Presbyopia: Symptoms, causes and treatment

Presbyopia is the normal loss of near focusing ability that occurs with age. Most people begin to notice the effects of presbyopia sometime after age 40, when they start having trouble seeing small print clearly — including text messages on their phone.

You can’t escape presbyopia, even if you’ve never had a vision problem before. Even people who are short sighted will notice that their near vision blurs when they wear their usual spectacles or contact lenses to correct distance vision.

The eye’s lens stiffens with age, so it is less able to focus when you view something up close.

 

Researchers estimate that nearly 2 billion people worldwide have presbyopia.

Though presbyopia is a normal change in our eyes as we age, it often is a significant and emotional event because it’s a sign of ageing that’s impossible to ignore and difficult to hide.

In parts of the world where there is no access to vision care, presbyopia is much more than an inconvenience — it’s a leading cause of vision impairment that reduces people’s quality of life and productivity.

Presbyopia symptoms

When you become presbyopic, you either have to hold your mobile phone and other objects and reading material (books, magazines, menus, labels, etc.) further away from your eyes to see them more clearly.

Unfortunately, when we move things further away from our eyes they get smaller in size, so this is only a temporary and partially successful solution to presbyopia.

If you can still see close objects pretty well, presbyopia can cause headaches, eye strain and visual fatigue that makes reading and other near vision tasks less comfortable and more tiring.

What causes presbyopia?

Presbyopia is an age-related process. It is a gradual thickening and loss of flexibility of the natural lens inside your eye.

These age-related changes occur within the proteins in the lens, making the lens harder and less elastic over time. Age-related changes also take place in the muscle fibres surrounding the lens. With less elasticity, it gets difficult for the eyes to focus on close objects.

Presbyopia treatment

Presbyopia can be treated with spectacles (including reading glasses), contact lenses and vision surgery.

Spectacles

Spectacles with progressive lenses are the most popular solution for presbyopia for most people over age 40. These line-free multifocal lenses restore clear near vision and provide excellent vision at all distances.

Another presbyopia treatment option is spectacles with bifocal lenses, but bifocals provide a more limited range of vision for many people with presbyopia.

It’s also common for people with presbyopia to notice they are becoming more sensitive to light and glare due to ageing changes in their eyes. Photochromic lenses, which darken automatically in sunlight, are a good choice for this reason.

Reading glasses are another choice. Unlike bifocals and progressive lenses, which most people wear all day, reading glasses are worn only when needed to see close objects and small print more clearly.

If you wear contact lenses, your optician, can prescribe reading glasses that you wear while your contact lenses are in. You may purchase reading glasses at a retail shop, or you can get higher-quality versions prescribed by your optician.

Regardless which type of spectacles you choose to correct presbyopia, definitely consider lenses that include anti-reflective coating. Anti-reflective coating eliminates reflections that can be distracting and cause eye strain. It also helps reduce glare and increase visual clarity for night driving.

Contact lenses

People with presbyopia also can opt for multifocal contact lenses, available in gas permeable or soft lens materials.

Another type of contact lens correction for presbyopia is monovision, in which one eye wears a distance prescription, and the other wears a prescription for near vision. The brain learns to favour one eye or the other for different tasks.

While some people are delighted with this solution, others complain of reduced visual acuity and some loss of depth perception. Because the human eye changes as you grow older, your presbyopia glasses or contacts prescription will need to be increased over time as well. You can expect your optician to prescribe a stronger correction for near work as you need it.

Presbyopia surgery

If you don’t want to wear spectacles or contact lenses for presbyopia, a number of surgical options to treat presbyopia are available as well.

One presbyopia correction procedure that’s gaining popularity is implantation of a corneal inlay.

Typically implanted in the cornea of the eye that’s not your dominant eye, a corneal inlay increases depth of focus of the treated eye and reduces the need for reading glasses without significantly affecting the quality of your distance vision.

The first step to see if you are a good patient for presbyopia surgery is to have a comprehensive eye exam and a consultation with a refractive surgeon who specialises in the surgical correction of presbyopia.

Presbyopia is a part of growing older

Presbyopia is a normal part of the ageing process, and we’re all going to have to deal with it sometime after age 40. Whichever option you choose – spectacles, contact lenses or surgery – you’ll be able to easily read messages on your phone or a book to your granddaughter without any trouble.

If you are beginning to notice signs and symptoms of presbyopia, contact us for an eye exam and consultation regarding the best presbyopia treatment options for you.

Source: https://www.allaboutvision.com/en-gb/conditions/presbyopia/


Presbyopia – an informative guide

When viewing an object that is far away, the eye – if we are perfectly sighted – is shaped so that the object is clearly focused on the retina. This means that the image is clear. When we look at something close up, for example reading a book, the muscles inside the eye that surround the lens contract to make the lens change shape. This focuses the light from the book onto the retina.

The lens inside a child’s eyes is elastic, and so will naturally alter its shape easily to allow for a change in focus from a distant to near object. As we get older however, the lens will stiffen and so change shape less easily. This means that the distance up to which we are able to focus becomes longer and we are no longer able to focus on things that are close to us, having to hold them further away to see them clearly. This is more noticeable with very close work, for example, when threading a needle. It can also mean that it may take longer for us to focus from looking at something close up to looking at something far away (or vice versa).

This change in focusing tends to become more noticeable when we reach our late thirties or forties as we then find it difficult to focus on things that are at the normal reading distance. It is quite common to see people who are presbyopic holding things away from them in an attempt to see them clearly. As this affects things that are close to us first, our vision of things that are further away – such as the computer – is not affected until later, when the lens has lost almost all of its elasticity.

This loss in elasticity is corrected with spectacles. This may mean having separate pairs for distance and reading and maybe for middle distance such as looking at the computer or reading sheet music.

What is the treatment for presbyopia?

Presbyopia is a natural part of ageing and there is no cure for it. The solution is generally to wear glasses for reading. Because reading glasses focus light from close objects, it is normal to find that distant objects are blurred when looking through them. They can either be removed for distance viewing or alternatively, bifocal or varifocal lenses can be used.

Bifocal lenses consist of two separate areas of the lens which are separated by a line: the top part of the lens focuses light from distant objects, and the bottom part of the lens focuses light from near objects. Varifocal lenses work in a similar way to bifocal lenses but without a visible line on the lens. This is because the power gradually changes from the top to the bottom of the lens, to allow objects at any distance to be seen clearly, simply by moving the head up and down to look through a different part of the lens.

Are there exercises I can do to stop needing reading glasses?

Presbyopia is not caused by muscle weakness but by the lens stiffening as we age. There are no exercises that can help this.

If you have any further questions please contact us