What Is Presbyopia?Its Causes and Treatments
Getting older means dealing with changes to our physical, emotional and mental well-being. One of the most common changes experienced is changes in eyesight. As you age, you may develop a condition known as presbyopia.
But what is presbyopia? Also referred to as “old eyes” by the Greeks, this condition is the gradual loss of the ability to focus on nearby objects. It is a refractive error that occurs when the eye’s lens becomes more rigid, losing its ability to change shape and allow light to focus on the retina, or layers of tissue at the back of the eye.
However, no need to panic: this condition is a normal part of aging. Read on as we dive deeper into everything you need to know about presbyopia, including its causes, symptoms and treatment options.
Understanding Presbyopia
To answer the question “what is presbyopia?” imagine the following scenario: You’re holding a book at arm’s length because your eyes have trouble adjusting to objects closeup. Or imagine having to peer very closely at an object because you can’t quite see its details in low light. These situations outline what it is like to live with presbyopia. A systematic literature review found that an estimated 1.09 billion people worldwide experience the symptoms of presbyopia.
The good news is that most people won’t experience this eyesight change until after they turn 45. And the really good news is that there are excellent treatment options to ameliorate its effects.
What Causes Presbyopia?
As we've said, presbyopia is a normal development as you get older. Most people lose elasticity in their eye' lenses, causing them to lose flexibility and become rigid.
The rigidity of the lens makes it difficult for your muscles to contract when focusing on nearby objects. As a result, closeup images appear blurry, so you have to squint when trying to focus on something.
Symptoms of Presbyopia
While the changes typically occur slowly over time, the symptoms most people notice are:
- Trouble seeing items up close
- Eye strain (soreness or tiredness)
- Frequent headaches
- Difficulty reading small print
- Relying on a nearby light source more than earlier in life
- Eye fatigue after working on things up close, such as a computer screen or book
What Are the Risk Factors of Presbyopia?
As you get older, you may notice presbyopia symptoms. However, certain factors can intensify the severity of the condition or increase the likelihood of getting it at an earlier age.
Some of the main risk factors for presbyopia include:
- Age: There is no surprise here. To a certain extent, most adults experience some form of presbyopia in their early-to-mid 40s.
- Certain medications: Some medications increase the risk of contracting presbyopia earlier, including attention-deficit drugs, antianxiety drugs, antidepressants, antipsychotics and diuretics.
- Diseases: Diseases such as diabetes can intensify presbyopia. A recent study found that “the prevalence of presbyopia in distinct age groups increases with worsening diabetes.”
- Head trauma: A history of head-related trauma can increase the risk of vision problems. According to the Model Systems Knowledge Translation Center, a traumatic brain injury can weaken the muscles that control the eyes’ lenses, which may lead to difficulty when changing focus.
What Is Farsightedness?
Farsightedness or hyperopia may be confused with presbyopia. This raises the question: what does it mean to be farsighted? About 5–10% of Americans are farsighted, or can see far-away objects clearly but struggle to see things up close.
While both presbyopia and hyperopia produce similar effects, the causes are different. Farsightedness occurs when the front-to-back length of the eye is too short, causing your eyesight focus to be slightly off. Hyperopia can also happen if the cornea (front surface of your eye) lacks a sufficient curve. Simply put, those with hyperopia must bend their lenses more than those without the condition.
Common symptoms of hyperopia include:
- Objects that are close appear blurry
- A constant need to squint your eyes to focus
- Aching or discomfort around the eyes
- Frequent headaches after extended time doing close tasks, such as reading or computer work
If you begin to have trouble engaging in everyday activities, it is time to consult an eye doctor, who can do the testing to distinguish presbyopia from hyperopia and treat appropriately.
4 Treatment Options for Presbyopia
Although no cure exists for presbyopia, medical technology advancements have produced viable treatment options. These include prescription glasses (reading glasses and multi-focal glasses), contact lenses and surgery.
1. Reading Glasses
Reading glasses offer a simple yet effective solution for correcting eyesight problems caused by presbyopia. If trouble seeing things up close is your only symptom, you can correct your eyesight with prescription reading glasses. They work by refracting (bending) light before it reaches your lenses, allowing you to see nearby objects more clearly.
2. Multi-focal Glasses
You can opt for multifocal glasses with different prescription strengths, such as bi-focal or tri-focals. The multiple focus points allow you to see objects at various distances.
Bi-focal glasses feature lenses with two different prescription strengths, splitting the correction into two zones. The lower zone allows you to see close objects, while the upper side allows you to view far-away objects. Progressive lenses are multi-focal lenses that help you see well at any distance because their lenses have three prescriptions—so you can do tasks that require close-up vision, intermediate vision and distance vision without changing glasses or taking them off.
3. Contact Lenses
Some people may not want to rely on eyeglasses to correct their vision. In this case, contact lenses are the way to go. There are a few types of contacts that can help correct presbyopia:
- Bi-focal contact lenses: Bifocal lenses correct close-up and far-away vision and come in either soft and hard materials.
- Monovision lenses: With monovision lenses, one lens corrects your distance vision while the other one corrects your close-up vision. It takes time for your brain to adjust to this new way of seeing, which may lead to headaches or eye discomfort when you first start wearing them.
- Modified monovision lenses: With modified monovision lenses, you wear one multi-focal lens that helps you see at all distances.
4. Surgery
Several surgical procedures can improve presbyopia symptoms. These include:
- Conductive Keratoplasty (CK): In this procedure, a surgeon uses radiofrequency energy to heat spots around the cornea, increasing its steepness and focusing ability. It can treat both presbyopia and hyperopia symptoms.
- Laser-Assisted In-Situ Keratomileusis (LASIK): Can LASIK fix presbyopia? Possibly, although it can’t prevent age-related presbyopia from occurring in the future. One of the more successful techniques is the LASIK procedure for monovision, treating one eye for distance and one for near vision loss.
- Photorefractive Keratectomy (PRK): This procedure shares some similarities with LASIK, although it involves the complete removal of the epithelium and the use of a laser to reshape the cornea.
Before opting for surgery, consult your primary care doctor to see whether you are a good candidate for an operation. Discuss your medical history, personal lifestyle, history of family illnesses and anything that might affect your ability to undergo a procedure safely and recover properly.
Depending on your health, lifestyle, personal preferences, and the severity of your condition, some treatments might produce better results than others. Always consult an eye care professional before making any decision that could affect your overall health.
Manage Your Eyesight with Visionworks
With proper care, treatment, and informed decision-making, you can improve your eyesight and return to enjoying your life again. At Visionworks, our team wants to help make this happen. As a leading eye care provider led by qualified professionals, we provide exceptional eye services while respecting our patients’ time.
We make it easy to get exactly what you need and want, thanks in part to our 100-Day-Guarantee on glasses. Find a location near you and schedule an eye exam today.
Information received through Visionworks® content is for informational purposes only and does not constitute medical advice, medical recommendations, diagnosis, or treatment. Always seek the advice of your eye doctor, physician, or other qualified health provider with any questions you may have regarding a medical condition.
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