Clear Solutions for Every Focus: Navigating Presbyopia with Expert Diagnosis and Care
As we reach middle age, particularly after age 40, it is common to encounter difficulty with reading and performing other tasks that require near vision. This is because with age, the lens of our eye becomes increasingly inflexible, making it harder to focus on close objects. This condition is called presbyopia, and it is a nearly universal experience as we advance in years.
To avoid eyestrain, people with untreated presbyopia tend to hold phones, books, and menus at arm’s length in order to focus properly. Trying to perform tasks at close range can often cause headaches, eye strain or fatigue.
Causes of Presbyopia
During our youth, the lens of our eye and the muscles that control it are flexible and soft, allowing us to focus on close objects and shift focus from close to distant objects without difficulty. As the eye ages however, both the lens and the muscle fibers begin to harden, making near vision a greater challenge.
Presbyopia is a natural result of the aging process and not much can be done to prevent it. Its onset has nothing to do with whether you already have another vision impairment such as nearsightedness, farsightedness or astigmatism. Everyone will notice some degree of loss of near vision as they age, although for some it will be more significant than others.
Symptoms of Presbyopia
Presbyopia is characterized by:
Difficulty focusing on small print
Blurred near vision
Experiencing eyestrain, fatigue or headaches when doing close work or reading
Needing to hold reading material or small objects at a distance to focus properly
Requiring brighter lighting when focusing on near objects
Presbyopia can be diagnosed in a comprehensive eye exam.
Treatment for Presbyopia
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Reading glasses are basically magnifying glasses that are worn when reading or doing close work that allow you focus on close objects.
Eyeglasses with bifocal or multifocal lenses such as progressive addition lenses or PALs are a common solution for those with presbyopia that also have refractive error (nearsightedness, farsightedness or astigmatism). Bifocals have lenses with two lens prescriptions; one area (usually the upper portion) for distance vision and the second area for near vision. Progressive lenses or PALs similarly provide lens power for both near and distance vision but rather than being divided into two hemispheres, they are made with a gradual transition of lens powers for viewing at different distances. Many individuals prefer progressive lenses because unlike bifocals, they do not have a visible division line on the lens.
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Multifocal contact lenses allow clear vision at different distances – near, intermediate, and far. There are different designs of multifocal contacts, including simultaneous vision lenses (where you see both near and far simultaneously) and alternating vision lenses (where specific zones are dedicated to either near or far vision).
Another option for those who prefer contact lenses is monovision. Monovision splits your distance and near vision between your eyes, using your dominant eye for distance vision and your non-dominant eye for near vision. Your eye doctor will perform a test to determine which type of lens is best suited for each eye and optimal vision.
Multifocal contact lenses are also available in both soft and Rigid Gas Permeable (RGP) varieties. -
Eye drops for presbyopia typically work by utilizing a specialized type of medication called a miotic. These drops help to constrict the pupil, which enhances depth of field and improves the ability of the eye to focus on close objects. By narrowing the pupil, the eye can better manage the loss of flexibility in the lens associated with presbyopia, allowing for improved near vision.
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There are surgical procedures also available for treatment of presbyopia including monovision LASIK eye surgery, conductive keratoplasty (CK), corneal inlays or onlays or a refractive lens exchange (RLE) which replaces the hardened lens in the eye with an intraocular lens (IOL) similar to cataract surgery.