What is Presbyopia, What Causes it and How is it Treated?

It might seem like almost everyone you know eventually has to wear glasses at some point in their life. Why is that? Well, meet presbyopia, a completely natural and normal loss of the ability to focus on things up close that typically happens after the age of 40. The bad news is, no one can escape it and presbyopia inevitably affects everyone. The good news is, some people notice a minimal impact and for everyone else, the issue is easily fixed by wearing reading glasses or switching up your current contacts or lenses to account for near vision. In fact, it’s a fairly common reason people come in to visit our Vancouver eyewear store for glasses.

What is Presbyopia?

First, what is presbyopia? By definition presbyopia is farsightedness (inability to focus on objects that are close) due to a loss of elasticity in the lens of the eye. Over time, the lenses become more and more inflexible. Normally, when rays of light come into the eye, the lens bends them and helps focus light on the retina. The lens is flexible so it can change its shape to focus on objects at different distances. It gets more stretched out to see things that are far away and becomes more rounded to focus on objects that are closer. As for what causes presbyopia, due to the loss of elasticity in both the lens and the muscles that control it, the lens becomes unable to round as much, hence why some of our ability to focus on near objects is diminished. Suddenly, things are blurry when we’re reading the paper, a book or text messages. Most people start to notice it in their 40s. By about 65 years old, the lens has almost no flexibility.

As we said, unlike other age-related vision problems, presbyopia is inevitable and it happens to everyone after 40. So, we’ll all experience some vision deterioration with age. Even if you’re currently farsighted (hyperopia), nearsighted (myopia) or have astigmatism presbyopia will still occur. Those who are farsighted, meaning they can see at a distance but not clearly up close, often experience it a little earlier in life than most other people. For those who are nearsighted, your contact lenses or glasses will still work for seeing in a distance but you won’t see as clearly up close.

What are the Presbyopia Symptoms?

  • Words are blurry from a distance that you used to be able to read comfortably from

  • Fine print becomes very difficult to read

  • You find yourself holding books, magazines, newspapers, your phone and other objects further away from your face in order to see clearly

  • Reading is harder when you’re tired or it’s late at night

  • You need brighter light to see details (this is because your pupils constrict when exposed to bright light, which alters the focus of the light on the retina)

  •  You get headaches, eyestrain and/or fatigue after doing close work or reading

  • You squint to make out details or gain clarity when looking at things up close

What are the Risk Factors of Presbyopia?

  • Age is obviously the biggest risk factor because everyone will experience some degree of near vision deterioration with age since the lens becomes more rigid.

  • A variety of medical conditions can cause premature presbyopia before the age of 40, including farsightedness, multiple sclerosis, cardiovascular diseases, diabetes, anemia, myasthenia gravis (a neuromuscular disorder), poor blood flow and eye trauma or disease.

  • Certain medications like antipsychotics, antianxiety drugs, antidepressants, antihistamines, antispasmodics and diuretics can also lead to premature presbyopia.

Can Presbyopia be Prevented?

Presbyopia is one of the few age-related vision problems that can’t be prevented. It is a natural part of aging. However, by eating a healthy diet, exercising and living a healthy lifestyle to ward off preventable risk factors, you can reduce the odds of developing premature presbyopia.

How is Presbyopia Diagnosed?

Most people who are over the age of 40 diagnose themselves when they realize they can’t read fine print anymore or they find themselves holding objects further away from their face in order to see clearly. Since the onset is gradual, it can take years from when the symptoms first begin to when they have enough impact on your day-to-day life that you feel the need to seek help. Yet, seeing an eye doctor earlier on can help you avoid the squinting and headaches. 
An eye care professional, like an optometrist or ophthalmologist, can also diagnose presbyopia. They’ll take your medical history and then test your vision with an eye chart. If they find you do have presbyopia, they’ll then determine the correct eyeglass lens prescription for you. To do that, they’ll have you look through corrective lenses, increasing the magnification power until you can see clearly.

How is Presbyopia Treated?

The easiest, least invasive way to treat presbyopia is to wear eyeglasses with corrective lenses when you’re reading or doing close up work. Here are some of your glasses options for presbyopia depending on your vision needs:

  • Reading Glasses – If you aren’t nearsighted or farsighted and don’t currently wear glasses, reading glasses are your best bet for correcting presbyopia. You’ll only need to wear them for tasks that require you to focus on things close up. You can also get reading glasses for close up tasks if you wear contact lenses. This way, you can wear your contacts for your far vision and just pop on your readers when needed.

Reading glasses are sold in a variety of diopters (the measurement of the power of the lens). For reading glasses, diopters increase in .25 increments. The higher the diopters, the stronger the lenses. Most people will start at +1.00 or +1.25 diopters for reading glasses and increase over the years as their presbyopia gets more pronounced. While you can get inexpensive reading glasses at a pharmacy or grocery store, custom glasses are typically better, particularly if you have a higher prescription.

Store bought, off-the-rack reading glasses are lower quality and you need to know your prescription for them to work properly. Additionally, they have generic optical centers and not everyone has the same distance between their eyes. If the optical center is off for you, it will lead to headaches and eyestrain. We recommend seeing an eyecare professional so they can determine an accurate prescription and then swinging by an eyewear store like the Spectacle Shoppe in Kerrisdale to get a custom pair of readers. The quality is better and you’ll be able to see clearly and comfortably.

  • Progressive Lenses, Bifocals or Trifocals– If you already wear prescription eyeglasses, you have the option of getting a second pair of reading glasses. However, switching between glasses is a pain. Most people opt for bifocals or progressive lenses. Bifocal lenses are split in two. When you look through the top portion, it corrects for distance and when you look through the lower portion, it corrects for near vision. Trifocal lenses have an added portion that corrects your intermediate vision for tasks like looking at a computer.

 The vast majority of people prefer progressive lenses to bifocals or trifocals. These multifocal lenses are line free and gradually adjust the magnifying power from near to middle to far vision. The transitions are less jarring and many people find them more comfortable to wear. At the Spectacle Shoppe, we use modern, digitally surfaced lenses customized to your needs. This means reduced aberration and an increased usable lens area, allowing even for improved peripheral vision. We also offer computer progressive lenses, which are super helpful if you work at a computer or have a lot of screen time.

  • Contact Lenses – You can use contact lenses to treat presbyopia but there are some drawbacks. Multifocal contact lenses have different zones set at different powers, yet many find their vision isn’t as sharp with them. However, if they are comfortable for you and your vision isn’t compromised, they’re a great option. Monovision lenses are where you have a prescription for far distances in one eye and a prescription for near distances in the other. Not everyone adjusts to them quickly though and the ability to judge something’s speed or distance can be affected. Again, if they do work for you and they’re comfortable, they can offer an alternative to glasses.

  • Presbyopia Surgery – There are presbyopia surgeries that can correct the problem, including monovision LASIK and corneal inlays. However, the benefits don’t outweigh the risks for many people, especially for those who only need to wear reading glasses on occasions. You should always go over the pros and cons of any procedure in depth with your doctor before making any decisions.

Presbyopia is a normal part of aging and while it can’t be cured or reversed, it will stabilize around the age of 65. It’s also easily treated with the addition of reading glasses or by switching up your current eyeglass lenses or contact lenses to correct your near vision as well. Stop by the Spectacle Shoppe to check out our full range of Vancouver glasses. We’ll help you find the perfect pair. 


Leo Franken
Leo Franken

Author

For Over 40 years, Leo has been passionately carrying on the tradition of professional service while featuring excellent quality and fashionable eyewear. Leo is a wealth of information and his blog is designed to share that information with you. Connect with