Why skipping eye check-ups after 60 can cost more than just vision

From cataracts to glaucoma and diabetic eye disease, many serious vision problems in older adults show no early symptoms. Doctors explain why routine eye tests matter even when vision seems fine

Many older adults do not prioritise eye health because vision loss appears gradual and painless. However, several common eye diseases in older adults progress silently and cause permanent damage if not detected early. 

Doctors stress that regular eye screenings remain a critical part of healthy ageing, not only to preserve vision but to reduce risks linked to falls, cognitive decline and loss of independence. Here is all you need to know:

What changes occur in the ageing eye?

Ageing brings predictable biological changes to the eye. The natural lens loses clarity, eye muscles weaken, the retina becomes less efficient, blood vessels stiffen, and tear quality declines. Reading becomes harder, glare feels sharper, and dryness creeps in. 

 

“These changes explain why presbyopia, cataracts and dry eye are common after 60,” says Dr Sharanya Rao, Consultant Ophthalmologist at Dr Agarwals Eye Hospital. “They are age-related, but importantly, they are also treatable if recognised early.” 

What is not a normal part of ageing is damage to the optic nerve or retina. Conditions like glaucoma, age-related macular degeneration and diabetic eye disease are often brushed off as “just getting old”, even though they are preventable or controllable with timely screening and risk management.  ALSO READ | Crossed 40? Doctor says stop these 5 habits now to slow ageing from within

Which eye diseases are driving irreversible vision loss in older adults?

Cataract still accounts for the largest share of blindness in India, but it is reversible. Surgery restores sight. 

The real long-term damage comes from glaucoma and diabetic retinopathy. 

“Unlike cataracts, damage from glaucoma or diabetic retinopathy cannot be undone once it sets in,” explains Dr Rao. “That’s because the optic nerve and retinal tissue do not regenerate.” 

According to Dr Rao, these conditions progress silently. Many older adults discover them only after significant vision loss. This is because routine screening, especially dilated retinal examinations, is still not the norm. 

“Patients don’t seek help because they don’t feel anything wrong,” says Dr Rao. “Detection depends entirely on regular eye examinations that include eye pressure measurement, optic nerve evaluation and visual field testing.”

How are ageing, diabetes and diabetic retinopathy connected?

The longer someone lives with diabetes, the higher their risk of diabetic retinopathy. According to Dr Rao, after 15–20 years of disease, the risk rises sharply, especially if blood sugar, blood pressure or cholesterol are poorly controlled. 

“Older adults with diabetes should undergo annual dilated retinal examinations, and even six-monthly checks if they have long-standing diabetes or early retinal changes,” Dr Rao emphasises. 

A routine vision test for glasses is not enough. The retina must be examined every time.  ALSO READ | Ageing and insomnia: Why older adults sleep worse and what actually helps

What should a complete eye check-up after 60 include?

A scientifically sound eye examination for older adults goes beyond reading letters on a chart. 

It should include distance and near vision testing, refraction, intraocular pressure measurement, slit-lamp examination and a dilated fundus examination to assess the retina and optic nerve. 

“In busy clinics, tests like visual fields or optical coherence tomography (OCT) imaging are often skipped due to time constraints,” Dr Rao notes. “Unfortunately, these are exactly what help catch glaucoma or retinal disease early.” 

Dr Rao stresses that regular eye screenings in older adults are not optional or cosmetic; they are preventive healthcare. Many age-related eye diseases progress without symptoms and cause irreversible damage if detected late. Timely examinations can preserve vision, maintain independence and reduce avoidable disability.  For more health updates, follow #HealthWithBS 

This content is for informational purposes only and is not a substitute for professional medical advice.