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A Close Up of Presbyopia

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Through each stage of life, from infancy through adulthood, your eyes and visual needs will change. One of those changes, and arguably the largest and most frustrating, will come in your early 40’s. Yes, we are referring to the need for reading glasses which is technically referred to as presbyopia.

Presbyopia is the gradual loss of your eyes’ ability to focus on near objects or tasks. The lens inside the eye loses its ability to change shape over time, which is necessary to focus at near. This is, unfortunately, a natural part of the aging process. Symptoms will include blurred vision up close, a tendency to hold reading material further away, or eyestrain after reading or computer work.

There are several ways to combat presbyopia, and the good news is, your optometrist can help!

1. Glasses

There are multiple glasses options available for our presbyopic patients. First, a simple pair of prescription reading glasses may help. With reading glasses in place, close objects will appear more in focus. However, since the distance prescription is now different than the near prescription, these glasses that were specifically designed to help with near, will unfortunately make vision in the distance significantly more blurry. This will result in a constant on and off with the glasses depending on the task at hand. Or, if there is also a need for distance correction, constant switching between distance and near glasses. For those who find this highly frustrating – enter multifocal glasses.

Multifocal glasses simply mean that both distance and near can be seen through the lenses; the top part is designated for distance, and the bottom for near. Even these come in two styles: blended or non-blended. The blended style is the most common and referred to as a progressive lens. The progressive lens gives clear vision at all ranges (far, intermediate, and close) and is more ideal for those who spend several hours on the computer throughout the day. The non-blended style is referred to as a bifocal. This style still gives distance in the top but has a small box in the bottom nasal corner of the lenses for reading. There is no intermediate/computer area in these lenses.

2. Contact Lenses

Several contact lens options exist for presbyopic patients as well! There are multifocal contact lens options which incorporate distance prescription as well as near prescription into the lenses. There is also an option referred to as monovision, where the dominant eye is set to see far and the nondominant eye is set to see close. Both multifocal and monovision contact lenses can take some getting used to, but after adapting, most patients do well with one of these options.

3. Surgery

Although traditional LASIK does not correct for presbyopia, LASIK can be performed in the monovision format – where one eye is corrected for far and the other eye is corrected for near. Since not all patients adapt well to monovision, it is wise to test this out for several months in contact lenses before opting for surgery. Furthermore, when it is time for cataract surgery, there are multifocal implant options now available.

4. Other Options

Hold tight for other presbyopic treatments in the pipeline! Vision focused pharmaceutical companies are working on clinical trials for the development of eyedrops to treat presbyopia. When this option is ready and available, we'll make sure our patients are of the first to know!