What Is Presbyopia? Symptoms, Risk Factors, and Treatment

what is presbyopia

Presbyopia vision, or over age 40 vision, affects most individuals over the age of 40. The main symptom is that near vision or reading vision becomes blurred to the point of not being able to see read and make out the text on a smartphone, tablet, or even a desktop computer. All near vision tasks will be affected, even to the point of not being able to see the food on a plate in front of you. Presbyopia gets increasingly worse with age, meaning that each year up to the age of 65, one will need even stronger glasses prescriptions or reading glasses in order to see up close. 

Presbyopia Symptoms & Signs

Presbyopia symptoms are virtually the same for all patients. They include:  

When to See a Doctor

If you’re having difficulty reading with or without glasses, we recommend that you schedule an eye exam with a doctor. Most people will have over the age of forty vision, also known as presbyopia, but some patients may have other conditions that can affect vision, such as cataracts. The eye doctor will perform a complete exam, making sure there is nothing else to explain the lack of near vision. They will test the power of the eye and provide a prescription for glasses or discuss other options to help with near tasks.

Risk Factors for Presbyopia

Presbyopia will occur in virtually all patients at some age over 40. Some people may be at risk for earlier onset presbyopia. Some refer to this as premature presbyopia. Risk factors include:

How Is Presbyopia Diagnosed?

presbyopia treatment

Presbyopia or over age 40 vision is diagnosed during a comprehensive routine eye examination. The eye doctor will test your ability to see up close and at a distance both with and without the help of corrective lenses. The doctor will also evaluate the internal structures of the eye to make sure that no other eye disease is causing loss of vision. It is recommended that all patients at age 40 get a complete eye exam by an experienced eye doctor.

Presbyopia Treatment

Presbyopia correction can be non-surgical, medical, or surgical. Glasses (reading glasses, bifocals, or no line progressive) and contacts are non-surgical approaches. Topical drops to help facilitate near vision are recently becoming available for patients. Surgical approaches including lasers, corneal implants, and intraocular lens implants can be recommended.

Eyeglasses

Glasses for presbyopia are typically the first approach an eye doctor will recommend. Depending on the situation, the doctor may recommend reading glasses alone (or over-the-counter reading glasses) as a solution. If one is already using reading glasses, the eye doctor may suggest a bifocal glasses prescription or a “no line“ progressive glasses prescription. Progressive lenses will allow the patient to see near, intermediate and distant targets or focus points.

Contact Lenses

For those wanting to avoid glasses, contact lenses may be an alternative. There are two typical approaches to contact lenses. Not all patients can tolerate either approach. About 70% of patients will do well with what is termed “monovision”. In this approach, one eye is focused on distance vision and the other is focused on near vision. This allows for objects at all distances to be seen clearly. Bifocal or multifocal contact lenses are another options for those wishing to avoid glasses. With multifocal contacts, an individual eye can see all focal points. In this scenario, both eyes are seeing all focal points equally. This is a great option for those not tolerating monovision. The one shortcoming of multifocal contacts is that image quality may be reduced, and there may be some issues with night time vision, such as halos.

Presbyopia Surgery

Surgery for presbyopia may be an option for patients who would like to minimize or eliminate the need for glasses for distance and up close. Corneal refractive surgery in the form of LASIK, SMILE, or PRK can be used to create a monovision similar to what can be done with contact lenses or intraocular lens implants. Intraocular lens implants can be used in a procedure called refractive lens replacement. In this procedure, the non-functioning lens that one is born with can be replaced with a man-made lens. The lenses can be single vision, trifocal (Synergy or Panoptix), or Light Adjustable Lenses to allow for distance, intermediate, or near vision with either monovision or multifocal vision, similar to what contacts can create. Corneal inlays are also an option but are relatively used relatively infrequently.

Complications of Presbyopia

presbyopia symptoms

When presbyopia is either undiagnosed or uncorrected, one’s vision will progressively get worse for near tasks. This will negatively affect the ease with which the patient can perform all tasks that are within arm’s length. It may get to the point that one simply cannot function every day near tasks and work. If one deals with numbers or text, one may experience increased errors and decreased productivity as a result of presbyopia. As the condition worsens, eye strain, fatigue, and headaches may occur. Presbyopia can occur with nearsightedness, farsightedness, and astigmatism. If this is the case, either glasses, contact lenses, or surgery must address all of these conditions to allow for good vision at near, intermediate, and distance focal points.

Outlook for Presbyopia

The good news for those who experience presbyopia is that the symptoms can be resolved with glasses, contacts, and surgery. Presbyopia starts at about age 40 and progresses to above age 65. Thereafter, the condition is typically stable.

How to Prevent Presbyopia

There is no definitive presbyopia prevention or cure as it progresses up to the age of 65. The gradual and continued decline of the ability to focus on near objects will impact virtually every patient over age 40. There are several suggested actions that might be of help: 

Tell your doctor or eye specialist about any changes in your vision or eye health. Many eye diseases and conditions can be helped with early diagnosis and treatment intervention. Contact us at Discover Vision Centers!


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