Eye Health After 50: What Changes and When to Get Checked

Your eyes age along with the rest of your body. Some changes are expected. Others can quietly harm your sight before you notice anything is wrong.

This guide covers five eye conditions that come up often in older adults' eye care: presbyopia, cataracts, glaucoma, diabetic retinopathy and AMD. For each one, we share what the National Eye Institute (NEI) and the American Academy of Ophthalmology (AAO) say, and we finish with a list of things worth telling your eye doctor.

When to get your eyes checked

The AAO recommends that adults get an eye disease screening by age 40. That first visit gives your eye doctor a baseline to compare against later. For older adults, the AAO's guide to eye exams is direct: if you are 65 or older, have your eyes checked every year or two.

Some people need a closer schedule because of a specific risk. The table below brings the verified recommendations together in one place.

If you are between your baseline screening and age 65 and none of these risks apply to you, ask your eye doctor how often to come back. The answer depends on what your exams show.

Presbyopia: when close-up reading gets harder

According to the NEI, everyone gets presbyopia as they get older, usually after age 45. In plain terms, it makes close-up reading harder.

Because it is so expected, it is easy to blame every change in your sight on presbyopia. Not every change is, though. Our article on the symptoms of macular degeneration explains which changes are worth raising with your eye doctor.

Cataracts: very common by age 80

A cataract is a cloudy area in the lens of the eye, the clear part that helps focus light. According to the NEI, most cataracts happen because of normal changes in the eye with age.

The NEI reports that more than half of Americans age 80 or older either have cataracts or have had cataract surgery.

The good news: NEI says surgery is the only way to remove a cataract, and that cataract surgery is safe and corrects the vision problems cataracts cause.

NEI lists these risk factors:

• Diabetes
• Smoking
• Drinking too much alcohol
• A family history of cataracts
• An eye injury or past eye surgery
• Radiation treatment
• Spending a lot of time in the sun
• Using steroid medicines

NEI also suggests some everyday habits: wear sunglasses and a hat with a brim outdoors, quit smoking, and eat plenty of fruits, vegetables, leafy greens, nuts and whole grains.

What about eye vitamins? NEI's summary of the AREDS and AREDS2 trials says the supplements tested in those studies do not have an effect on cataract. A 2013 AREDS2 report found that lutein and zeaxanthin had no overall effect on the need for cataract surgery (hazard ratio 0.96).

Glaucoma: often no early warning

Glaucoma is a group of eye diseases that can cause vision loss and blindness by damaging the optic nerve, a nerve in the back of the eye. The NEI says there is no cure, but early treatment can often stop the damage and protect your vision. Treatment cannot undo vision already lost, which is why finding it early matters so much.

The hard part about glaucoma is that, at first, it usually causes no symptoms. The NEI says these groups are at higher risk:

• People over 60, especially Hispanic or Latino adults
• African Americans over 40
• People with a family history of glaucoma

If any of these apply to you, NEI advises a comprehensive dilated eye exam every 1 to 2 years.

Diabetic retinopathy: a yearly exam if you have diabetes

Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people with diabetes. The NEI explains that it is caused by high blood sugar, which over time can damage the retina.

The NEI notes that the early stages of diabetic retinopathy usually have no symptoms.

For that reason, NEI says people with diabetes should get a comprehensive dilated eye exam at least once a year. Diabetes is also on NEI's list of cataract risk factors, so it is worth making sure your eye doctor knows about it.

NEI suggests three ways people with diabetes can lower their risk: manage your diabetes by staying active, eating healthy and taking your medicine; keep blood pressure and cholesterol under control, since having either one high along with diabetes raises the risk; and keep up with regular eye exams, because finding it early helps you protect your vision.

Age-related macular degeneration (AMD)

AMD is an eye disease that can blur your central vision. The NEI explains that it happens when aging damages the macula, the part of the eye responsible for sharp, straight-ahead vision. Losing central vision can make it harder to see faces, read, drive or do close-up work.

NEI calls AMD very common. A 2022 study in JAMA Ophthalmology, with a co-author from the CDC's Vision Health Initiative, estimated that in 2019 about 18.34 million Americans age 40 and older had early AMD (11.64%). About 1.49 million had late AMD (0.94%).

The NEI lists four risk factors:

• Age: people 55 and older are more likely to have AMD, and NEI's trial page notes that risk rises sharply after 65
• A family history of AMD
• Being Caucasian
• Smoking

Most people with AMD have the dry form. Wet AMD is a less common type of late AMD that usually causes faster vision loss. If you want to understand the difference, our article on dry vs. wet macular degeneration walks through what happens inside the eye.

A few other NEI facts are helpful to know. Early AMD does not cause symptoms. Straight lines that look wavy are a warning sign of late AMD. Having late AMD in one eye raises the risk of late AMD in the other eye. And AMD does not cause complete blindness.

What may lower your risk of AMD

NEI names four choices that may lower your risk:

• Quit smoking, or never start
• Get regular physical activity
• Keep your blood pressure and cholesterol at healthy levels
• Eat healthy foods, including leafy green vegetables and fish

Many people wonder whether eye vitamins belong on that list. NEI's AREDS/AREDS2 FAQ says plainly that nutritional supplements cannot prevent AMD. In the trials, the formulas benefited people who already had intermediate or late AMD, and there was no benefit for people with early AMD or no AMD. Our answer to whether AREDS2 can prevent macular degeneration explains those numbers, and What Is AREDS2 and Who Needs It? covers who the formula is for.

What happens at a dilated eye exam

The NEI calls a dilated eye exam the only way to check for eye diseases early, when they are easier to treat and before they cause vision loss. Since many eye diseases have no symptoms or warning signs, you could have a problem and not know it.

The exam is simple and painless. Your eye doctor checks how clearly you see, then gives you eye drops that dilate (widen) your pupils so they can check for eye diseases.

What to tell your eye doctor

An eye exam works best when your doctor has the full picture. Before your next visit, consider jotting down the following:

• Family history. Mention any relatives with AMD, glaucoma or cataracts. Each is a risk factor NEI lists.
• Smoking, now or in the past. Smoking is a risk factor for AMD and cataracts. It also matters if you are considering eye vitamins: NEI says current and former smokers should take the AREDS2 formula rather than the original AREDS formula. AREDS2 found more lung cancers in former smokers taking the original formula's carotenoid, which is one reason it was replaced with lutein and zeaxanthin.
• Diabetes. It calls for a yearly dilated exam and raises cataract risk.
• Steroid medicines, past eye injuries or eye surgery. These are on NEI's cataract risk list.
• Every medicine and supplement you take. NEI notes that high-dose supplements can sometimes interfere with medications and compete with other nutrients for absorption, so bring a list that includes over-the-counter products. Our article on AREDS2 safety and interactions goes into detail.
• Any change in your vision. Be specific, and mention straight lines that look wavy, since NEI calls that a warning sign of late AMD.
• Your AMD stage, if you have AMD. Ask whether it is early, intermediate or late, and whether it is in one eye or both. NEI's guidance on AREDS2 supplements depends on the stage.

NEI includes leafy greens and fish on its list of healthy choices. If you are curious how much the AREDS2 nutrients show up in an ordinary diet, see can you get AREDS2 nutrients from food? And if you are reading about eye vitamins, our science page lists the doses used in the trials.

Related reading

• Nutrition and eye health: what the research shows
• The symptoms of macular degeneration: what to watch for
• Dry vs. wet macular degeneration: what's actually happening in your eye
• Can AREDS2 prevent macular degeneration?
• 5 vitamins and nutrients that matter for your eyes
• Browse the Eye Health Library

References

1. American Academy of Ophthalmology. Eye disease screening (updated April 30, 2026). aao.org
2. American Academy of Ophthalmology. Eye exams 101. aao.org
3. National Eye Institute. Presbyopia. nei.nih.gov
4. National Eye Institute. Cataracts. nei.nih.gov
5. National Eye Institute. Glaucoma. nei.nih.gov
6. National Eye Institute. Diabetic retinopathy. nei.nih.gov
7. National Eye Institute. Age-related macular degeneration (updated June 22, 2021). nei.nih.gov
8. National Eye Institute. About AREDS and AREDS2 (updated October 22, 2025). nei.nih.gov
9. National Eye Institute. AREDS/AREDS2 frequently asked questions (updated November 19, 2020). nei.nih.gov
10. National Eye Institute. Get a dilated eye exam. nei.nih.gov
11. Rein DB, Wittenborn JS, Burke-Conte Z, et al. Prevalence of age-related macular degeneration in the US in 2019. JAMA Ophthalmol. 2022;140(12):1202-1208. doi:10.1001/jamaophthalmol.2022.4401
12. Age-Related Eye Disease Study 2 (AREDS2) Research Group. Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. 4. JAMA Ophthalmol. 2013;131(7):843-850. doi:10.1001/jamaophthalmol.2013.4412

This article is for general education and is not medical advice. Talk with your eye doctor before starting any supplement, especially if you smoke, take other medicines, or have a health condition. These statements have not been evaluated by the Food and Drug Administration. TruVista products are not intended to diagnose, treat, cure, or prevent any disease.