The 10 most common eye diseases in old age

As you age, the risk of many eye diseases increases. It’s therefore all the more important to monitor your eye health and attend regular check-ups with an ophthalmologist. Additionally, any noticeable deterioration in vision should never be taken lightly and should always be examined by an ophthalmologist. After all, these changes could indicate serious eye diseases that require appropriate treatment.

In this article, we discuss the 10 most common eye diseases in old age. You will learn why presbyopia is particularly common yet needs to be considered separately, and we outline treatment options for age-related eye diseases.

1. Cataract

A cataract occurs when the eye’s lens becomes cloudy over the course of life. People affected perceive their surroundings as blurred, colours appear fainter, and visual acuity decreases. In advanced stages, vision can be severely impaired and, if left untreated, may lead to blindness.

Cataract is one of the most common causes of visual impairment in older adults: more than 50% of people over 4 are affected.¹ The treatment is a surgical procedure in which the cloudy lens is removed and replaced with a clear artificial lens. This procedure is considered safe and effective, so patients can often see clearly afterward.

2. Glaucoma (glaucoma)

Glaucoma, also known as “green star”, is a condition in which the intraocular pressure is elevated. Elevated intraocular pressure damages the optic nerve and, if left untreated, can lead to blindness. The insidious nature of glaucoma is that it often progresses for a long time without symptoms and is only noticed after part of the visual field has already been lost.

In Germany, about 950,000 people have glaucoma. Because glaucoma is one of the most common causes of blindness here, early detection and taking symptoms seriously are crucial.² Symptoms can include visual field loss, headaches, or halos around lights.

Treatment aims to reduce intraocular pressure, usually through eye drops, laser therapy, or surgical procedures. Regular check-ups with an ophthalmologist are essential to detect glaucoma early and act promptly.

¹Gesundheitsinformation.de: Cataract. https://www.gesundheitsinformation.de/grauer-star-katarakt.html

3. Age-related macular degeneration (AMD)

Age-related macular degeneration (AMD) is a disease of the retina that primarily affects people over 60. In Germany, about 7 million people are affected by AMD, which in the worst case can lead to blindness. It is considered the most common cause of vision loss in industrialized countries.³
Age-related macular degeneration is classified into dry AMD and the more aggressive wet AMD. In both forms, the macula—the point of sharpest vision—undergoes changes.
Early signs include distorted vision and a blurred area in the center of the visual field. In advanced stages, central vision may be lost.

While dry AMD remains incurable, wet AMD can be slowed by injections into the eye or by laser treatments. In addition, studies indicate a genetic predisposition to AMD that can be detected, as can an individual’s response to certain therapies.³

4. Diabetic retinopathy

Diabetic retinopathy is a complication of diabetes mellitus caused by damage to the blood vessels in the retina. High blood sugar levels can lead to the growth of abnormal new blood vessels (neovascularization) and bleeding, which can severely impair vision.

Symptoms include blurred vision, flashes of light, or the perception of black spots. Treatment involves glycaemic control, laser therapy and, in severe cases, surgery. Close monitoring by an ophthalmologist is essential, especially for people with diabetes, to enable early intervention.

² Dresden University Hospital: Glaucoma. https://www.uniklinikum-dresden.de/de/das-klinikum/kliniken-polikliniken-institute/augenheilkunde/leistungsspektrum/spezialsprechstunden/glaukom.
³ University Hospital Tübingen: Breakthrough in research on age-related macular degeneration. https://www.medizin.uni-tuebingen.de/de/das-klinikum/pressemeldungen/396.

5. Retinal detachment

In the case of retinal detachment, the retina separates from the underlying tissue, which can lead to blindness if left untreated. The first signs are flashes of light, a shower of floaters, or the sensation of a shadow in the visual field.

Retinal detachment is an ophthalmic emergency and requires immediate treatment. Treatment is often surgical, using cryotherapy or laser therapy to reattach the retina. The sooner the procedure is performed, the better the chances of preserving vision.
By the age of 85, approximately 3% of the population is affected by retinal detachment.⁴

6. Dry eyes

Dry eye is common among older adults – 11.7% of Germans are affected by Sicca syndrome.⁵ Tear production decreases with age, resulting in an inadequate tear film. Symptoms include burning, itching, redness, and the sensation of a foreign body.

The treatment usually consists of eye drops or gels that act as a substitute for the natural tear film. In some cases, medications or minor procedures may also help. To prevent dry eyes, factors such as dry air or prolonged screen use should be avoided.

⁴ Gesundheitsinformation.de: Retinal detachment. https://www.gesundheitsinformation.de/netzhautabloesung.html.
⁵ LMU Clinic. Dry eye. https://www.lmu-klinikum.de/augenklinik/patientenportal/behandlungsschwerpunkte/trockenes-auge/56e6ce8659c81e11.

7. Age-related changes in the vitreous body

The vitreous body is the gel-like substance inside the eye. As we age, opacities can develop in it, known as “mouches volantes” or “floaters”. Those affected see small shadows or threads that drift with eye movements.

In most cases, these changes are harmless. However, if they appear suddenly or become more frequent, they should be evaluated to rule out serious conditions such as retinal detachment.

8. Hypertensive eye changes

High blood pressure can damage the fine blood vessels of the retina and lead to hypertensive retinopathy. Symptoms include blurred or double vision. Over time, vision may deteriorate.

The best prevention is to control blood pressure with medication and lifestyle changes. Regular eye examinations also help detect and treat any damage early.

9. Eye infections in old age

As we age, the immune system weakens, making eye infections more likely. Bacterial or viral inflammation causes redness, pain, and visual disturbances.

The treatment depends on the pathogen and usually involves antibiotic or antiviral eye drops. A rapid diagnosis is important to avoid complications.

Especially with eye infections, people often come to my practice only after trying a number of home remedies. However, this can be risky, as some home remedies may even worsen the symptoms.

This includes, for example, rinsing the eyes with chamomile tea. The problem is that chamomile’s fine hairs can further irritate the eyes.

10. Eyelid margin inflammation (blepharitis)

Blepharitis is an inflammation of the eyelid margins, often caused by blocked sebaceous glands. Symptoms include swollen eyelids, itching, and crusted eyelashes.

Treatment consists of regular cleaning of the eyelid margins and, in some cases, the application of antibiotic ointments. Good eyelid hygiene helps relieve discomfort and prevent recurrent inflammation.

Not a disease – why presbyopia isn’t a medical condition

Presbyopia is not a pathological condition but a natural part of aging. Over time, the eye’s lens loses elasticity, reducing its ability to focus on near objects (accommodation).

This means that objects up close can no longer be seen clearly. Presbyopia in nearsighted individuals can be especially noticeable, as they experience vision problems both up close and at a distance.

The correction is usually achieved with visual aids such as reading glasses, progressive lenses, or contact lenses. However, modern laser eye treatments are also an option for longer-lasting results.

Treatment options and prevention

Regular check-ups with an ophthalmologist are important at every stage of life to detect eye diseases in old age early. In addition, a healthy lifestyle with a balanced diet and regular exercise supports eye health. For example, certain foods that support healthy eyes in old age can help improve vision.

Various treatment options are available for existing eye diseases, ranging from medication and laser therapy to surgical procedures. Modern visual aids and therapies can make it possible to maintain good vision despite age-related eye diseases. It depends on which specific eye disease is involved, the overall state of the patient’s eye health, and the treatment outcomes the patient hopes to achieve.

Therefore, professional, trustworthy advice is all the more important. An ophthalmologist you trust will not only help you obtain an early diagnosis but will also support you throughout your treatment.

Bányai Neue Augen – Laser treatments as a modern solution

At Bányai Neue Augen, we specialize in modern laser therapies for the correction of refractive errors, certain eye diseases and age-related changes in the eye. Our experienced ophthalmologists use the latest technologies to help you achieve clear vision.
We place particular importance on safe and gentle procedures as well as on the well-being of our patients. That is why, in addition to extensive preliminary examinations, we also offer personal consultations to weigh the treatment options individually with you. In this way, we want to ensure that you can look to the future safely and with confidence.