Presbyopia - your first sign of ageing?

Are you over 40 years of age? Do you find that you are seeing less clearly close up? Do you have to hold things further away to see them more clearly? Chances are you have presbyopia, an eye condition which affects most people as part of the natural aging process. Although usually seen in adults over the age of 40, the age of onset varies and there are other factors which play a role. Since presbyopia develops with aging, it is possible to have it in conjunction with other eye conditions such as astigmatism or shortsightedness.

What causes presbypoia?

In the young eye, the lens and tiny muscles surrounding it are flexible, and are able to quickly and easily adapt to both close and distant images. As the eye ages, the lens loses its elasticity, becoming more rigid and less able to change its shape to effectively focus light on the retina. This is a gradual process, which occurs over a number of years but may be noticed fairly suddenly.

Are there risk factors other than age?

Certain factors may pose a higher risk of you developing presbyopia earlier than normal. These include certain medical conditions such as cardiovascular disease, medication such as diuretics or antidepressants, and trauma or surgery to the eye. Your optometrist will take a detailed medical history to ensure that these or other risk factors are taken into account.

What are the signs of presbyopia?

The first sign of presbyopia is a decreased ability to read close up and a need to hold reading material further and further away from the face. Other symptoms include headaches associated with close work, eye strain or fatigue, a need for brighter lighting, and squinting at near objects.

While these symptoms are similar to the symptoms experienced with farsightedness, the causes are different: farsightedness is related to the shape of the eye and is present from birth, while presbyopia is caused by a hardening of the lens and occurs with aging.

How is presbyopia diagnosed?

Presbyopia is diagnosed as part of a comprehensive eye examination, even if you are not experiencing symptoms.

How is presbyopia treated?

Although presbyopia can obviously not be cured, there are a number of alternatives which will help improve your vision. As mentioned, presbyopia often occurs with other eye conditions, and this will need to be taken into account when treatment decisions are being made. The most convenient and affordable choices are glasses or contact lenses, but surgery is also an option. There are various options in terms of glasses:

• Reading glasses, which are used only for reading or close work are best prescribed by your optometrist.
• Bifocal glasses, in which the upper part has a prescription for distance vision, while the lower part is used for close work
• Bifocal contact lenses function in a similar way to bifocal glasses
• Progressive lenses are similar to bifocal lenses but the transition between the upper and lower prescriptions is more gradual
• Monovision glasses or contact lenses have one lens corrected for distance vision, while the other has a prescription for close work or reading. The brain adjusts for the difference.
• Multifocal contact lenses work in a similar way to progressive or multifocal glasses.

Because the eyes will gradually continue to age and your prescription may need to be adjusted, it is important to have your eyes rechecked regularly. Several surgical treatments are constantly being researched and developed, but presently the most common surgical options are laser vision correction and lens implants.

Management of presbyopia

As much as we would like to “prevent” or even slow down the aging process, this is not possible, but certain steps can be taken to protect our eyes. Control health conditions that may contribute to visual problems, and maintain good health habits generally. Protect your eyes from harmful ultraviolet rays from the sun. Although not a serious condition, presbyopia can interfere with the comfortable performance of daily activities, so it is advisable to visit your optometrist regularly after the age of 40.