Presbyopia is the gradual inability of the eyes to focus on up close on near objects.

You’re still capable of seeing clearly, but your eyes ability to accommodate (adapt from far distance to close) is gradually lost.

Causes of presbyopia

There’s only one unavoidable cause to presbyopia: birthdays.

Blow out about 40 candles, and presbyopia is lurking around the corner. Many other fun things that come with birthdays (like wrinkles, aching joints, etc) vary from person to person, but presbyopia is consistent and hits everyone at nearly the same age–it doesn’t care about your great genetics, how well you eat, how much you exercise, etc. If you have good distance vision, you’re going to start having presbyopia symptoms around age 42.

So what’s the reason? The lens inside our eye is able to change shape when we’re young. This allows us to change the distance our eyes are focusing at.

While being 40 years old is the biggest cause, there are other things that can make your near vision worse:

  • cataract surgery before your 40s
  • certain medications (antidepressants, antipsychotics, anticholinergics–some allergy, motion sickness, and antispasmodic medications)
  • extended periods of near work (this effect is temporary–see do computers make my near vision worse?)

Symptoms of presbyopia

Here are the most common symptoms I hear from patients who have presbyopia:

  • “I can’t see my (up-close/my phone/my computer/books)”
  • “My eyes are tired after using the computer for a while” OR just “my eyes are tired” because people use their handheld computers (phones) so often now
  • “My eyes hurt”: eye pain is a reason to see your eye doctor ASAP, but if you’re around 40 years old and have a general ache around both eyes, there’s a good chance it’s presbyopia

Other common symptoms are headaches, squinting up close, difficulty reading medicine bottles or other fine print.

So basically… difficulty focusing up close causing tired and achy eyes.

Treatments for presbyopia

There is no way to stop presbyopia (currently), but there are ways you can get your near vision back:

  • glasses: reading glasses, progressives, trifocals, bifocals (learn more about glasses for presbyopia)
  • contact lenses: multifocal, monovision, modified monovision, or readers over contact lenses (read more about contacts for presbyopia)
  • LASIK: laser surgeries for presbyopia are limited (read more about can LASIK fix presbyopia)

Currently, the treatment options for presbyopia can be frustrating. Glasses give you the clearest vision, but glasses for presbyopia have their drawbacks and not everyone wants to wear glasses. Contacts can be good, but the technology doesn’t allow for us sharp of vision at both distance and near as you might like.

What about eye drops? Surgery? Or anything else that could help me ditch the readers? There’s not much here now, but there are many future treatments coming down the pipeline. The next decade could be an exciting one for adults over 40.

Other presbyopia frequently asked questions

Does presbyopia mean I’m old?

I don’t know many people (except children) that consider 40 old. We’re still active. We still have good health, and have decades ahead of us in life. But, reading glasses and bifocals can make you feel like you fast-forwarded into becoming your grandparents.

Are there exercises for presbyopia?

The short answer is no. People associate up-close work with using or working out your eyes. So it makes sense to think that doing eye exercises could “strengthen” your near vision. Unfortunately, the lens’ ability to refocus to see up close isn’t something we can work out.

Is my near vision going to continue getting worse? Will I go blind?

Sometimes as your near vision is getting worse, you ask, “Is this going to every stop?” The answer is yes. Presbyopia stops getting worse at 60 years old. And in my experience, most people feel it worsens the most from 40-50 years old, and the changes from 50-60 years old aren’t as dramatic. More importantly, you won’t go blind. Your vision will always be correctable to 20/20 (perfect vision)–you’ll just need glasses to get there!

Sources:

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/420914
https://uwpress.wisc.edu/journals/pdfs/AOJ_49_178.pdf

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