What Eye Conditions Should You Be Screened for After 40?

Something changes around age 40. Your eyes may still feel fine, but several serious conditions can begin developing — without any symptoms at all. The challenge is that by the time you notice a problem, the damage is often permanent.

Routine screening is the only reliable way to catch these conditions while treatment can still make a difference.

What about glaucoma?

Glaucoma damages the optic nerve, usually due to elevated pressure inside the eye. It destroys peripheral vision so gradually that most people do not notice until significant, irreversible loss has occurred.

There are no early warning signs. The only way to detect glaucoma is through a comprehensive eye exam that includes pressure measurement, optic nerve evaluation, and often OCT imaging. If you have a family history of glaucoma, your risk is 4 to 9 times higher.

What about cataracts?

A cataract is a gradual clouding of the eye's natural lens. Nearly everyone develops some degree of cataract change after 40, though it may not affect vision for years.

Early cataracts are detected during a routine eye exam long before they cause noticeable symptoms. Monitoring their progression allows your optometrist to recommend treatment at the right time — before vision loss affects your daily life.

What about macular degeneration?

Age-related macular degeneration (AMD) damages the macula, the part of the retina responsible for central vision. It is the leading cause of vision loss in Canadians over 50.

Early AMD has no symptoms. By the time straight lines appear wavy or a dark spot develops in your central vision, significant damage has already occurred. Retinal imaging can detect the earliest signs — small deposits called drusen — years before vision is affected.

What about diabetic eye disease?

Diabetic retinopathy is the leading cause of preventable vision loss in working-age Canadians. High blood sugar damages the small blood vessels in the retina over time.

The early stages are completely silent. Annual dilated eye exams are critical for anyone with Type 1 or Type 2 diabetes, because treatment is far more effective before symptoms appear.

What about dry eye disease?

Dry eye becomes increasingly common after 40, particularly in women approaching or past menopause. Hormonal changes reduce tear production and alter tear composition.

Unlike the conditions above, dry eye usually does have symptoms — burning, grittiness, or fluctuating vision. Your optometrist can assess tear quality and recommend treatment before chronic inflammation damages the eye surface.

What about presbyopia?

Presbyopia — the gradual loss of near-focus ability — affects virtually everyone starting around age 40 to 45. It is not a disease but a normal change in the lens. If you are holding your phone further away to read, this is likely why. Your optometrist can discuss correction options including reading glasses, progressives, and multifocal contact lenses.

Do any risk factors mean I should be screened earlier?

Yes. Consider earlier or more frequent screening if you have:

• A family history of glaucoma, macular degeneration, or retinal disease
• Diabetes or high blood pressure
• High myopia (strong nearsightedness)
• A history of smoking — the single most modifiable risk factor for AMD
• African or Caribbean ancestry — associated with earlier and more severe glaucoma
• Prolonged UV exposure without eye protection

If any of these apply to you, discuss screening frequency with your optometrist. Catching a condition early does not guarantee perfect outcomes — but missing it almost always means losing options that were available only in the early stages.