I find full screen magnification (following mouse and keyboard focus) extremely effective once you have gotten comfortable with it. I feel like I‘m barely disadvantaged as long as things are happening on screen. I can comfortably design pages and apps in sketch or figma and have not gotten much negative feedback on that. It‘s still possible these things wheren‘t up to standard, but good enough to ship at an agency and have happy clients. Now I am solo designing and developing my startup‘s app and we get positive anonymous feedback on the design. This sounds like I‘m bragging and I would edit it down but I‘m trying to show you that it is still very workable, if you want to keep doing it. I am no design savant: just put a little more thought into it, follow some rules on typography, spacing and color and zoom into the details to get them right. Also shamelessly follow some trends that seem nice to you. Since you‘ve been doing it for a while, you already know what to do.
This is if you want to keep doing it. If you know your eyesight will keep getting worse, or you just feel uncomfortable working with screens this much, it‘s wise to look for the next thing. The DevOps suggestions in the thread seem good, as do the accessibility consulting ones. You could transition to text to speech and maybe braille displays in those positions.
If you have questions, general or specific, about how to make it work, I‘m happy to talk. My twitter username is the same as here and you can DM me.
Edit: I think I misread your vision numbers because i am not used to that format but a 0-100% one. My visus is hovering around 20%. I think 20/40 would be 50%?