The most common eye diseases affecting people over 60 are cataracts, age-related macular degeneration (AMD), glaucoma, diabetic retinopathy, and dry eye disease. These conditions account for the vast majority of vision loss and blindness in older adults, and most develop gradually—often without obvious symptoms in the early stages. A 70-year-old who notices that faces have become blurry in the center of her vision while peripheral sight remains clear is likely experiencing early AMD, not simply needing a stronger glasses prescription.
Understanding which conditions are most prevalent, how they differ, and what early warning signs to watch for can make a significant difference in preserving vision. This article covers each of the major eye diseases that become more common after age 60, how they damage vision, what risk factors accelerate their progression, and what treatment options are currently available. It also addresses the connection between vision loss and cognitive decline—a relationship increasingly recognized in dementia research. Finally, it provides practical guidance on monitoring eye health and knowing when to seek care beyond a routine optometry visit.
Table of Contents
- Which Eye Diseases Are Most Common After Age 60?
- How Does Diabetic Retinopathy Affect Older Adults?
- What Is Dry Eye Disease and Why Does It Worsen With Age?
- How Should People Over 60 Monitor and Protect Their Eye Health?
- What Is the Link Between Vision Loss and Dementia?
- Retinal Detachment and Other Urgent Conditions to Know
- Looking Ahead: Advances in Diagnosis and Treatment
- Conclusion
- Frequently Asked Questions
Which Eye Diseases Are Most Common After Age 60?
The single most prevalent eye condition in older adults is cataracts—a clouding of the lens inside the eye that causes blurred, hazy, or yellowed vision. By age 75, more than half of Americans either have cataracts or have already had surgery to remove them. Cataracts develop because proteins in the lens gradually break down and clump together, scattering light rather than focusing it cleanly onto the retina. The process is slow and painless, which is why many people dismiss early symptoms as general aging. Age-related macular degeneration is the leading cause of irreversible central vision loss in people over 50. It damages the macula, the small central portion of the retina responsible for sharp, detailed sight—the part you use to read, recognize faces, and drive.
There are two types: dry AMD, which progresses slowly through accumulation of drusen (fatty protein deposits under the retina), and wet AMD, which is less common but far more aggressive because abnormal blood vessels leak fluid and cause rapid tissue damage. A person with wet AMD may lose significant central vision within weeks without treatment. Glaucoma is the second leading cause of blindness worldwide and is particularly dangerous because it causes no pain and no symptoms until meaningful vision has already been lost. It damages the optic nerve, usually through elevated pressure inside the eye, and the resulting vision loss begins at the periphery. By the time a patient notices anything wrong, up to 40 percent of optic nerve fibers may already be dead. Open-angle glaucoma—the most common form—is particularly insidious because intraocular pressure rises so slowly that patients adjust without realizing it.
How Does Diabetic Retinopathy Affect Older Adults?
Diabetic retinopathy results from high blood sugar damaging the tiny blood vessels inside the retina. Over time, these vessels leak, swell, or grow abnormally, disrupting the retina’s ability to process light accurately. For older adults with type 2 diabetes—a group that represents the majority of diabetes diagnoses over 60—retinopathy is a serious and progressive risk. Studies suggest that roughly one in three people with diabetes over age 40 has some degree of retinopathy, and the risk increases substantially with longer disease duration and poor blood sugar control. What makes diabetic retinopathy particularly damaging in older patients is that it often occurs alongside other retinal conditions.
An older adult may simultaneously have early AMD and moderate retinopathy, with each condition compounding the other’s effects on vision. Treatments including anti-VEGF injections and laser photocoagulation can slow progression, but they do not restore vision already lost—they prevent further deterioration. This distinction matters enormously for patient expectations and treatment compliance. However, if diabetes is well-controlled in the years before retinopathy develops, the risk of progression to vision-threatening stages drops substantially. A major caveat applies here: tight blood sugar control reduces risk but does not eliminate it. Patients who have had poorly controlled diabetes for many years before achieving better management may still develop retinopathy even with improved A1C levels, because prior vascular damage persists.
What Is Dry Eye Disease and Why Does It Worsen With Age?
Dry eye disease is among the most underdiagnosed eye conditions in older adults, partly because its symptoms—grittiness, burning, occasional blurry vision that clears with blinking—are often attributed to allergies, fatigue, or simply “getting older.” The condition occurs when the eyes either produce insufficient tears or produce tears that evaporate too quickly due to poor quality. After age 60, tear production naturally declines, and the meibomian glands that produce the oily outer layer of the tear film often become clogged or dysfunctional. Women are disproportionately affected, particularly after menopause, because estrogen influences tear production. A postmenopausal woman in her late 60s who spends several hours daily reading or using a computer may develop symptoms severe enough to cause persistent discomfort and reduced visual acuity—not because her eyes are diseased in a structural sense, but because inflammation triggered by chronic dryness damages the surface cells of the cornea over time.
Untreated, this surface damage can create corneal scarring that meaningfully impairs vision. Dry eye also interacts with other treatments. Many older adults taking antihistamines, antidepressants, diuretics, or certain blood pressure medications find that these drugs significantly worsen dryness. Artificial tears help, but preserved eye drops used more than four times daily can paradoxically irritate the eye surface. Preservative-free formulations, punctal plugs, and prescription anti-inflammatory drops like cyclosporine are more appropriate for chronic moderate-to-severe cases.
How Should People Over 60 Monitor and Protect Their Eye Health?
The single most effective action people over 60 can take is committing to annual comprehensive dilated eye exams, not just quick vision screenings. A dilated exam allows the ophthalmologist to examine the retina, optic nerve, and macula directly—structures that cannot be assessed through standard acuity testing. Many serious conditions, including early glaucoma and AMD, are only detectable through dilation. Contrast this with automated screenings available at pharmacies or DMV offices, which test only visual acuity and will miss retinal or optic nerve pathology entirely. Lifestyle modifications offer meaningful but often underappreciated protection. Smoking is among the strongest modifiable risk factors for both AMD and cataracts—current smokers have roughly four times the AMD risk of nonsmokers.
A Mediterranean-style diet rich in leafy greens, fatty fish, and colorful vegetables supports retinal health through antioxidants like lutein and zeaxanthin. For patients already diagnosed with intermediate AMD, the AREDS2 supplement formula (vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper) has been shown in large clinical trials to reduce progression to advanced AMD by about 25 percent. The tradeoff with supplements is important to understand. AREDS2 formulas are specifically validated for people with intermediate or advanced AMD in one eye—not as a general preventive for people with no AMD. Taking them unnecessarily provides no documented benefit and adds cost. Similarly, high-dose zinc supplementation in these formulas can occasionally worsen urinary issues in men with prostate conditions, so medical review before starting is reasonable.
What Is the Link Between Vision Loss and Dementia?
Research published over the past decade has established a clinically significant relationship between sensory loss—including vision impairment—and increased dementia risk. A 2021 study in JAMA Internal Medicine found that older adults with self-reported vision impairment had higher odds of cognitive decline and dementia diagnosis over time, independent of age, education, and other health conditions. The mechanisms proposed include reduced sensory stimulation leading to decreased neural engagement, social withdrawal caused by vision difficulties, and shared vascular pathways that damage both the retina and brain. The retina itself is increasingly studied as a window into brain health. Since the retina is an extension of the central nervous system, changes in retinal vessel structure, thickness of the nerve fiber layer, and even amyloid deposits visible in the retina may reflect parallel changes occurring in the brain.
Researchers are investigating whether retinal imaging could eventually serve as an accessible, low-cost early biomarker for Alzheimer’s disease—though this remains investigational rather than clinical practice. A critical warning: treating vision loss as inevitable or acceptable in older patients may have consequences beyond sight itself. Evidence suggests that correcting refractive error and treating conditions like cataracts may have protective effects on cognitive function. A 2022 study in JAMA Internal Medicine found that cataract surgery was associated with a 30 percent lower risk of dementia diagnosis compared to those who did not have surgery. Whether this reflects restored sensory input, increased social engagement, or shared biological mechanisms is not yet fully understood—but it suggests that eye care is not separate from brain care.
Retinal Detachment and Other Urgent Conditions to Know
Not all age-related eye emergencies develop slowly. Retinal detachment—where the retina separates from the underlying tissue layer—can occur suddenly and constitutes an ocular emergency. Symptoms include a sudden shower of new floaters, flashes of light in peripheral vision, or a shadow or curtain moving across the visual field. An older adult who wakes up and notices a dark veil across half their vision needs emergency evaluation that same day; retinal detachment treated within 24 hours has far better visual outcomes than cases where evaluation is delayed by several days.
Posterior vitreous detachment, a more common and less dangerous event that often precedes retinal tears, produces similar floaters and flashes, making any sudden onset of these symptoms worth urgent assessment. Similarly, acute angle-closure glaucoma—distinct from the more common open-angle form—presents with sudden severe eye pain, headache, nausea, and halos around lights. This constitutes a medical emergency that can permanently damage vision within hours without treatment. It is often misidentified as migraine or gastrointestinal illness, leading to dangerous delays.
Looking Ahead: Advances in Diagnosis and Treatment
The coming decade is likely to bring significant changes to how age-related eye diseases are detected and managed. Artificial intelligence tools are now capable of detecting early AMD, diabetic retinopathy, and glaucomatous optic nerve changes from fundus photographs with accuracy comparable to or exceeding that of specialist physicians in controlled trials.
The FDA has already cleared AI diagnostic systems for diabetic retinopathy screening in primary care settings, meaning patients may receive retinal assessments during routine medical visits without needing a specialist referral. Gene therapy trials are underway for wet AMD subtypes caused by specific genetic variants, and sustained-release drug implants aim to reduce the treatment burden of monthly anti-VEGF injections that burden patients with advanced AMD. For patients and families managing chronic conditions like dementia alongside eye disease, these developments matter: reduced treatment frequency and earlier detection may help maintain quality of life longer and reduce caregiver strain.
Conclusion
The eye diseases most commonly affecting people over 60—cataracts, age-related macular degeneration, glaucoma, diabetic retinopathy, and dry eye disease—share a common feature: they progress quietly, often without pain, and become far harder to treat once significant damage has occurred. Regular dilated eye exams, awareness of sudden symptom changes that require emergency evaluation, and attention to modifiable risk factors like smoking and blood sugar control give older adults the best chance of preserving functional vision. Treatment options for most of these conditions have improved substantially, but they remain most effective when started early.
The connection between vision health and brain health adds further urgency to proactive eye care after 60. For individuals and families navigating dementia risk or cognitive decline, addressing treatable vision problems is not a cosmetic concern—it is a meaningful step toward maintaining sensory engagement with the world, social connection, and potentially reducing cognitive burden. Encouraging older family members to see an ophthalmologist annually, not just an optometrist for glasses, and knowing which symptoms require same-day evaluation rather than a scheduled appointment, can make a real difference in long-term outcomes.
Frequently Asked Questions
Can cataracts come back after surgery?
No. Once the clouded lens is removed and replaced with an artificial intraocular lens, cataracts cannot return in the same eye. However, a significant minority of patients develop posterior capsule opacification—sometimes called a “secondary cataract”—where the membrane holding the lens becomes cloudy. This is easily treated with a brief laser procedure called a YAG capsulotomy.
Is vision loss from glaucoma reversible?
No. Once the optic nerve fibers are destroyed by glaucoma, they do not regenerate. Treatment—typically eye drops that lower intraocular pressure, laser therapy, or surgery—can halt or slow further damage, but vision already lost cannot be recovered. This is why early detection through regular exams is critical.
At what age should someone switch from an optometrist to an ophthalmologist?
There is no strict age cutoff, but people over 60, or anyone with diabetes, a family history of glaucoma, or symptoms of retinal disease, benefit from seeing an ophthalmologist (a medical doctor specializing in eye disease) rather than relying solely on optometry. Optometrists provide excellent routine care, but managing progressive retinal or optic nerve conditions typically requires an ophthalmologist’s level of training and access to surgical interventions.
Does the AREDS2 supplement formula prevent AMD from developing?
No. The AREDS2 formula has only been validated to slow progression in people who already have intermediate or advanced AMD. It has not been shown to prevent AMD from developing in people who currently have healthy retinas. Taking it without an AMD diagnosis provides no documented benefit.
How does vision loss increase dementia risk?
Researchers believe several mechanisms are involved: reduced sensory input decreases cognitive stimulation; vision impairment often leads to social isolation and reduced physical activity, both of which are independent dementia risk factors; and some shared vascular or neurodegenerative processes may damage both the eyes and the brain simultaneously. The relationship appears bidirectional—cognitive decline can also impair a person’s ability to notice or report vision changes.
