Presbyopia - Terre Haute Regional Hospital | Terre Haute, IN
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Definition

Presbyopia is the inability to focus on and clearly see objects that are at a normal reading distance or closer.

Causes

Presbyopia is caused by an age-related, gradual loss of flexibility within the lens of the eye. Because the lens is less elastic, it cannot adequately change its shape to sharply focus on objects at close distances.

Anatomy of the Eye
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Risk Factors

Age over 40 years increases your chance of getting presbyopia.

Symptoms

Symptoms may include:

  • Having to hold items at arm's length to focus on them
  • Blurred vision when reading
  • Eye fatigue, discomfort, or drowsiness when doing close-up work such as:
    • Reading
    • Needlepoint
    • Computer work

Symptoms are often made worse by over-tiredness or stress.

Diagnosis

A vision specialist will ask about your symptoms and medical history, and perform an eye exam. You will be asked to read materials at your normal reading distance while the doctor places different lenses in front of your eyes. This test determines the extent of your presbyopia.

Treatment

Presbyopia is usually treated with corrective lenses. Lens options include:

Glasses

If you already wear glasses, you may need a second set for reading and other close-up activities.

Bifocals combine two prescriptions into one pair of glasses. The upper half of bifocals corrects distance vision and the bottom half corrects close-up vision.

Trifocals are similar to bifocals, except that they have a medium range lens between the distance and near portions to help with intermediate vision tasks.

Another option is progressive lenses, which provide a gradual increase in reading prescription as you look down on the lens. This provides a range of correction for you to use depending on the distance between you and the object you are trying to look at.

If you currently do not need vision correction for distance, then you will only need a pair of glasses to correct your up-close vision. However, some people with perfect distance vision still opt to wear bifocals that are clear on top and have the reading prescription on the bottom so that they can wear them all the time rather than having to put glasses on and off to read.

Contact Lenses

Bifocal contact lenses are available and act the same way as bifocal glasses, with an area for distance and an area for near vision correction. Another option is monovision contact lenses. One eye wears a lens to correct distance vision and the other to correct near vision.

Conductive Keratoplasty

Conductive keratoplasty (CK) is a procedure performed by an ophthalmologist to correct presbyopia in one eye. The surgeon places a small probe that emits radiofrequency energy into the cornea to reshape it. This is performed in one eye only. The other eye is dominant for distance vision and the eye receiving the CK is focused for near vision.

Multifocal Intraocular Lenses

Multifocal intraocular lenses can be placed inside the eye in place of the eye’s natural lens. This is typically performed at the time of cataract surgery. The multifocal lens focuses on both distant and near objects simultaneously, often eliminating the need for glasses.

Prevention

Presbyopia is thought to be an inevitable part of the aging process. There are no current guidelines for preventing it or delaying its onset.

Revision Information

  • American Optometric Association

    http://www.aoa.org

  • National Eye Institute

    http://www.nei.nih.gov

  • Canadian Association of Optometrists

    http://opto.ca

  • Canadian Ophthalmological Society

    http://www.cos-sco.ca

  • The correction of presbyopia. Int Ophthalmol Clin. 2001 Spring.

  • Presbyopia. American Optometric Association website. Available at: http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/presbyopia. Accessed July 11, 2013.

  • What is presbyopia? American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/diseases/presbyopia.cfm. Accessed July 11, 2013.