In our life, we often encounter some middle-aged and elderly patients who think that it is natural to have poor vision as they get older, thus neglecting eye pathologies and delaying treatment with serious consequences, which is a great pity! Here, we select some common eye diseases in middle and old age and introduce their main symptoms and prevention methods. Cataracts In China, cataracts are still the most common blindness-causing eye disease. The so-called cataract is the degeneration of the transparent lens that loses its transparency during the aging process, and the cloudy crystals are like opaque glass, blocking vision and causing patients to gradually lose their vision, often in both eyes. There is no specific treatment for cataracts in their early stages, and topical use of some eye drops and taking vitamin-based medications may delay the development of cataracts, but surgical intervention is often eventually required. It is important to note that surgery is currently the only effective treatment for cataracts. The timing of surgery needs to be tailored to the individual case with the advice of a specialist. Therefore, after a cataract is diagnosed, it is important to have regular checkups in order to receive timely and effective treatment. Presbyopia Presbyopia, commonly known as “presbyopia”, is the most common eye change in middle-aged and elderly patients, caused by the decline of eye regulation as they age. For example, under normal circumstances, our eyes may be 10 times the zoom of a camera from 20 to 40 years old, and this zoom value may gradually decrease after 45 years old, and by 70 years old, the zoom range may only be 2 times. The range in which one can see clearly also becomes smaller, and for the patient, the main manifestation is a lack of clarity in seeing close objects. Technically speaking, presbyopia is not a disease, but currently it is not given the attention it deserves, leading to many other eye problems. The most common misconception about presbyopia correction is to just buy glasses. Although the correction of presbyopia is somewhat empirical and has a lot to do with personal eye habits, to achieve a satisfactory correction, it is important to have regular optometry and regular review and replacement. Buying inappropriate glasses can increase the burden of eye adjustment and lead to fatigue, resulting in sore eyes, photophobia, congestion and even headaches. Glaucoma When the intraocular pressure is higher than normal or the tissues in the eye cannot withstand a certain level of intraocular pressure, it can cause atrophy of the optic nerve and impair visual function, which is called glaucoma. Triggering factors for glaucoma such as strain, mood swings, long hours of darkroom work and use of atropine drugs can easily contribute to the onset of symptoms. Acute attacks of closed-angle glaucoma have very obvious symptoms and are usually not ignored by patients, often showing severe eye pain, eye redness, headache, nausea and vomiting, and sudden loss of vision. Other glaucoma has no obvious symptoms and is easily overlooked, with occasional eye swelling, orbital soreness, occasional mild blurring of vision and iris vision. Advanced glaucoma cannot undo the damage to visual function even if the IOP is controlled, so prevention and early treatment are important in glaucoma. For middle-aged and elderly people with a family history of glaucoma, it is best to have regular examinations of intraocular pressure, visual acuity, fundus and visual field. Once the diagnosis of glaucoma is confirmed, it is important to pay full attention to it, avoid irregular and non-adherent medication, and to follow up regularly. If it cannot be controlled by medication, laser or surgical treatment should be considered as early as possible. Age-related macular degeneration The macular area is the most sensitive part of vision. The severe degeneration of optic cells and pigment epithelial cells in the macular area of the elderly is called age-related macular degeneration, which can lead to vision loss. Age-related macular degeneration is divided into wet and dry: the former has abnormal formation of neovascular membrane in the macula, which has a faster and significant impact on vision and can be treated by several special lasers. The latter is dominated by atrophic changes in the macular area, which generally develops more slowly and affects vision in the late stage, and currently lacks effective treatment methods. Good lifestyle habits, enhanced UV protection and proper supplementation with vitamins and some other antioxidant drugs are helpful in preventing age-related macular degeneration. Central retinal artery obstruction and central venous obstruction Although these two diseases differ by only one word, the symptoms, causes and outcomes are completely different. Central artery occlusion is one of the most critical eye diseases of the elderly. The main blood supply to the retina comes from the central retinal artery, and once it is blocked, the supply is lost and dysfunction occurs. The progression is extremely rapid, and often within a few minutes, the retinal function is completely lost and irreversible. Arterial blockage often occurs in patients with pre-existing hypertensive atherosclerosis or heart disease, and the sudden onset of vision loss or loss of vision at one glance requires immediate hospital consultation, and every second counts. In some patients, a history of transient black clouding has been followed, but it is often overlooked. Had it been detected earlier and prevented, the outcome would have been completely different. Central venous obstruction is an obstruction of the blood vessels that return flow to the retina, with fundus hemorrhage as the main manifestation. Hypertension, hyperlipidemia, diabetes, glaucoma, and cervical spondylosis can all contribute to the development of venous obstruction. Patients often experience rapid loss of vision with dark shadows floating and obscuring in front of their eyes. The consequences of venous obstruction vary from person to person, and because the cause is not clear and there are no targeted means of prevention, early detection, early treatment and regular follow-up are important. Systemic disease-related eye diseases Arteriosclerosis, hypertension, and diabetes are common and frequent diseases that threaten the health of middle-aged and elderly people. These diseases, often, also involve the eyes, especially diabetic retinopathy, which has a long course and causes severe visual impairment in the late stage, and can also cause secondary neovascular glaucoma, which aggravates the patient’s pain. For such patients, control of systemic disease is the basis for prevention and treatment of ocular disease. On this basis, it is necessary to be aware of ocular lesions and to have regular eye examinations for early diagnosis and treatment and to obtain better treatment results. Retinal detachment Although retinal detachment is not a very common eye disease, the incidence has increased in recent years and is not uncommon among middle-aged and elderly patients. The treatment effect of retinal detachment is not only related to the surgeon’s surgical level, but also closely related to the patient’s awareness and attention to the disease. High myopia, trauma and retinal detachment are closely related, and many patients with retinal detachment have precursor symptoms of vitreous opacities (mosquitoes), of course, not with vitreous opacities must occur retinal detachment, but for the sudden occurrence of mosquitoes with flashing sensation, we should pay special attention to timely consultation and follow-up. The range of common eye diseases in middle-aged and elderly people is very wide, involving almost every aspect of ophthalmology. Although these diseases are serious, if they are detected and treated early, they can get better treatment results.