After 15 years of working with leading Ophthalmologist in Glaucoma, Cataracts, Retina, and Comprehensive clinics, I have heard the same question asked about a billion times. “Why is my vision suddenly blurry?” As always, I cannot diagnose the issue without looking at each eye individually but I can give you a few places to start to see if it helps the situation until you can be seen by an Ophthalmologist.
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Why is my reading suddenly getting blurry?
At some point over 40 you are noticing that reading is getting more difficult and maybe you need glasses. Sadly, this is normal. Sometime after your mid-40’s most adults start to notice more trouble seeing small print like cell phones, menus, and paperwork.
This does not necessarily mean you need prescription glasses. If you are seeing well for distance, you can start off with a pair of inexpensive over-the-counter reading glasses. Every couple of years the power will need to increase to adjust for the amount of focusing power we lose.
1. Time for Reading glasses: blurry vision at near
It is called presbyopia which is just a fancy name for the natural aging of the internal lens you have inside your eyes. When you are born, your natural lens inside the eyes are clear and flexible allowing you to bring things into focus more. As we age, this lens gets more rigid and less flexible and this limits the amount of focusing power your eyes have.
When you enter presbyopia, you need an additional amount of power to read up close. If you are one of the lucky ones, you may not have ever needed glasses before and the over-the-counter reading glasses will fix the issue. However, if you have needed glasses before this hit (prior to 40 years old) then your ophthalmologist or optometrist may recommend a small “add power” which is a bifocal onto your distance glasses prescription.
Don’t freak out. You do not have to get the lined bifocals like your grandpa wore. Most people these days prefer to get the no line bifocal/trifocals called progressives. With these lenses the power tapers from distance at the top (so you can see to drive, watch tv, see people across the room) to just under the pupil line where the computer zone is (things done at an arms length away) and then at the bottom of the lens is the reading zone (small print). Getting this type of glasses when you first start needing reading power is quite easy to get used to.
2. Time for Progressive glasses or bifocals: blurry vision all the time
Anyone getting progressive glasses for the 1st time will need to wear them full time for at least 2 weeks to get used to them. No one loves them in the first hour, your brain learns how to wear them and how to tilt to see through the correct zones.
Take them back to the optical shop to have the fit checked. The progression must align correctly with your eyes. I would say most of the repeat appointments I see at the ophthalmologist office is corrected by steps 1 & 2 but many people skip these steps.
If still having an issue, make an appointment to have the prescription rechecked. Occasionally a small power adjustment can help.
Working in this field, I got my 1st pair a little earlier than most. At 43, I barely needed the add power but I had an opportunity to get a free pair so I did. Because of the very small prescription, I could not really tell that they helped.
However, at 46 I got my next pair and WOW–what a difference! I did have to go back to the optical shop to have the ear pieces adjusted because they were too low and I had difficulty seeing in my reading zone (it was almost on my cheek). Once they did some fitting adjustments, these have been my favorite glasses for the past several years. I absolutely cannot read without them now.
What if I am blurry after working all day on the computer?
3. Need Computer glasses: blurry vision at computer
This is a really common issue as well. 1st I would say do you need computer glasses. Once you hit your 50’s, you already have lost some near and it may be progressing into the computer zone. If you are doing well with over-the-counter reading glasses for small print, you can try cutting the reading power in 1/2 and getting over-the-counter computer glasses. Example: Currently reading small print with a +2.00 reader, try a +1.00 for the computer and see what you think.
The down side to this is that you will be switching between 2 pairs of glasses depending on the tasks you are doing. The other option would be to get a prescription pair of progressive lenses or trifocal lenses that will include all 3 zones of vision: 1-distance at top, 2-computer in middle, and 3-near at the bottom as discussed before.
4. Eye Fatigue: Blue Light Glasses – blurry vision after working
If you are not needing extra power for the computer or are already wearing a current prescription pair of glasses that correct it you may be getting eye fatigue. Long hours of computer work or other screen time exposes the eye to a lot of “blue light”. That is the wave length that is used to brighten the white screens of electronics.
Getting blue light filtering glasses has been shown in studies to reduce glare, lower frequency of headaches from eye strain, improve sleep, and may even lower chances of retinal issues. I had my most recent prescription glasses made with blue filter lenses due to chronic migraines and screen time and I feel that it does help. If you do not need glasses, many companies sell non-prescription blue filtering glasses too.
5. Dry Eyes: Try using Artificial Tears – blurry vision that comes and goes
This sounds too easy but the fact is that humans reduce the number of blinks per minute when focusing on computer work or paper work. Naturally, this will cause more evaporation of your natural tears which over time will make your eyes tire and become blurry. Taking breaks from long hours of work to really blink and rest your eyes or adding over-the-counter artificial tears can soothe your eyes and allow you to keep working.
Dry eyes are extremely common among computer users. They are also more common among adults over 40 who are losing moisture and collagen from aging — dry hair, dry nails, etc… Add to that winter months when the environment is drier and it is the perfect store. My doctors recommend starting over-the-counter artificial tears a couple of times a day. They do NOT recommend any tears that say “get the red out” or “allergy eyes” as those drops are intended for other things and can make the issue worse.
What if things look wavy?
6. Astigmatism Worsening: blurry vision diagonally
If things just look out of focus or slanted you may have some astigmatism that needs correcting. Astigmatism just means your eye is oval more than round. This is actually quite common. Most people have some astigmatism but small amounts may not be noticed.
Larger amounts of astigmatism will seem like a camera that is out of focus. Prescription glasses that correct the astigmatism bring your eye back into focus. Sometimes astigmatism can worsen and become more bothersome with aging. A routine eye exam will correct this with a glasses prescription.
What astigmatism looks like uncorrected.
7. Retinal issues: blurry vision in specific areas
One of the more common causes for wavy lines or spots missing from central vision is macular degeneration. This is very rare in young adults but risks increase with age. This is considered an eye disease and will need routine monitoring.
There are 2 types of ARMD (age related macular degeneration), wet and dry. Dry ARMD is the more common type and does not have any treatment at this time. However, it needs to be monitored closely for progression and change. Studies show that starting the AREDS2 formula eye vitamins at diagnosis can slow the progression of ARMD.
The 2nd type, wet ARMD is more aggressive and can cause significant changes to vision more quickly. It is called wet because fluid gets caught in the layers of the retina. Usually treating the eye for Wet ARMD includes eye injections to try decrease the fluid buildup. Eye injections are not fun and have to be repeated regularly as the fluid often tries to come back. There is no cure for either type of ARMD.
There are many other types of retinal issues. Diabetics can have retinal complications as well. Retinal issues can only be monitored with dilated eye exams by ophthalmologists. The local optometrist can sometimes catch it without dilation, but frequently early changes can be missed even with the newer retinal scans. I strongly suggest yearly dilated exams after entering your 50’s to monitor for eye diseases as these risks increase with age.
Why does my vision look cloudy or hazy?
8. Cataracts Growing: blurry vision like a cloud
The most common cause for cloudy vision is the development of cataracts. A cataract is the aging of your natural lens that was clear and flexible until it started getting more rigid around middle age and getting gradually more cloudy. Cataracts can also form after an eye injury or progress more quickly after taking steroids. Adults typically begin to be more bothersome in their 60’s & 70’s but it is still very common in late 50’s.
The most common symptoms are noticing more difficulty driving at night due to glare from headlights and street lights, overall cloudiness or dim to vision, needing more light to read, and not improving with new glasses. However, after years in this business I can tell you that a ton of patients SHOULD be complaining because their cataracts are pretty advanced but are in denial because they don’t drive at night anymore and “things are just fine”.
The rule of thumb is that insurance will cover cataract surgery when it starts to be bothersome so there is no reason to wait for the vision to get really bad. Plus, the surgery is quick and easy for most people these days with the improvement to technology over the past 20 yrs.
9. Posterior Capsular Opacification (PCO) Forming :
This is sometimes called a secondary cataract but the cataract cannot come back. What happens is that the cataract sets inside a clear bag in the eye. During cataract surgery, the front of the bag is cut away and the cataract is removed. The back of the bag is left in place. Sometimes the back of the bag starts to get cloudy like the cataract did but it is not another cataract.
If the doctor sees that the PCO is getting bothersome, they can do a quick laser in the office to clear it off. Once the Yag Capsulotomy is done, the vision should return to the clarity you had post cataract surgery. It can take months or years after cataract surgery if ever for this to happen but it is considered to be common. There is no way to predict if or when a PCO will form.
Summary: If you notice a gradual decrease in your vision for near it is fine to try out over-the-counter reading glasses if you are middle aged and in relatively good health. However, if you have been wearing glasses for a while you may need to update your prescription. Blurry vision that is noticed more toward the end of the day or along with dry, irritated, or tired eyes can sometimes benefit from tear drops to help lubricate them.
However, if symptoms are sudden in nature you should always call a doctor at onset. If symptoms do not resolve, you should be seen by an ophthalmologist. They say the eyes are the window to your soul for a reason. They are the only window that doctors can actually see blood vessels, nerves, and tissues without using cat scans or scalpels. Routine eye care by qualified and highly skilled physicians should be part of your overall health care routine.
I love sharing these things with you guys. If you have any questions, please drop me a comment below!
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