Presbyopia

(Age-Related Near Vision Loss)

Key Takeaways:

  • Presbyopia is a common age-related condition that causes difficulty in focusing on nearby objects.
  • Symptoms may include blurred near vision or difficulty in reading.
  • Diagnosis can only be done by an eye specialist through eye exams, including a refraction test.
  • Various treatments are available, such as reading glasses, contact lenses or surgeries.
  • Adopting a healthy lifestyle and having regular eye check-ups helps monitor your vision and overall eye health.

What is Presbyopia?

Presbyopia is a common type of vision condition where your eyes lose the ability to focus on nearby objects. This happens because your eye’s natural lens becomes less flexible with age. The condition usually becomes noticeable around the age of 40 and may continue to worsen until your mid-60s. You may notice an increased difficulty when reading, and you may find yourself holding a book or phone at arm’s length to see the words clearly. Other symptoms may include headaches or eye strain. Presbyopia is part of the natural ageing process and can often be corrected with glasses, contact lenses, or surgery.

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Elderly woman experiencing eye strain and rubbing her eye while holding reading glasses, a common sign of presbyopia and age-related near vision loss

Causes of Presbyopia

When you are younger, the lens of your eye is soft and flexible, allowing the surrounding muscles to easily reshape the lens to focus on both close and distant objects. With age, the lens gradually hardens and loses its elasticity to change shape. These changes make it harder for your eyes to focus on close objects. The hardening of the lens affects how the surrounding muscles adjust its shape, which then impacts how light is focused onto the retina. Presbyopia usually develops slowly over several years.

Symptoms of Presbyopia

As you age, your near vision may gradually become less clear. You might start to find it harder to see objects up close or to read small print. Other common symptoms of presbyopia are:

  • Squinting or holding a book at arm’s length to see the letters clearer.
  • Blurred vision at a normal reading distance.
  • Headaches or eye strain after doing close-up work like reading or using a computer.
  • The need for more light or brighter conditions to work in.
  • A need for reading glasses, even if you are already wearing contact lenses or prescribed glasses.

How is Presbyopia Diagnosed?

An eye care specialist can diagnose presbyopia through a comprehensive eye exam. The examination usually includes a refraction assessment to measure how well you see near and distant objects. This test helps determine if you have conditions such as presbyopia, astigmatism, short-sightedness, or long-sightedness.

The specialist may also perform an eye health assessment, which usually involves using eye drops to dilate the pupils. Dilation gives your specialist a clearer view of the inside of your eyes and may cause increased light sensitivity for a few hours.

Even if you do not experience any of the common symptoms, regular eye examinations after the age of 40 can help your doctor detect early signs of vision problems or other eye conditions.

Presbyopia Treatment Options​

At Philip D Izaac, we have treatment options for presbyopia. These options range from simple solutions to procedural treatments. We will help you decide on the option that is most suitable, depending on your individual needs and eye health, through a thorough eye examination and discussion with our specialist.

Reading Glasses

Reading glasses are a common option to correct close-up vision affected by presbyopia. They work by bending light before it enters your eye, helping you see more clearly at near distances. Non-prescription reading glasses are available, but an eye examination is recommended to determine your accurate power, which typically ranges from +1.00 to +3.00 diopters.

If other vision problems occur, such as astigmatism, short-sightedness, or long-sightedness, then bifocals, trifocals, or progressive lenses may be needed for clear vision.

  • Bifocals correct near and distance vision with a visible horizontal line that separates the prescriptions. The top section is for distant objects , and the bottom section is for close-up vision.
  • Trifocals come with two visible lines in the lenses with three sections to correct for close-up, middle distance, and distance vision.
  • Progressive multifocal lenses have a line that divides each refractive area with an upper section for distance vision, a middle section for intermediate vision (computer distance), and a lower section for near vision.

Contact Lenses

The two types of contact lenses that help with presbyopia:

  • Monovision: One eye wears a lens for distance vision (usually the dominant eye), and the other eye wears a lens for near vision. This procedure requires some time for the brain to adapt receiving images from different eyes to form a single clear image.
  • Multifocal: These lenses have multiple zones with different powers, giving way to near and far vision at the same time. The brain selects the right focus for what we want to see, which may make the vision slightly less sharp.

Surgery

Surgery can be an option for people who want a long-term solution for presbyopia and other vision issues.

  • Refractive Surgery: This procedure reshapes the cornea to improve vision. For presbyopia, one eye is corrected for distance and the other is corrected for near vision (similar to monovision contact lenses). Surgical procedures include LASIK, LASEK, TransPRK, Conductive Keratoplasty, which are irreversible. Implantable Collamer Lens (ICL) is reversible.
  • Corneal Inlays: A small device is implanted into the cornea of the non-dominant eye to improve near vision. The central opening allows in focused light so that you can see close objects. This procedure is reversible, and the corneal inlay can be removed if needed.

Eye Drops

Eye drops are a good option for some people with presbyopia. This non-surgical option temporarily reduces the size of the pupil to improve near vision. The first eye drop for presbyopia was approved by the FDA in 2021.

How to Prevent Presbyopia

Presbyopia is a natural part of ageing and cannot be prevented. However, you can take steps to protect your eye health:

  • Take regular breaks from close work, especially if you are working with a computer or having an intense reading.
  • Use bright lighting when reading to help your eyes focus.
  • Wear sunglasses to shield your eyes from harmful UV rays.
  • Eat foods rich in nutrients for your eyes, such as Vitamin A, Vitamin C, and Vitamin E

 

Everyone, at some point, will probably experience presbyopia as part of the ageing process. If you notice difficulty in reading, blurred vision of objects up close or eye strain, it is important to consult an eye care specialist. Uncorrected or undiagnosed presbyopia will lead to further deterioration of your vision.

Talk to us at Philip D Izaac for professional assessment and guidance on your eye health.

Frequently Asked Questions

Can presbyopia be prevented?

Presbyopia is part of the natural ageing process of the eye and cannot be prevented.

Are there any foods that can help with presbyopia?

No specific diet or food has been proven to help with presbyopia. However, a healthy diet that is rich in fruits and vegetables, and low in processed foods, can be beneficial for overall eye health.