment can help maintain quality vision even in advanced age. As Chief Doctor MUDr. Radan Zugar says: “The eyes are the only place in the body where we can directly see blood vessels and nerve tissue. We shouldn’t miss that opportunity — an eye examination is not only about vision, but also about overall health.”