Why Is My Vision Getting Worse Every Year?

Short answer: The most common reasons vision worsens progressively are ongoing myopia progression (most common in children and young adults), the development of presbyopia (mid-forties and beyond), cataract formation (typically from the fifties onward), and in some cases, corneal disease or retinal conditions. The cause matters — and so does the rate of change.

This question is addressed throughout Eye Health and Vision Care. Here is what the most common causes mean clinically.

Myopia Progression in Children and Young Adults

The most common cause of worsening prescription in people under 30 is myopia progression. The eyeball continues to elongate as it grows, increasing the degree of nearsightedness with each annual exam. This is normal and expected during childhood and adolescence.

Myopia typically stabilizes in the early to mid-twenties — but “typically” is not “always.” Some adults continue to progress through their late twenties or even thirties. An adult whose prescription is still changing significantly is not a good candidate for laser vision correction until stability is demonstrated over at least one to two years.

Rapidly worsening myopia in an adult — particularly in combination with increasing irregular astigmatism — warrants evaluation for keratoconus, a corneal condition in which the cornea progressively thins and steepens. See corneal health and vision correction for more detail.

Presbyopia: Why Near Vision Changes in Your Forties

If your distance vision has been stable but your reading is getting harder, you are almost certainly experiencing presbyopia — the age-related stiffening of the crystalline lens that reduces near focusing ability. This is not a worsening of your prescription per se; it is a separate physiological process.

Presbyopia begins for most people in their early to mid-forties and progresses through the fifties, reaching full expression by approximately age 60. It affects everyone — including people who previously had LASIK for distance correction, people with perfect distance vision, and people who have never worn glasses in their lives.

Adult Myopia Increase: Less Common but Clinically Important

Significant myopia progression in adults (typically defined as more than 0.50 D of change per year) is less common but clinically meaningful when it occurs. Causes include:

Nuclear cataract formation: A nuclear sclerotic cataract changes the refractive index of the lens, often increasing myopia (called “myopic shift”). This is sometimes described as “second sight” — people who needed reading glasses may find they can suddenly read without them, as the denser lens provides additional near power. It is temporary; the cataract eventually degrades overall vision.
Uncontrolled diabetes: High blood glucose levels cause osmotic changes in the crystalline lens, temporarily altering its power and causing fluctuating or increasing myopia.
Keratoconus progression: Progressive corneal thinning and steepening causes increasing irregular myopia and astigmatism.

When Worsening Vision Is a Warning Sign

Not all vision changes are prescription changes. Sudden or rapid worsening of vision — particularly if accompanied by:

New floaters or flashes of light (potential retinal tear or detachment)
A curtain or shadow in peripheral vision (retinal detachment)
Sudden central vision blurring (possible macular event)
Severe eye pain, nausea, and halos (possible acute angle-closure glaucoma)

…requires urgent evaluation. These are not wait-until-my-next-appointment symptoms. See when should I see an eye doctor immediately for the complete list of urgent presentations.

Is Worsening Vision a Reason to Delay Surgery?

Yes, for laser vision correction. Surgeons require documented prescription stability before proceeding. A prescription that changes by more than 0.50 diopters in any axis over the past year or two is not yet stable, and performing surgery on an unstable prescription risks a suboptimal outcome that requires enhancement or correction.

For younger patients, the best strategy is to confirm stability with annual exams, wait out the stabilization period, and plan a surgical evaluation once two consecutive stable annual refractions are on record.