Presbyopia is a vision condition in which the crystalline lens of the eye begins to harden and lose flexibility, making it difficult to focus on objects up close. Presbyopia usually occurs around or after the age of 40, which is why it is sometimes referred to as age-related farsightedness.
Although presbyopia is an unpreventable and natural part of aging, there are several options available to correct the blurred vision and eyestrain that is symptomatic of the condition. Your medical history, prescription, and lifestyle will all determine which presbyopia treatment is right for you.
Glasses and Contact Lenses
Glasses and contact lenses are the most dependable type of presbyopia treatment. If you already wear glasses for astigmatism, myopia, or other refractive errors, you may need an additional pair for reading and other up-close activities. Bifocals, which combine two prescriptions in one pair of glasses, are an excellent option. If you have no other vision problems, you will only need one set of reading glasses to correct your presbyopia.
Contacts are also a reliable method of presbyopia treatment. With contacts, you will have two options. You can either wear bifocal contact lenses, which act similarly to bifocal eyeglasses by correcting distance vision on the lenses' top half and up-close vision on the bottom, or you can use contacts to achieve monovision. Monovision simply involves dividing your separate prescriptions between your two lenses. One contact lens will correct your distance vision while the other will correct up-close vision.
To avoid the daily hassle of contacts or glasses, many people with presbyopia choose implantable lenses as their preferred form of treatment. An intraocular lens (IOL) actually replaces the eye’s natural lens and is a good option for people seeking a more permanent solution to presbyopia. A lens implant, which acts similarly to a contact lens, is placed either between the cornea and the iris (the colored part of the eye), or directly behind the iris.
Most implantable lenses treat only nearsightedness, but there are currently three types of lenses available in the United States that treat presbyopia. These include the ReSTOR®, ReZoom™, and crystalens® intraocular lenses. These lenses are a great alternative for patients who cannot undergo LASIK for their presbyopia treatment. The Array® lens is also an option, but is now rarely used, as crystalens®, ReSTOR®, and ReZoom™ have proven to be more effective treatments
Although monovision was once only possible through the use contact lenses, recent developments in LASIK surgery have made it possible to achieve permanent monovision. Through the LASIK procedure, which involves using an excimer laser to reshape the cornea so it can properly focus images, your surgeon can correct distance vision in one eye and up-close vision in the other.
The drawback of permanent monovision is that your eyes will no longer work together. Some patients find it difficult to get used to one eye being blurry all the time. Patients considering LASIK for presbyopia treatment should first try monovision with contact lenses to see how they adjust.
Conductive keratoplasty (CK) is a fairly new type of refractive surgery that uses radiofrequency (RF) energy, instead of a laser or scalpel, to reshape the cornea and bring up-close vision back into focus. The mild heat produced by the RF waves shrinks small areas of corneal tissue, making the cornea steeper and changing the way that the eye focuses light. CK works best as a presbyopia treatment for patients over 40 who have no other vision problems.
Presbyopia is characterized by the inability to focus on objects that are closer than an arm’s distance away. If you suffer from presbyopia, words will appear blurry as you read, and you may find yourself needing more or brighter light in order to see clearly at night. Individuals with presbyopia begin to experience difficulty reading newspapers, books, menus, and other objects at close distances, even if they have had perfect vision their whole lives. Many patients also experience pain, fatigue, and headaches as a result of the extra strain on their eyes.
Causes of Presbyopia
Age-related farsightedness usually results from a loss of flexibility in the eye’s crystalline lens, which tends to harden over time. Presbyopia is caused by a gradual loss of the lens’ ability to flatten and thicken, which it must do to focus on close objects. Although presbyopia seems to come on suddenly, it actually takes place over a period of several years. Because it is a natural part of the eye’s aging process, it cannot be prevented and may worsen over time.
Hyperopia vs. Presbyopia
Although the symptoms of hyperopia and presbyopia are similar, their causes are actually quite different. Hyperopia is a refractive error that causes up-close objects to appear blurry. With hyperopia, the eye is too short from front to back, causing light to be focused behind the eye rather than on the retina. Hyperopia is usually present from birth, whereas presbyopia comes on later in life.
Presbyopia can be diagnosed through a comprehensive eye exam, during which your ophthalmologist will conduct a number of tests to determine your degree of presbyopia and any other problems with your eyes. One of the things he or she will have you do is read a series of words from a distance that is typically comfortable. You will then try out several corrective prescriptions to determine which one will best correct your farsightedness.
Degrees of Presbyopia – Moderate to Severe
The degree of age-related farsightedness you experience can vary greatly, from mild to severe. People with mild presbyopia sometimes choose not to wear corrective lenses, but those with moderate to severe presbyopia will need to seek treatment in order to read and carry out other day-to-day functions.
Presbyopia is part of the natural aging process and cannot be prevented. However, people who spend a lot of time in front of a computer or who do close visual work may develop more severe symptoms earlier in life. If you engage in up-close work, you can help avoid developing premature presbyopia by taking frequent breaks, during which time you should focus your eyes on distant objects.
Contact an Ophthalmologist for an Eye Exam
Because age-related farsightedness tends to develop over a long period of time, people often fail to recognize its symptoms, making regular eye exams necessary for diagnosis. According to the American Academy of Ophthalmology, even if you do not have presbyopia or other vision problems and are at a low risk of developing eye disease, you should see an ophthalmologist at least once between the ages of 20 and 29, twice between 30 and 39, every two to four years between 40 and 65, and every one to two years after 65. To find a qualified ophthalmologist who can guide you through a lifetime of healthy vision, use our eye care specialists database.