Eye health tips for older people

Because our eyesight changes as we get older, almost all of us will need to wear glasses or contact lenses by the time we’re 65.

If you have regular eye tests, wear the right lenses and look after your eyes, there’s a better chance your sight will remain clear.

Have regular eye tests

What's free on the NHS?

Find out if you're entitled to free NHS eye tests or optical vouchers and how to claim for help.

An eye test is not just good for checking whether your glasses are up to date. It’s also a vital check on the health of your eyes. An eye test can pick up eye diseases, such as glaucoma and cataracts, as well as general health problems, including diabetes and high blood pressure.

The good news is that if you’re 60 or over, you can have a free NHS eye (sight) test as often as you need one. This is normally every two years, but may be more often in certain circumstances.

Your optometrist will be able to advise you as to how often you need to be seen.

If you can’t leave your home because of illness or disability, you can have an NHS eye test at home. Contact your usual optician to find out if they can visit you at home. Otherwise, NHS England will have a list of opticians in your area that do home visits. Contact NHS England on 0300 311 22 33 or email england.contactus@nhs.net.

Find out more about eye tests.

Wear the right lenses

An eye test will establish whether you need a different prescription for your glasses or contact lenses.

It’s important to wear the correct prescription lenses. This will improve your quality of life and reduce the risk of accidents such as falls.

You may be entitled to help with the cost of NHS glasses or contact lenses, so ask your optician about this.

Find a local optician.

Read more about free NHS eye tests or optical vouchers.

How to keep your eyes healthy

As well as having regular eye tests and wearing the correct glasses, you can do several things to keep your eyes as healthy as possible:

• Eat well. Eating a healthy, balanced diet is important for your eyes. Eating plenty of vegetables and fruit will benefit your overall health and may help protect against some conditions such as cataracts and age-related macular degeneration (AMD, see below). Read tips on how to have a healthy, balanced diet.
• Wear sunglasses. Strong sunlight can damage your eyes and may increase your risk of cataracts. Wear sunglasses or contact lenses with a built-in UV filter to protect your eyes from harmful rays. Read more about protecting your eyes (and skin) from the sun.
• Quit smoking. Smoking can increase your chances of developing conditions such as cataracts and AMD. Find out how the NHS can help you stop smoking.
• Stay a healthy weight. Being overweight increases your risk of diabetes, which can lead to sight loss. Check if you're a healthy weight.
• Use good lighting. To see well, your eyes need three times as much light when you're 60 as they did when you were 20. Increase the daylight in your home by keeping windows clean and curtains pulled back. Make sure you have good electric lighting too, especially at the top and bottom of stairs so you can see the steps clearly. For reading or close work, use a direct light from a flexible table lamp, positioned so the light is not reflected by the page and causing glare.
• Exercise. Good circulation and oxygen intake are important for our eye health. Both of these are stimulated by regular exercise. Read more about how much exercise you should do.
• Sleep well. As you sleep, your eyes are continuously lubricated and irritants, such as dust or smoke, that may have accumulated during the day are cleared out. Here are 10 tips to beat insomnia.

Eye problems as you get older

As you get older, you become more likely to get certain eye problems:

• Difficulty reading. Eye muscles start to weaken from the age of 45. It's a natural ageing process of the eye that happens to us all. By the time you're 60, you'll probably need separate reading glasses or an addition to your prescription lenses (bifocals or varifocals).
• Floaters. These tiny specks or spots that float across your vision are normally harmless. If they persist, see an optician as they may be a sign of an underlying health condition.
• Cataracts. Easily detected in an eye test, this gradual clouding of the eye's lens is extremely common in over-60s. A simple operation can restore sight.
• Glaucoma. This is related to an increase in pressure in the eye that leads to damage of the optic nerve, which connects the eye to the brain. Left untreated, glaucoma leads to tunnel vision and, ultimately, blindness. However, if it's detected early enough, these complications can usually be avoided with eye drops.
• Macular degeneration. This is a disease of the retina caused by ageing. The retina is the nerve tissue lining the back of your eye. There are two types of macular degeneration. The first type, called dry macular degeneration, gets worse very slowly. The other type gets worse very quickly. This needs to be seen as an emergency in a hospital eye unit for prompt treatment.

Eye safety

As well as being incredibly painful, any injury or damage to the eye may affect your sight.

Dr Susan Blakeney, optometric adviser to the College of Optometrists, warns: “Eye injuries can really hurt, and the eye is vulnerable because the cornea (the transparent layer protecting the eye) is only 1/2mm thick.”

“My first bit of advice,” she says, “is to think about what you’re about to do. Ask yourself, ‘what are the risks?'"

Here are ways that accidents can happen, with tips from Dr Blakeney on guarding against injury.

Eye safety at home

In the garden

“Injuring yourself in the garden is quite common,” says Dr Blakeney. “I recently saw a lady with a severe corneal lesion (damage to the cornea). It happened when she was poked in the eye with a garden cane." Other threats include:

• branches: beware of twigs and branches at eye level
• soil: keep loose particles away from the face
• pond water: water (and soil) can contain a nasty bug called acanthamoeba, which causes corneal ulcers

Any kind of glasses, including sunglasses, are an easy way of protecting your eyes in the garden. Dr Blakeney says that even in the winter (when we may not be wearing sunglasses) it's important to protect our eyes.

In the sun

"Looking at the sun, which is tempting during a solar eclipse, can cause solar retinopathy (sun damage)," says Dr Blakeney. "Very strong radiation can cause permanent damage to the back of the eye, like a scar or a burn."Always avoid looking directly at the sun.

On a sunny day, it's vital to protect your eyes against the sun. The College of Optometrists recommends buying good quality, dark sunglasses (these needn’t be expensive). Look for glasses carrying the 'CE' mark, and the British Standard BS EN 1836:2005, which ensures that the sunglasses offer a safe level of ultraviolet protection.

Using chemicals

Chemical burns are another cause of eye problems. Chemicals used at home include weedkiller, plant sprays, caustic soda, bleach or any other household substance. Dr Blakeney points out that alkaline substances cause more damage than acids because they penetrate the eye faster.

In the event of a chemical splash, Dr Blakeney says you must wash the chemical out of your eye as quickly and thoroughly as possible, using lots of fluid. She recommends using:

• eye wash: this is ideal to have in your first aid kit
• contact lens rinsing solution: borrow some from a friend if you don’t use contact lenses
• water from the cold mains (kitchen) tap: let the tap run for a few seconds so that the water is fresh

Practising DIY

Many eye injuries are caused by DIY accidents. “Angle grinding is a real risk since it causes tiny, hot metal filings to shoot out,” says Dr Blakeney. “It's particularly important to avoid getting iron particles in your eyes, as there's a risk of a condition called siderosis bulbi, which can affect vision.”

Dr Blakeney’s advice is to wear proper safety glasses, which must:

• be impact-resistant
• adhere to relevant British standards
• fit properly
• fit over your glasses (if worn)

Leisure

Being struck by a moving object is another cause of eye accidents. There's a high risk of this while playing sport, and Dr Blakeney says squash balls are particularly dangerous. “They're a similar size to your eyeball and could dislodge the eye from its socket. There's also a risk of being caught in the eye by your opponent’s racquet,” she says. It's recommended that you wear sports safety glasses while playing.

When swimming, Dr Blakeney stresses that you must "never wear your contact lenses". Wear goggles to protect your eyes if they're sensitive. Prescription goggles are available if you wear glasses and swim regularly.

Wearing protective glasses for cycling is also recommended to avoid injury from road chippings or prevent flies and dust from getting in your eyes, which could cause an accident.

Eye safety at work

Employers are required by law to protect their employees from risk of injury. You can visit the Health and Safety Executive website for more information.

Using computers

Dr Blakeney says that computers are a common cause of problems in her patients. While they won’t cause lasting damage to the eyes, working for long periods of time on the computer can strain them or make the symptoms of existing eye conditions worse. Symptoms include eye discomfort, headaches, itchy eyes and difficulty in focusing.

Rest the eyes while working on the computer. Look regularly at more distant objects. For example, stare out of the window during your thinking time. Take frequent breaks from computer work. Visit the optometrist regularly for eye check-ups, and make sure they know you use computers often.

Adequate lighting

Ensure that you're working in well-lit conditions but without light reflecting off the computer screen as this can cause eye strain or headaches.

Outdoor and manual jobs

Ask your employer which activities require protective goggles. This will make them aware of the risks you face. Again, beware when using machinery, such as angle grinders and drills (see ‘Practising DIY’ above), and chemicals, which can cause nasty burns (see ‘Using chemicals’ above).

When driving

The advice for driving is simple: make sure you can see the number plates of the cars around you (DVLA guidelines say you must be able to read them from 20 metres away), and make sure that you have regular eye examinations. Dr Blakeney says: “If you wear glasses and drive at night, ask your optometrist for glasses with an anti-reflection coating. This reduces the reflections from the front and back of the spectacle lenses. They look nicer and reduce glare, which helps you to stay safe.”

Contact lens safety

More than 3 million people in the UK wear contact lenses, but many don't follow the instructions on safe use.

Wearing contact lenses increases the risk of eye infections. Failing to follow the instructions raises that risk considerably.

Here's some advice on how to use contact lenses safely.

Follow the instructions

The two main types of contact lens are rigid gas permeable or soft. Instructions for using and caring for your lenses will vary accordingly. It's vital to follow your practitioner's instructions.

Whether you're using contact lenses to correct your vision or change the appearance of your eyes, under UK law they have to be fitted by a registered optometrist, a qualified dispensing optician, or a medical practitioner.

Reusable contact lenses

For lenses that are reused, rather than worn once and discarded, the following guidance applies.

After removing your contact lenses, it's essential you disinfect them as this prevents harmful organisms building up on the lens.

Your practitioner will advise you on the best contact lenses for you and how to care for them. This may include extra cleaning procedures, such as using a protein remover and rubbing or rinsing your lenses.

Disinfection tips:

• to disinfect your lenses, soak them in solution in a storage case for a specific amount of time – your practitioner will advise you
• never reuse disinfecting solution or top it up – it must be discarded and replaced with fresh solution each time the lenses are stored
• only use the care products recommended by your practitioner, and follow the instructions carefully

Dirty contact lens cases are a major source of infection.

To avoid infections:

• rinse your storage case, leave it open to dry after use each day, and replace it monthly
• clean the storage case each week using a clean toothbrush and contact lens solution

Disposable lenses

Daily disposable lenses don't need cleaning or disinfecting because they are only worn once and then thrown away.

Don't reuse these lenses as they're unsuitable for repeated use. Even if you wear daily disposables, it's still important to have regular check-ups with your practitioner.

Extended wear lenses

Extended wear lenses are specially designed for wearing overnight, and can be worn continuously for up to a month before being discarded.

Don't sleep while wearing lenses unless your practitioner advises it. They will also advise you on how to look after the lenses if you need to remove them temporarily.

You may need more frequent check-ups if you wear this type of lens.

All types of contact lens

You should always:

• wash, rinse and dry your hands thoroughly before handling your lenses
• have an up-to-date pair of spectacles to wear when you need to remove your lenses
• keep the contact lens packet with the batch number on in case you have a bad reaction
• only use the lenses for the time recommended
• replace the lenses and lens solution at intervals specified by your practitioner
• have regular check-ups with your practitioner
• seek professional advice if you're having problems with your contact lenses.

Ask yourself these three important questions when wearing your lenses:

• Do my eyes look good?
• Do my eyes feel good?
• Can I see well?

If you can't answer "yes" to all of these questions or you have any other doubts about your contact lenses, remove them immediately and talk to your practitioner.

Remember:

• if you develop blurred vision or painful, red or swollen eyes, seek advice immediately
• if a lens looks damaged or torn, don't put it in your eye
• never wear someone else's contact lenses
• never rinse your lenses with or store them in tap water – you risk getting a severe eye infection
• don't transfer contact lens solution into smaller travel-size bottles – it may not be sterile any more
• never wet your lenses with saliva – it's not sterile and could cause an eye infection
• never wear your lenses while you're having a shower or going swimming (unless you use water-tight goggles)

Look after your eyes

Find out why regular eye tests are important, and how a healthy lifestyle can help maintain good vision.

Why are regular eye tests (sight tests) so important?

It's easy to neglect your eyes because they rarely hurt when there's a problem.

Having an eye test won't just tell you if you need new glasses or a change of prescription – it's also an important eye health check.

It can spot many general health problems and early signs of eye conditions before you're aware of any symptoms, many of which can be treated if found early enough.

How often should I have an eye test?

Optometrists recommend that most people have an eye test about every two years. People over 40 and people from black or minority ethnic groups may need sight tests more often.

What should I do if I notice a change in my sight?

Visit your optician or GP if you're concerned about any aspect of your vision at any time.

Are some people more at risk from eye disease than others?

Anyone can develop sight problems, but some people have a higher risk of eye disease.

It's especially important to have regular eye tests if you are:

• above 60 years old
• from certain ethnic groups – for example, people from African-Caribbean communities are at greater risk of developing glaucoma and diabetes, and people from south Asian communities are at a greater risk of developing diabetes; diabetic retinopathy, where the retina becomes damaged, is a common complication of diabetes
• someone with a learning disability
• from a family with a history of eye disease

What about my child's sight?

Children do not usually complain about their sight, but may show signs of not being able to see properly.

Things to look out for include sitting close to the TV, holding objects very close to their face, blinking a lot, eye rubbing, or one eye turning in or out.

If your child is having any sort of sight problems, take them to an optometrist for further investigation.

Children don't have to be able to read letters to have their eyes examined. Like adults, children should have regular eye checks around every two years.

What else can I do to look after my eyes?

Give up smoking

Smokers are much more likely to develop age-related macular degeneration and cataracts compared with non-smokers. Find out about the help and support available to stop smoking.

Get moving

While it might seem odd that exercise can help the eyes, it can be important. Research shows that exercise may reduce the risk of sight loss, which can occur as a result of high blood pressure, diabetes, and narrowing or hardening of the arteries. See some ideas for getting fit your way.

Eat healthily

A healthy, balanced diet that includes a wide variety of fruit and vegetables will benefit your overall health, and may help keep the retina healthy. Get tips on healthy eating.

Drink within the recommended limits

Heavy alcohol consumption is associated with an increased risk of early age-related macular degeneration.

To keep health risks from alcohol to a low level:

• men and women are advised not to drink more than 14 units a week on a regular basis
• spread your drinking over three or more days if you regularly drink as much as 14 units a week
• if you want to cut down, try to have several drink-free days each week

Keep tabs on your drinking with the Drinkaware alcohol tracker.

Protect your eyes from the sun

Never look at the sun directly, even when something exciting is happening, such as an eclipse. Doing so can cause irreversible damage to your eyesight and even lead to blindness. Several studies also suggest sunlight exposure is a risk factor for cataracts.

Wearing a wide-brimmed hat or sunglasses can help protect your eyes from UV rays. The College of Optometrists recommends buying good-quality dark sunglasses – these needn't be expensive.

Look for glasses carrying the CE mark or the British Standard BS EN ISO 12312: 2013, which ensures they offer a safe level of ultraviolet protection.

Can I get help with the cost of a sight test or glasses?

Lots of people are entitled to free NHS-funded sight tests and an optical voucher, which will help with the cost of glasses or contact lenses.

Find out more about eyecare entitlement, including mobile sight tests when an optometrist visits you in your own home.

Sunscreen and sun safety

Advice for adults and children on sunscreen and sun safety in the UK and abroad.

• Sun safety tips
• What factor sunscreen (SPF) should I use?
• What are the SPF and star rating?
• How to apply sunscreen (video)
• Swimming and sunscreen
• Children and sun protection
• Protect your eyes
• Clothing and sunglasses
• Sunburn
• Who should take extra care?
• Mole protection
• Sunbed advice

Sunburn increases your risk of skin cancer. Sunburn doesn't just happen on holiday – you can burn in the UK, even when it's cloudy.

There's no safe or healthy way to get a tan. A tan doesn't protect your skin from the sun's harmful effects.

Aim to strike a balance between protecting yourself from the sun and getting enough vitamin D from sunlight.

Sun safety tips

Spend time in the shade when the sun is strongest. In the UK, this is between 11am and 3pm from March to October.

Make sure you:

• spend time in the shade between 11am and 3pm
• make sure you never burn
• cover up with suitable clothing and sunglasses
• take extra care with children
• use at least factor 15 sunscreen

What factor sunscreen (SPF) should I use?

Don't rely on sunscreen alone to protect yourself from the sun. Wear suitable clothing and spend time in the shade when the sun's at its hottest.

When buying sunscreen, the label should have:

• a sun protection factor (SPF) of at least 15 to protect against UVB
• at least four-star UVA protection

UVA protection can also be indicated by the letters "UVA" in a circle, which indicates that it meets the EU standard.

Make sure the sunscreen is not past its expiry date. Most sunscreens have a shelf life of two to three years.

Don't spend any longer in the sun than you would without sunscreen.

What are the SPF and star rating?

The sun protection factor, or SPF, is a measure of the amount of ultraviolet B radiation (UVB) protection.

SPFs are rated on a scale of 2-50+ based on the level of protection they offer, with 50+ offering the strongest form of UVB protection.

The star rating measures the amount of ultraviolet A radiation (UVA) protection. You should see a star rating of up to five stars on UK sunscreens. The higher the star rating, the better.

The letters "UVA" inside a circle is a European marking. This means the UVA protection is at least one third of the SPF value and meets EU recommendations.

Sunscreens that offer both UVA and UVB protection are sometimes called broad spectrum.

How to apply sunscreen

Most people don't apply enough sunscreen. As a guide, adults should aim to apply around:

• two teaspoons of sunscreen if you're just covering your head, arms and neck
• two tablespoons if you're covering your entire body while wearing a swimming costume

If sunscreen is applied too thinly, the amount of protection it gives is reduced. If you're worried you might not be applying enough SPF15, you could use a stronger SPF30 sunscreen.

If you plan to be out in the sun long enough to risk burning, sunscreen needs to be applied twice:

• 30 minutes before going out
• just before going out

Sunscreen should be applied to all exposed skin, including the face, neck and ears – and head if you have thinning or no hair – but a wide-brimmed hat is better.

Sunscreen needs to be reapplied liberally and frequently, and according to the manufacturer's instructions.

This includes applying it straight after you've been in water – even if it's "water resistant" – and after towel drying, sweating, or when it may have rubbed off.

Watch a video about staying safe in the sun

Check moles for change

Keep an eye on any moles or freckles you have. If they change at all (for example, if they get bigger or bleed), see your GP as this can be an early sign of cancer.

The earlier skin cancer is caught, the easier it is to treat, so see your GP as soon as possible.

Swimming and sunscreen

Water washes sunscreen off, and the cooling effect of the water can make you think you're not getting burned. Water also reflects ultraviolet (UV) rays, increasing your exposure.

Water-resistant sunscreen is needed if sweating or contact with water is likely.

Sunscreen should be reapplied straight after you've been in water – even if it's "water resistant" – and after towel drying, sweating, or when it may have rubbed off.

Children and sun protection

Take extra care to protect babies and children. Their skin is much more sensitive than adult skin, and damage caused by repeated exposure to sunlight could lead to skin cancer developing in later life.

Children aged under six months should be kept out of direct strong sunlight.

From March to October in the UK, children should:

• cover up with suitable clothing
• spend time in the shade – particularly from 11am to 3pm
• wear at least SPF15 sunscreen

Apply sunscreen to areas not protected by clothing, such as the face, ears, feet, and backs of hands. Get more sun safety advice for children.

To ensure they get enough vitamin D, all children under five are advised to take vitamin D supplements.

Protect your eyes in the sun

A day at the beach without proper eye protection can cause a temporary but painful burn to the surface of the eye, similar to sunburn.

Reflected sunlight from snow, sand, concrete and water, and artificial light from sunbeds, is particularly dangerous.

Avoid looking directly at the sun, as this can cause permanent eye damage.

Clothing and sunglasses

Wear clothes and sunglasses that provide sun protection, such as:

• a wide-brimmed hat that shades the face, neck and ears
• a long-sleeved top
• trousers or long skirts in close-weave fabrics that don't allow sunlight through
• sunglasses with wraparound lenses or wide arms with the CE Mark and European Standard EN 1836:2005

How to deal with sunburn

Sponge sore skin with cool water, then apply soothing aftersun or calamine lotion.

Painkillers, such as paracetamol or ibuprofen, will ease the pain by helping to reduce inflammation caused by sunburn.

Seek medical help if you feel unwell or the skin swells badly or blisters. Stay out of the sun until all signs of redness have gone.

Read more about treating sunburn.

Get tips on preventing and treating heat exhaustion in hot weather.

Who should take extra care in the sun?

You should take extra care in the sun if you:

• have pale, white or light brown skin
• have freckles or red or fair hair
• tend to burn rather than tan
• have many moles
• have skin problems relating to a medical condition
• are only exposed to intense sun occasionally – for example, while on holiday
• are in a hot country where the sun is particularly intense
• have a family history of skin cancer

People who spend a lot of time in the sun, whether it's for work or play, are at increased risk of skin cancer if they don't take the right precautions.

People with naturally brown or black skin are less likely to get skin cancer, as darker skin has some protection against UV rays. But skin cancer can still occur.

The Cancer Research UK website has a tool where you can find out your skin type to see when you might be at risk of burning.

Protect your moles

If you have lots of moles or freckles, your risk of getting skin cancer is higher than average, so take extra care.

Avoid getting caught out by sunburn. Use shade, clothing and a sunscreen with an SPF of at least 15 to protect yourself.

Keep an eye out for changes to your skin. Changes to check for include:

• a new mole, growth or lump
• any moles, freckles or patches of skin that change in size, shape or colour

Report these to your doctor as soon as possible. Skin cancer is much easier to treat if it's found early.

Use the mole self-assessment tool to see whether you could have a cancerous mole.

Using sunbeds

The British Association of Dermatologists advises that people shouldn't use sunbeds or sunlamps.

Sunbeds and lamps can be more dangerous than natural sunlight because they use a concentrated source of UV radiation.

Health risks linked to sunbeds and other UV tanning equipment include:

• skin cancer
• premature skin ageing
• sunburnt skin
• eye irritation

It's illegal for people under the age of 18 to use sunbeds, including in tanning salons, beauty salons, leisure centres, gyms, and hotels.

Find out more by reading Are sunbeds safe?