Presbyopia: A Complete Guide For Old Eyes

Presbyopia is a progressive eye condition that happens to everyone later in life. People with presbyopia have a hard time focusing up close.

While hyperopia is commonly known as farsightedness and myopia as nearsightedness, presbyopia might be called “oldsightedness.” The term presbyopia is derived from Greek and Latin origins that mean “old eyes.”

Although presbyopia is usually seen in adults over the age of 40, the exact age of onset varies from person to person and depends on what type of eyeglass prescription (if any) the individual wore prior to its development.

Many people with myopia (near-sightedness) can read comfortably without eyeglasses or contact lenses even after age 40. Presbyopia may seem to appear suddenly, but the actual loss of flexibility in the lens takes place over a period of years.

This is not a disease, and it cannot be prevented. There is no cure for it, but there many ways to improve near vision. Many new treatments are currently being researched (see below).

What Signs and Symptoms Should I Look For With Presbyopia?

Early signs of presbyopia include a need to hold magazines, books, or other reading material at arm’s length in order to focus. Symptoms may include:

  • Eye strain
  • Headaches
  • Blurred vision at normal reading distances
  • Eye fatigue or general fatigued feeling, especially at the end of the day
  • Squinting to focus on near objects
  • Decrease in ability to focus on near objects

What Is Causing My Presbyopia?

This condition is caused by the aging process. When we are younger, the lens of the eye is flexible and changes its shape in order to focus up close – this process is called “accommodation.”  As we age, the lens becomes progressively more rigid and loses its ability to accommodate.

Trauma, occupation, and lifestyle may be factors for some people, but presbyopia is a natural part of the aging process and will eventually happen to everyone.

How Is Presbyopia Diagnosed?

Presbyopia can be diagnosed by symptoms and age alone, although your eye doctor may perform a series of eye exams and tests. These may include:

  • Visual acuity exam
  • Refraction test
  • Eye movement evaluation
  • Pupil evaluation
  • Slit lamp exam
  • Dilated fundus exam

Can My Presbyopia Be Treated?

People with this condition may need treatment for both close-up vision and distance vision. Eyeglasses and contacts are common choices due to their affordability, availability, and convenience.

A few surgical procedures are available, and several more are still undergoing trials. There are a number of different solutions, including:

  • Reading glasses
  • Monovision contact lenses (one eye set for near, one eye set for distance)
  • Multifocal contact lenses (contact lenses with both distance and near vision built in)
  • Laser vision correction with either monovision or blended vision.
  • Multifocal intraocular lens implants—i.e., Presbyopia IOLs, which are designed to provide a full range of vision without the use of bifocal or trifocal lenses. To learn more about presybyopia IOLs, click here.
  • Corneal inlays that increase depth of field
  • Combinations of options above

Prognosis for Presbyopia

By definition, it is not a disease; it can always be corrected by glasses or contact lenses, and will never affect distance vision. And note, it worsens over time.

Talking to Your Eye Doctor

  • What are my treatment options?
  • Are you aware of any new treatment options that have recently come on the market?
  • Is your clinic doing any research into the prevention or treatment of presbyopia?
  • Which vitamins are good for my lens health?
  • Am I a candidate for monovision or any other types of presbyopia treatments?
  • Do I have any other eye problems that are contributing to vision loss?

Sources and References:
We have strict guidelines for each of our sources and references. We rely upon vision, eye and medical information from peer-reviewed studies, medical associations and academic research institions.
  • American Optometric Association, Presbyopia,
  • J. DiGirolamo, MD “The Big Book of Family Eye Care” (Basic Health Publications, Inc., 2011) 57-70
  • J. Anshel, MD “Smart Medicine for Your Eyes” (SquareOne Publishers, 2011) 296-298