What Is Presbyopia and How Is It Corrected/Treated?

Presbyopia is an eye condition that makes it hard to see clearly up close. It’s a normal part of aging. Most people start to notice their near vision is beginning to get blurry around age 40.

Presbyopia Causes

To form an image, the cornea and the lens in the front of your eye help to focus the light reflected from objects onto the retina at the back of your eye. The tiny ring of muscle around the lens also helps focus light by relaxing when you’re looking into the distance and contracting to see something up close.

When you’re young, the lens is flexible and changes shape when the circular muscles surrounding it contract or relax. These muscles adjust your lens so you can see clearly both close up and at a distance.

As you age, the lens hardens and becomes less flexible, and the muscle around it also loses some function. The result is that the lens can’t change shape to focus on close-up images anymore. Your eye slowly loses its ability to focus light on the retina when you are looking up close. And near work such as reading and looking at your phone becomes harder because objects close to your eyes are blurry.

A few other things to know about presbyopia:

• Presbyopia is a normal part of getting older and can’t be prevented.
• Currently, there’s no known way to stop, slow or reverse it; although some surgeries can decrease the visual symptoms.
• Presbyopia can get worse over time because the lens of your eye continues to thicken become less flexible. The condition progresses until around age 65. At this age, the lens won’t get any more inflexible.
• Presbyopia does not lead to blindness. It only affects your near vision.

Presbyopia Symptoms

Are you holding a book, the newspaper or your phone far away from your eyes to try to see the words clearly? Are you over 40? These are signs you may have presbyopia and need glasses.

Presbyopia doesn’t happen overnight, but it does happen to everyone. Other symptoms include:

• Difficulty reading small print
• Blurry vision at normal reading distance
• Headaches or eye strain after reading or doing close-up work
• Feeling tired after doing close work
• Squinting
• Needing brighter light for reading or close-up tasks
• Generally having trouble seeing and focusing on objects close to you

Presbyopia Diagnosis

If you have any symptoms of presbyopia, your eye doctor can tell for sure during an eye exam. Even if you’re over 40 and can still see clearly up close, it’s a good idea to get regular eye exams. This allows your eye doctor to monitor your eye health and detect any problems in the early stages.

Presbyopia Treatment

Presbyopia is a condition that currently has no cure, but there are various treatments that can be used to improve your eyesight. Depending on your situation and lifestyle, you can opt for corrective lenses, contact lenses, or surgery to correct your vision.

Once you’re diagnosed, there are many ways you can treat presbyopia:

Eyeglasses

Presbyopia can be treated with eyeglasses, including reading glasses.

Progressive lenses

Progressives are the most popular type of lens for presbyopia. They have three different zones in each lens to correct for near, intermediate and distance vision. Many wearers choose them because there is no visible line on the lens between the zones.

Progressive lenses take some getting used to but are convenient since you don’t have to take them on and off or change glasses to see clearly at different distances.

Over-the-counter reading glasses

The lenses in these glasses allow you to see better up close. The number with a plus sign tells you how strong the power is. The higher the number, the stronger the power.

The power of these lenses usually ranges from around +1.00 diopters to +2.75 diopters. You can often find readers at your local drug store. You may want to get an eye exam and a prescription from your eye doctor before you buy readers to see if they will work for you.

Single-vision reading glasses

Single-vision reading glasses have lenses that are made with your prescription for your individual needs.They can have more power than over-the-counter readers and can correct other vision issues such as astigmatism (which can cause blurry vision at all distances). These glasses are for reading and other near-vision tasks.

Glasses with multifocal lenses

Multifocal lenses can correct all of your vision issues, including presbyopia in a single pair of glasses. Bifocal and trifocal lenses are exampmles of multifocal glasses.

Bifocal lenses have two zones — one for near vision and one for distance vision — in each lens. There is a visible line on the lens to separate the zones. The top of the lens is for distance vision and the bottom for near vision is at the bottom.

Trifocals have three zones — distance vision on top, intermediate vision in the middle and near vision on the bottom. There are lines on the lens between each zone. They function the same as progressive lenses.

Contact Lenses

Contact lenses are also an option to treat your presbyopia. Monovision contact lenses have one lens to correct distance vision and the other to correct near vision. Multifocal contacts are similar to multifocal eyeglass lenses — the lens has different powers built in.

Bifocal contact lenses for presbyopia work by having different prescriptions in different areas of the lens, allowing the wearer to see clearly at both near and far distances. Modified monovision contact lenses can also treat presbyopia by placing a single vision contact lens in one eye and a multifocal contact lens in the other eye.

This may improve depth perception and allow the brain to adapt to the different images from each eye, providing clear vision at all distance.

Surgery

Eye surgery is another option you have to treat presbyopia. Options include:

Refractive surgery

LASIK and other types of corneal refractive surgery reshape the cornea for sharper vision. This option for presbyopia has an approach similar to monovision contact lenses in which one eye is corrected for distance vision and one eye for near vision.

Corneal inlay surgery

A lens is inserted into the cornea of your non-dominant eye. This lens helps focus the light correctly for your near vision without compromising your distance vision.

Intraocular lens implant surgery

The lens in the eye is replaced with an artificial one that restores some focusing function.

Eye Drops

Eye drops are the newest option available to temporarily treat presbyopia. Miotic eye drops reduce the size of the pupil for up to six hours bycreating a pinhole effect. This improves vision both at near and far.

Lens-softening drops soften the lens and restore some of its lost flexibility. These drops can help the lens in your eye perform like it did when you were as much as 10 years younger. Lens-softening drops are still in clinical trials.

When To See Your Eye Doctor

If you’ve noticed things are blurry up close, make an appointment with your eye doctor. They can determine if you have presbyopia and let you know what options are available.

See your eye doctor right away if you have the following symptoms, even if you’re not sure if you have presbyopia:

• Sudden hazy or blurred vision
• Sudden loss of vision in one eye
• Double vision
• Seeing black spots, flashes of light or halos around lights

Presbyopia will eventually affect everyone. Your eye doctor is your best source for diagnosis and treatment of presbyopia and for helping you keep your eyes healthy and your vision clear.