Welcome to Presbyopia

As we age, our bodies undergo many significant changes. One such change that often causes concern for people is the gradual loss of near vision that occurs when we reach our 40’s. This normal and unavoidable effect of aging is called presbyopia, or “old eyes.” Presbyopia is completely normal and will ultimately happen to everyone.

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What is presbyopia?

Presbyopia is a condition that typically becomes noticeable for most people around age 45. In children and young adults, the lens inside the eye can easily focus on distant and near objects. With age, the lens loses its ability to focus adequately. Although presbyopia is not completely understood, it is thought that the lens and its supporting structures lose the ability to make the lens curvature greater during close vision effort. To compensate, affected individuals usually find that holding reading material further away makes the image clearer. Ultimately, aids such as reading glasses are typically needed by the mid-forties. Besides glasses, presbyopia can be dealt with in a number of ways. Options include: monovision and multifocal contact lenses, monovision laser vision correction, and new presbyopia correcting implant lenses.

Presbyopia Symptoms

The symptoms for presbyopia are familiar to anyone over age 45. At first, you will notice that after you’ve been reading for a short time, the words seem to run together. After a brief rest, you can again read for a short time before it happens again. Over time, reading small print – such as numbers in the phone book, the box scores in the newspaper, or items on a menu – becomes harder and then impossible. You may notice that if you hold reading material farther away than normal, the words come into sharper focus. As presbyopia continues to develop, you may find yourself holding your newspaper farther and farther away until at last your arms aren’t long enough to compensate.

Presbyopia arises due to changes in the lens of the eye. Like in a camera, the lens of the eye is responsible for adjusting focus. When we are young, we can easily change focus to look at objects that are nearby or far away. This is because our lens is young and soft and can quickly and easily change its shape to accommodate between distance and near focus. But as we age, the lens becomes stiff and can no longer easily change its shape. As a result, we can no longer adjust our focus to see up close without some help. This most commonly starts around age 42, but can come on a few years earlier in some people, and show up later in others.

Help for presbyopia comes in the form of glasses, contact lenses, or refractive surgery. If you do not use glasses for distance vision, then a pair of reading glasses is the easiest solution. Reading glasses are necessary only for up-close tasks such as reading or sewing, and must be removed to see clearly off at a distance. Reading glasses come in different strengths. Usually weak reading glasses (in the range of +1.25 to +1.50 diopters, or focusing units) will work well when presbyopia symptoms are just beginning, and stronger glasses will be needed every few years until presbyopia stops getting worse, usually in your late 50’s to early 60’s. Once presbyopia stops progressing, most people end up with reading glasses in the range of +2.50 to +2.75 diopters. If you do use glasses for distance vision even before presbyopia starts, the solution for you will involve bifocals. Bifocals are glasses that have your distance prescription in the top of the lens and your presbyopic reading prescription in the bottom of the lens. The strength of the bifocal part of the lens will have to be increased over the years as presbyopia progresses, just as with reading glasses. Monofocal, bifocal, and multifocal contact lenses are sometimes prescribed for presbyopia.

Refractive surgery options are also available to presbyopic patients. Refractive Lens Exchange involves taking out the natural lens in the eye replacing it with an intraocular lens that corrects both distance and near vision. These presbyopic-correcting lenses may be either accommodative or multifocal.

Monovision

The eye doctors at the Kentucky Eye Institute offer the possibility of Monovision for some presbyopic patients. Prior to Monovision, a contact lens trial should be conducted under the supervision of your ophthalmologist. Monovision is a technique of correcting one eye for distance and one eye for near. Monovision is typically accomplished using contact lenses. However, monovision can also be achieved through LASIK. Not all pateients can adapt to having one eye corrected for distance and one eye corrected for near. Your Kentucky Eye Institute eye doctor will help determine if monovision is right for you.

Monovision LASIK

If you are a patient considering monovision LASIK you should first wear monovision contact lenses for at least a week to determine if you can make the monovision adjustment. Please consult the skilled ophthalmologists at the Kentucky Eye Institute directly regarding this monovision trial. Monovision LASIK should be considered a permanent surgical procedure, although there are exceptions.

This presbyopia website page resource is intended to highlight relevant considerations in a summary manner and should not be construed as individual legal advice. You should consult with legal counsel before acting on information contained in these documents. If you are seeking vision correction alternatives for presbyopia please feel free to consult with our eye doctors located at several locations throughout Kentucky. Refractive surgery options are available for presbyopic patients. Refractive lend exchange involves taking out the natural lens of the eye and replacing it with an intraocular lens that corrects both distance and near vision.

 

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