Presbyopia is a condition that generally occurs after age 40 and affects your eye’s ability to focus on objects that are nearby. Normally, the lens in your eye is flexible and able to bend light depending on the location of what your eye is focusing on. As you age, the muscles around the eyes become weaker and there is a natural hardening of the lens. Both factors cause light to be focused behind the retina instead of directly onto it which causes blurriness when viewing things close up. This is a very common, natural part of aging and usually this condition worsens until sometime around age 65.

But I’ve never needed glasses!

Presbyopia can effect anyone and this often comes as a surprise to many people who have never experienced vision problems. Signs and symptoms of presbyopia may gradually develop with difficulty focusing on nearby objects being the most common issue. You may find that you need to hold objects at an arm’s length in order to see things more clearly. As with other vision problems, continuously straining the eyes in order to focus can induce headache or fatigue.

Presbyopia can be diagnosed during a standard eye exam. The doctor may do a series of exams to assess your vision including dilation, which helps the doctor evaluate the inside of the eyes, and tests with various lenses to evaluate your near and far vision.

How can I get a clearer view?

The main goal of presbyopia treatments is to correct the eyes inability to see things close by.

Non-surgical treatments

Eyeglasses are the most common means to correct presbyopia and for many people who had uncorrected vision prior to their presbyopia diagnosis, a doctor may simply recommend reading glasses. Reading glasses are available over-the-counter but for people who are nearsighted, farsighted or have an astigmatism, a doctor may recommend prescription lenses. Bifocals or progressive addition lenses are commonly used and have two different prescriptions in the lens, one aiding in distance vision in the upper portion and one aiding in near vision in the lower portion. Trifocals are also an option and these have three corrections; one for distance, one for middle vision and one for close vision.

For people who do not want to wear glasses, contact lenses may also be an option. Bifocal contact lenses are similar to bifocal glasses and correct distance and near vision in one contact lens. Monovision is also common among contact lens wearers and with this treatment, one eye wears a contact for distance vision and the other wears a prescription for near vision. Normally the brain will adjust to the varying prescriptions, favoring one eye over the other depending on the task at hand. This treatment may not work for everyone though and can sometimes lead to a decrease in visual acuity and depth perception.  Modified monovision is another option where one bifocal lens is worn and one distance vision lens is worn. This allows both eyes to see distance and the weaker eye to be corrected for both near and far vision.

Surgical procedures

It’s possible your doctor will recommend surgery to help your presbyopia and may suggest surgically reshaping the cornea to create monovision without the use of glasses or contact lenses. It is important to note that some treatments do not permanently resolve vision problems and need to be re-corrected down the road. Monovision LASIK surgery uses a laser to create a thin flap in the cornea after which a refractive surgeon will remove some of the inner layers of the cornea. Conductive Keratoplasty uses radio waves to heat and shrink the edges of the cornea and improve vision. Surgical options will vary based on your eyes and long term goals and it is important to speak with your doctor in order to determine exactly what treatment option would work best for you.