What Is Presbyopia?

Presbyopia is a common, age-related vision condition where the eyes gradually lose the ability to focus on nearby objects. Despite its complex name, presbyopia is not a disease but a natural part of ageing that can be easily corrected.

Presbyopia vs. Hyperopia

Presbyopia is often confused with hyperopia (farsightedness). While both conditions make it difficult to see objects up close, their causes differ. Hyperopia results from an eyeball shape that causes light rays to focus behind the retina instead of on it. In contrast, presbyopia occurs when the eye’s lens loses flexibility with age, making it hard to focus on close objects.

Presbyopia vs. Myopia

Myopia (nearsightedness) means that nearby objects appear clear, but distant objects look blurry. This condition arises when the shape of the eye causes light to focus in front of the retina. Unlike presbyopia, which typically begins in middle age, myopia can develop in childhood and may run in families. (You can read more about Myopia here: https://pasteureyehospital.co.za/myopia/)

Presbyopia Symptoms

If you have presbyopia, you might notice:

The need to hold reading material at arm’s length
Blurred vision at an average reading distance
Headaches or fatigue when doing close work

Presbyopia Causes

The lens in each eye flexes to help you focus. As you age, the lens becomes less flexible, making it difficult to shift focus to close-up objects, resulting in blurry vision.

Presbyopia Risk Factors

Risk factors for presbyopia include:

Age: Most people develop presbyopia between the ages of 40 and 65.
Medical Conditions: Conditions like heart disease, diabetes, or multiple sclerosis can lead to premature presbyopia.
Farsightedness: Being farsighted increases the risk of developing presbyopia earlier.
Medications: Drugs such as antihistamines, antidepressants, and diuretics can trigger presbyopia.

Presbyopia Diagnosis

Your eye doctor can diagnose presbyopia through an eye exam, which may include:

Refraction Assessment: Testing your ability to see objects at various distances.
Eye Health Exam: Dilating your pupils to examine the internal structure of your eyes.

Presbyopia Treatment

While there is no cure for presbyopia, various treatments can help improve vision:

Presbyopia Glasses

Reading Glasses/Readers: Magnify text for easier reading.
Bifocals: Combine two prescriptions in one lens for distance and close-up vision.
Trifocals: Include three prescriptions for distance, intermediate, and close-up vision.
Progressive Lenses: Offer a gradual transition between different prescriptions.

Presbyopia Contacts

Multifocal Lenses: Available in soft or gas-permeable forms.
Monovision Lenses: One lens corrects for distance, the other for close-up vision.

Presbyopia Eye Drops

Pilocarpine Eye Drops (Vuity): Help improve near vision by reducing pupil size. Potential side effects include headaches and risks like retinal detachment.

Presbyopia Surgery

Laser-Assisted In Situ Keratomileusis (LASIK): Reshapes the cornea to improve vision.
Photorefractive Keratectomy (PRK): Alters cornea shape without cutting into it.
Small-incision lenticule Extraction (SMILE): Uses a laser to remove a disc-shaped portion of the cornea.

Presbyopia Lens Implants

Multifocal IOLs: Provide near and distance focus.
Accommodative IOLs: Mimic the natural lens’s ability to change shape.
Extended Depth-of-Focus Lenses: Offer a single corrective zone for both near and far vision.

Presbyopia Corneal Inlays

Intracorneal inlays are implants that can help with presbyopia, although they are less common than other surgical options. The availability and cost can be limiting factors.

Presbyopia Prevention

Although you can’t prevent presbyopia, you can take steps to care for your eyes:

Regular Eye Exams: Schedule checkups based on your age and vision needs.
Corrective Lenses: Use the right prescription for your glasses or contacts.
Protective Eyewear: Shield your eyes from UV rays and potential injuries.
Healthy Diet: Eat foods rich in beta-carotene and antioxidants, like carrots and leafy greens.

Presbyopia is a natural part of ageing, but with the proper care and treatment, you can maintain clear vision and enjoy a high quality of life. If you notice presbyopia symptoms, consult your eye doctor to explore the best options for you.