As an optometrist at the John A. Moran Eye Center, Edward Nicholls, OD, gets a lot of questions about vision. From new parents to senior patients, he shares some of the most common questions and his answers—plus sound advice for lifelong eye care.
Age 10 and Under
When should my kids get their first eye exam?
I recommend a child's first comprehensive eye exam when they start kindergarten or sooner if parents are worried about something specific.
School vision screenings are great, but they only screen for nearsightedness (myopia). They often miss farsightedness (hyperopia), strabismus, and focusing problems. All of these issues can affect how a child learns. Struggles with reading might indicate that a child needs prescription eyeglasses to catch up with their peers.
When will my eyeglasses prescription stop changing?
Your eyes continue to change and grow just like your body at this stage of life. Almost everyone continues to become more near-sighted until their mid-20s. This is typically a normal change and no cause for alarm. In general, your prescription will stabilize by age 25 and stay roughly the same until your early-40s.
When can I get LASIK?
I recommend patients wait until their refractive error has stabilized over a couple of years. It's never wise to get permanent surgery on a changing eye. Once you're ready, however, refractive surgeries such as LASIK may offer an excellent solution for better vision without glasses.
Why are my arms not long enough?
The average age for people needing visual help while reading or using a computer is 42-45. At this stage, you may experience blurred vision and find yourself trying to compensate by holding menus, books, or prescription bottles further away to try to focus.
This is common presbyopia, and it's due to the natural lens of the eye hardening after 40-plus years of living. The most common solution is progressive lenses that allow you to see at a distance and up close with the same pair of glasses. The natural lens continues to harden into our early-60s until it is no longer malleable. As a result, the reading power on our glasses continues to increase until our early-60s. During this time, we recommend an annual dilated eye exam for general eye health and to ensure proper focus up close, thereby avoiding unwanted eye strain.
Why are things getting foggy?
As the natural lens hardens further, it also starts to change color and develop opacities that stop light from passing through the cornea to the retina. Now we're talking about cataracts.
While there are different types and causes of cataracts, they all have the same result of clouding our vision. It almost feels like looking through a window that has gathered years of dust and haze. You can see through it, but you don't realize how dirty it is until it's cleaned. The only way to fix cataracts is with a common surgery that removes the natural lens (cataract) and implants a new, artificial lens in its place.
What are common diseases affecting vision in later years?
Glaucoma can develop in any decade of life. However, it becomes more prevalent as we age. The retina in the back of the eye has over a million nerves; as we age, it is normal to lose some of them. Glaucoma, simply put, is when someone loses nerves faster than someone their age. In-end stage glaucoma, people develop decreased peripheral vision and may have problems running into door frames or tripping over rugs and curbs.
Glaucoma treatment is mainly preventative. We want to keep as much vision as possible because it cannot come back once lost.
Age-related macular degeneration is the most prevalent disease after 70 years old; however, changes can start as soon as our early-50s. The disease begins by destroying the cells in the retina responsible for central vision.
In the beginning, vision can decrease from roughly 20/20 to 20/40. As the disease progresses, the retina can bleed, further reducing vision, leading to 20/200 vision if not treated. It effectively creates a central blind spot, making it impossible to read or even see the faces of loved ones. We have treatments that can help prevent vision loss and, in some cases, lead to mild improvement if treated quickly.
No matter your age, you can always take action to protect your eye health:
- Always wear sunglasses while outside.
- Don't start smoking. If you do smoke, quit.
- Eat green leafy vegetables, and make sure you have a variety of colors on your plate.
- Keep up with your annual eye exam. Prevention is the best method to avoid damaging vision changes in the future. When you experience a vision change, see your eye doctor.