Here are 5 key points about presbyopia:

1. Presbyopia is a normal aging change of the eye
2. It causes difficulty seeing clearly when looking at close objects around 40 years of age
3. The crystalline lens in the eye stiffens over time
4. Commonly associated with blurred vision, eyestrain, visual fatigue and headaches
5. It can be corrected with prescription spectacles or contact lenses

What is presbyopia?

At approximately 40 years of age, it can become harder to focus on close up tasks, like reading small print.  Trouble reading in poor lighting, tired eyes and headaches with prolonged near work are also often experienced.  You may even find yourself holding things further away, at arm’s length, so you can see them more clearly. You may even be using ready made magnifiers or chemist readers to read. We’ve written about ready made readers and the hidden dangers before.

It can be disheartening to deal with a deterioration in vision and come to terms with the need to wear vision correction. However, presbyopia is a normal change that we will all go through with age and it’s easily managed.

Causes of presbyopia

The eye has an internal crystalline lens which helps focus an image onto the sensory retina.  In early life this lens is flexible and changes shape easily when the ciliary muscle (focusing muscle) pulls on it to focus. Over time, the lens stiffens and moves less easily. As a result the closest distance that the eye can focus gets further away, until the lens is completely crystalized.  When this happens, it is no longer possible to change the eye’s focus from distance to near.

Symptoms

Most people first notice difficulty seeing clearly when looking at objects that are at a usual reading distance.  It is common to become fatigued with prolonged computer work and experience eyestrain and headaches.  Reading vision is often worse in poor lighting and where the text is small. Tasks such as threading needles can also be difficult.

Symptoms of presbyopia can seem to appear quite suddenly. It can feel like your eyes have deteriorated very quickly over some weeks or months and you suddenly can’t see up close like you used to. However, the changes that cause presbyopia will have been gradually occurring for many years, with the symptoms gradually increasing over time.

Diagnosis

The optometrist will measure your vision and ability to focus your eyes on near vision tasks. Diagnostic lenses are used to determine your stage of presbyopia and the amount of correction needed alleviate your symptoms. Your age also forms an important part of the diagnosis, as presbyopia develops and follows a relatively predictable path.

Treatment

Prescription optical lenses and prescription contact lenses are used to compensate for the decrease in focusing ability the eye has with presbyopia. Near vision (or reading) glasses are often one of the first solutions for presbyopia. As presbyopia progresses with age, the lenses used to correct your vision will begin to assist at more distances, such as the distance that a desktop computer screen is positioned. 

When it becomes necessary to see clearly at a variety of working distances, the optometrist may prescribe extended focus or multifocal lenses.  These have varying prescription powers through the lens which enables the wearer to continue focusing at multiple distances.

Unfortunately, eye exercises won’t change the onset of presbyopia because the problem is the eye’s lens, not the fucusing muscles.

Reducing your risk

Presbyopia is a normal change over time, for which there is no prevention.  Eye exercises cannot help as it is not caused by a muscular weakness but rather by the change in the lens structure.  Choosing to wear or not wear reading glasses will make no difference to the worsening of presbyopia. Almost everyone will experience presbyopia between 40 and 60 years of age.