Over Forty-five? You probably are Presbyopic


Over Forty five? You will become presbyopic

Presbyopia, a Common Vision Problem

Presbyopia affects everybody and begins between the age of 45 and 50 years, even affecting those without previous vision problems. Reading and sewing become difficult due to blurring of vision and if you are shortsighted you will find yourself taking off your glasses to see more clearly, something you didn’t have to do when you were younger. Presbyopia is a normal aging process and not something to be worried about; however people find the condition very annoying and quite disabling.

Causes and Symptoms

Presbyopia is believed to be caused by a gradual thickening and loss of lens natural flexibility. Muscle fibres around the lens are affected and become weaker with age making it more difficult to focus on near images. It is a condition that comes on only with age unlike astigmatism and farsightedness, which are caused by genetic and environmental factors.

Headaches, eye strain and fatigue when reading, sewing or handwriting are often experienced by people with presbyopia. In order to focus on the print, reading material is held at arm’s length. Eventually, one has to hold the text so far away in order to focus that it is either out of arms reach or too far away to see!

Treating Presbyopia

Glasses are used to treat presbyopia.

Reading glasses these are used to help the patient’s eyes focus on objects which are close to them. People who have never used glasses before often just buy cheap, over the counter readers and in most cases this suffices. However, we recommend that you visit our optometrist so that you can have your refraction properly measured so your glasses will be optimised for your particular eyes. It is also important to have the health of your eyes regularly checked, particularly as you get older. You will be checked for glaucoma and other conditions when you have your eyes tested for glasses so it is well worthwhile making the extra effort to have a two yearly eye examination.

At a certain age (45 50 years) people who are used to wearing glasses to see in the distance will also need reading glasses, which are customised to their particular prescription. If these people choose to have reading glasses they will need a separate pair of glasses to see clearly in the distance. A few lucky individuals who are slightly short sighted may not need reading glasses but most people will benefit form a combination lens of some kind.

Bifocal lenses these are useful for people who need glasses to see in the distance and do not want a separate pair for reading. They come with 2 focus points: the upper part for distance vision and the lower part close work. You can notice people wearing bifocals because the line in the lens separating the distance and reading section can be obvious.

Varifocal lenses these are similar to bifocal lenses but with a more gradual visual change between the upper and lower parts and there is no dividing line. These are particularly useful for people who use computers as the middle of the lens can be used to see a computer screen which might be at a distance slightly further away than a newspaper but still too close to comfortably focus on. In other words varifocal lenses have three focal points and this can be very useful. These lenses take a little getting used to in the initial period.

Contact lenses – Multifocal contact lenses can be prescribed instead of glasses and are particularly popular with those who are involved in outdoor pursuits such as golf and other sporting activities. Monovision contact lenses are prescribed where one eye (usually the dominant eye) has the prescription for distance and the other eye has the reading lens. People using monovision contact lenses lose some of their ability to maintain stereoscopic (3-D) vision and this affects some individuals more than others. The other alternative is to get multi-focal or bifocal contact lenses which can be successfully fitted in many cases. Our optometrists at Medical Optics are expert dispensers of all these types of contact lenses and will advise you on what is best suited to your needs.

Surgical Treatments

Refractive surgeons still have not come up with the perfect answer for treating presbyopia. However, there are some new techniques which can help a person see close up and might be discussed if a person was undergoing refractive surgery for the correction of a distance prescription. The most common procedure is to utilise the concept of monovision which was discussed above. There are other new techniques, currently undergoing trials, which might be considered, such as multifocal LASIK, corneal inlays and conductive keratoplasty. Patients undergoing refractive surgery may wish to discuss the possibility of multifocal intraocular lens implants. Currently, refractive surgery is not indicated solely for the correction of presbyopia.