Presbyopia

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What is presbyopia?

Presbyopia, a name derived from Greek words meaning "old eyes," is a condition in which near objects become more difficult to focus. Because it is associated with aging, presbyopia is often met with a groan and the realization that reading glasses or bifocals are inevitable, but today even more options are available to help us regain our vision and still feel young and adventurous!

What are the symptoms of presbyopia?

Often patients with presbyopia have blurred vision, tired eyes, or headaches when they are doing close work, such as reading, sewing, knitting, or painting.

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What causes presbyopia?
As we age, body tissues normally lose their elasticity. As skin ages, it becomes less elastic and we develop wrinkles. Similarly, as the lenses in our eyes lose some of their elasticity, they lose some of their ability to change focus for different distances.

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The crystalline lens plays a key role in focusing light on the retina. When we are young, the lens is flexible. With the help of tiny ciliary muscles, it changes shape, or accommodates, for both near and distant objects by bending or flattening out to help focus light rays. As we age, the lens becomes stiffer, and the muscles become weaker. Changing shape becomes more difficult. Not only does focusing on near objects become more difficult, but the eye is also unable to adjust as quickly to rapid changes in focus on near and distant objects.

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Who develops presbyopia?

Everyone will develop presbyopia eventually, but the age in which it starts varies from person to person. The loss is gradual. Long before we become aware that seeing close up is becoming more difficult, the lenses in our eyes have begun losing their ability to focus. Only when the loss of elasticity impairs our vision to a noticeable degree do we recognize the change. On average, this happens in our early to mid-forties. 

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Unfortunately, this cannot be prevented. Presbyopia is a part of our natural aging process

How is presbyopia diagnosed?

A comprehensive eye health examination, including a testing of the quality of your near vision, is necessary to diagnose presbyopia.

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How is presbyopia treated?
To compensate for presbyopia, our optometrists can prescribe reading glasses, bifocals, trifocal, progressive addition lenses, contact lenses, or even special drops to help out! Your optometrist will have a discussion with you about which options would work best for your lifestyle. 

If you do not have other vision problems, such as nearsightedness or astigmatism, you may only need glasses for reading or other tasks performed at a close range. If you have other refractive errors, such as nearsightedness, bifocal or progressive addition lenses (in which the power of the lens changes gradually towards the bottom to allow reading, without the reading portion of the bifocal lens being obviously visible) are often prescribed for full-time wear. In most cases, our patients find that wearing glasses all the time is more beneficial and convenient for them. 

Every year newer and better contact lenses are being developed to help with presbyopia. Bifocal contact lenses are becoming more popular, because they help patients see both far and near in each eye. Monovision contact lenses help patients see near and far by having a distance contact lens in one eye and a near contact lens in the other. Although this sounds strange, it is a great option for many patients. Other patients opt to wear contact lenses for distance only and then wear reading glasses over them to see at near. All three options are very popular with patients, depending on their visual requirements. 

 

There are a few refractive surgeries that could be discussed to help with presbyopia. 

You will be asked a number of questions about your usual lifestyle or daily activities during your comprehensive eye examination to help determine the solution most suited to your needs.

What is the prognosis for presbyopia?

Presbyopia is a gradual change, happening over a number of years, so your prescription will need to be updated periodically. Changes are best made at your regular eye examination.