Every good pair of eyes eventually gets old and with age comes a condition called presbyopia. Presbyopia, which usually begins to set in some time around 40, occurs when the lens of the eye begins to stiffen, making near vision (such as reading books, menus, and computer screens) blurry. You may have this age-related farsightedness if you notice yourself holding the newspaper further and further away in order to make out the words, and you may begin to experience headaches or eyestrain as well.
The good news is, presbyopia is very common. It happens to most of us eventually and these days there are a number of good options to correct it. First of all, let’s take a look at what causes the condition.
What Causes Presbyopia?
As the eye ages, the natural lens begins to lose its elasticity as the focusing muscles (the ciliary muscles) surrounding the lens have difficulty changing the shape of the lens. The lens is responsible for focusing light that comes into the eye onto the retina for clear vision. The hardened or less flexible lens causes the light to lose focus on the retina when looking at close objects. This causes blurred vision.
Presbyopia is a progressive condition that gets worse with time. It is a refractive error just like myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.
Signs of presbyopia include:
- Blurred near vision
- Difficulty focusing on small print or close objects
- Eyestrain, headaches or fatigue, especially when reading or doing close work
- Holding reading material at a distance to see properly
- Needing brighter light to see close objects
Presbyopia can be diagnosed through an eye exam.
Treatments for Presbyopia
There are a number of options for presbyopia treatment which include glasses, contact lenses or surgery.
The most common form of correction is eyeglasses. Reading glasses adjust the focal point of the target to reduce the focusing demand on the eyes. A side effect of the convex lenses is that they also magnify the target. For some, reading glasses are sufficient to improve close vision. Others, especially those with another refractive error, require more complex lenses.
Bifocal or multifocal lenses, including progressive addition lenses (PALs), offer a solution for those with nearsightedness or farsightedness. These lenses have two or more prescriptions within the same lens, usually in different areas, to allow correction for distance vision and near vision within the same lens. While bifocals typically divide the lenses into two sections (or more), requiring the patient to look in the proper section depending on where they are focusing, progressive lenses provide a progressive transition of lens power creating a smooth, gradual change. Some people prefer progressive lenses for aesthetic reasons as they don’t have a visible line on the lens.
Like glasses, contact lenses are also available in bifocal and multifocal lenses. Alternatively, some eye doctors will prescribe monovision contact lens wear, which divides the vision between your eyes. Typically monovision involves fitting the dominant eye with a single vision lens for distance and the weaker eye with a single vision lens for near. Some patients find that monovision can affect their depth perception, so it can take a while to adjust to. Sometimes your eye doctor will prescribe modified monovision which uses a multifocal lens in the weaker eye to cover intermediate and near vision. Recent contact lens technology is making both lenses multifocal, which provides better depth perception.
Based on your prescription and visual needs, your eye doctor will help you decide which option is best for you. Since there are so many baby boomers with presbyopia, the multifocal contact lens choices have increased within recent years.
There are a few surgical treatments available for presbyopia. These include monovision LASIK surgery (which works similarly to monovision contact lenses), corneal inlays (implants placed in the cornea), and refractive lens exchange (similar to cataract surgery, this replaces the old, rigid lens with a manufactured intraocular lens). These procedures vary in cost, recovery and outcome. If you are interested in surgery, schedule a consultation with a doctor to learn about the different options.
Medication - On the Horizon
There are currently clinical trials with promising early results that are testing eye drops that restore the flexibility of the human lens. It could be possible that eye drops could be used to reduce the amount of time that people have to use reading glasses or contact lenses in the future.
As people are living longer, presbyopia is affecting a greater percentage of the population and more research is being done into treatments for the condition. So if your arm is getting tired from holding books so far away, see your eye doctor to discuss the best option for you.