Why my midlife eyesight isn’t as bad as I feared and what every woman over 40 should know

I braced myself for today’s eye test. Not because I’m squeamish, but because turning 50 has come with a steady stream of “system updates” and a flurry of NHS invites for every condition under the sun. Breast screening, bowel screening, blood tests, the lot. It feels like your MOT is doomed to fail the moment you hit the big 5-0, as if someone is saying, “We’d better check everything… just in case.” the sort of thing they surely would have spotted years ago if anyone had bothered to look sooner.

I don’t usually blog about visits to my optician. But after the Botox episode earlier this year, I realised I’m probably not the only one who’s sat there, fretting over every twitch and ache, convinced something sinister is happening. So here I am, sharing it all.

Read more about my Botox disaster here if you want to! 

The optician handed me my results with a smile, saying my eyesight was excellent for 50. I felt a rush of relief and surprise, but couldn’t stop wondering why my eye kept twitching and why the pain lingered.

The fear that had been sitting in the back of my mind

The truth is, I didn’t go into that appointment feeling calm. I’ve had a run of eye symptoms that sent my imagination down every worst-case scenario these past few months. Throbbing pain behind my eye. Sharp, sudden shooting pain that felt like someone was jabbing a hot poker straight into my eyeball. A left-eye twitch that arrived whenever I was on a call. Some days it stopped me mid-sentence and had me apologising for rubbing my eye. Other days, the nausea had me with my head in my hands until it passed. All I wanted to do was go and lie down in a dark room.

With my family history, it’s no wonder. My dad lives with glaucoma and lost sight in one eye after a detached retina and a disastrous surgery. So when my own symptoms began, I certainly didn’t just jump to the conclusion that it was dryness and too many hours staring at screens.

And then there’s the Botox from May. My self-inflicted bright idea to celebrate my half a Century on this planet. I’ve been kicking myself ever since. Every twinge, every ache, I blamed on that. I’ve taken painkillers, squinted into mirrors, and covered my eye with my palm after calls. I convinced myself I’d irritated a nerve that was important.

But the optician was clear. The stabbing pain, the twitching, the throbbing, even the nausea, all come down to dry eyes and not taking enough screen breaks. She sees it constantly, especially in women my age. Hormones, screens, stress, and perimenopause.

She prescribed Hycosan “intense” eye drops, the strong ones, because the drops I’d been relying on were, in her words, not doing much. And suddenly everything made sense. No glaucoma warning signs. No retinal issues. Nothing sinister. Just midlife and my own catastrophising.

What the rest of my results actually show

Here’s the simple version of my prescription.

• Distance vision: Essentially perfect. One eye is Plano, the other is -0.25.
• Astigmatism: A whisper of +0.25 in each eye. Barely worth mentioning.
• Reading add: +1.25 in both eyes. Completely normal for midlife and milder than many women around my age.

So my reading vision needs a small boost, but my distance vision is sharp.

The field test surprise

What genuinely lifted my spirits was the visual field test, the one where you press a button every time a little grey light flashes. I hit every single one. Every. Single. One. Cyrus would have been proud. It felt more like one of his Roblox games, only with an eye patch, making me look like Jack Sparrow as I played.

While my memory hasn’t been that great lately, this was a reminder that not everything fades with age. Some things do stay reliable.

Why this happens after 40

As we age, the lens inside the eye stiffens and makes focusing up close harder. That’s presbyopia. Everyone gets it. Perimenopause affects tear production and eye comfort, which doesn’t help. Dryness makes everything feel more dramatic than it is. The optometrist told me nearly everyone needs reading help by their mid-40s. If anything, my +1.25 suggests my eyes are ageing gracefully.

How I look after my midlife eyesight

Here’s what genuinely helps me stay on top of things.

• Proper lighting. Menus are not shrinking, however much it feels like they are.
• Dry eye care. Warm compresses and the right drops work wonders.
• Screen breaks. Apparently four or more are essential per day for me.
• Correct-strength readers. Glasses need to be right.
• Regular tests. An annual check for someone over 40 whose father has glaucoma is free on the NHS.

Why eyesight matters for women’s health

Good vision supports confidence and how well I can work in what I do. As someone who also loves writing, I rely on clear eyesight more than I realised. Squinting is not the look I’m aiming for.

And no, Botox isn’t the culprit

For all the sleepless nights I’ve spent blaming that appointment back in May, it turns out Botox wasn’t the culprit in this story. My eyes aren’t damaged. Nothing has shifted or collapsed. I simply need to look after them, hydrate them and give them more TLC with regular breaks from the glow of a screen.

In theory, it sounds simple. In reality, when you work, blog, parent and run half your life through a phone, it feels like telling a midlife woman to relax more. Lovely idea, but it’s easier said than done. It’s a relief to know the answer is practical, not permanent though. And honestly, that feels like a huge weight has been lifted.

So yes, my eyes are doing better than I expected

At 50, juggling family life, perimenopause and the daily effort to feel strong, this feels like a win. And in midlife, we have to celebrate the wins, no matter how small they are.