WHAT IS PRESBYOPIA?
When you suddenly find yourself holding your phone further away or small text becomes more difficult to see – you probably have presbyopia. It's a very serious sounding name for a not-so-serious condition but it is something that all of us get naturally as we enter our 40s.
What is it?
Presbyopia is the natural aging process of the eye that leads to difficulty focussing on things that are close to us. It is derived from the Greek term which literally means old eye (presbys “old man” - ops “eye”). Most people start noticing in their 40s that they have to start holding reading material much further away or they require much brighter light to be able to see it more clearly.
What are the signs and symptoms?
Some of the symptoms of presbyopia may be:
Difficulty seeing small print
Having to hold things further away to read
Blurred vision for things at close range
Requiring more light to see clearly
Easier to read without short-sighted glasses (for those who are short-sighted)
If you experience any of these symptoms you should see an eyecare professional for a comprehensive eye exam.
What causes presbyopia?
For us to see clearly, light has to bend and focus onto the retina (the back of the eye). To achieve this focus when we look at things close to us, our natural lens inside the eye has to reshape itself to increase its power. However, with normal aging this lens gradually thickens and loses its flexibility making it progressively more difficult to see at close range. From about the age of 40 to 60 the focussing power gradually and steadily declines. Generally after 60 presbyopia stabilises as the lens has already lost most of its flexibility.
Can I still have presbyopia if I have myopia (short-sightedness)?
All refractive errors such as myopia (short-sightedness), astigmatism or hyperopia (long-sightedness) will all co-exist with presbyopia. Luckily for most of those who are myopic, they can often remove their distance glasses can see fairly clearly up close and therefore do not think they have presbyopia.
What are the options if I have presbyopia?
There are many ways to correct for presbyopia. The most common are glasses and contact lenses but various other surgical alternatives which may also be an option. Surgery should always be discussed in depth with your optometrist first as it is a far riskier and potentially irreversible procedure.
Glasses are the most common and easiest way to correct for presbyopia. They work by bending the light so that it refocusses on the retina again. It essentially supplies the power that has been lost when the natural lens becomes more rigid.
Reading glasses are worn only when focussing up close for things like reading books, looking at phones, laptops or computers. They are removed when looking further away or walking around because won't be clear at those distances. This is why some people push the reading glasses down low on their nose to look over the top.
Bifocals or progressive lenses have the distance prescription in the top portion of the lens and the reading prescription on the bottom portion. They are a great option for those who do not want to constantly remove their reading glasses when they don't need them or already have distance glasses and don't want two pairs of glasses.
2) Contact lenses
Soft contact lenses are the most widely used type of contact lenses. The optometrist may either choose to fit a monovision correction for you where one eye is corrected to be your “distance eye” and the other is corrected to be your “reading eye”. Over time the brain learns to favour one eye or the other depending on the distance you are looking at. They may also try a multifocal lens which works on simultaneous vision. With this special lens design it both clear distance and near vision is provided to both eyes at the same time and the brain adapts for the required distance and ignores the rest.
As technology becomes more advanced more surgical options are beginning to become available for those who want to be glasses and contact lens free most of the time.
Refractive surgery such as LASIK can correct your prescription to give you monovision similar to wearing contact lenses. However, monovision can reduce the quality of vision as you no longer have binocular vision (both eyes working together) and also impairs your depth perception.
Refractive Lens Exchange
Refractive Lens Exchange is where the natural lens is replaced with lens implant which is exactly the same procedure as in cataract surgery. The artificial lens that is implanted can be either a multifocal IOL (intraocular lens) or an accommodating IOL that attempts to mimic the natural lens by the ability to change focus.
While corneal inlays are not available in Australia yet, in the US they are able to implant the Kamra inlay and the Raindrop Near Vision inlay into the front window of the eye called the cornea. They are generally implanted in one eye only and that is the non-dominant eye. These devices increase the depth of focus almost like a narrow camera aperture.
Where can I find out more information?
Please speak to your local optometrist about presbyopia as they are very well equipped to discuss the options with you. It can sometimes be an emotionally distressing for people to first hear they have presbyopia because it can be associated with overall 'aging' or progressive disability. It is important to remember that it happens to everybody and is completely normal.
If you are experiencing any symptoms with your eyes please don't put it off. Book in to see one of our friendly optometrists for a bulk billed eye exam today.