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Presbyopia

A Close Up of Presbyopia

Through each stage of life, from infancy through adulthood, your eyes and visual needs will change. One of those changes, and arguably the largest and most frustrating, will come in your early 40’s. Yes, we are referring to the need for reading glasses which is technically referred to as presbyopia.

Presbyopia is the gradual loss of your eyes’ ability to focus on near objects or tasks. The lens inside the eye loses its ability to change shape over time, which is necessary to focus at near. This is, unfortunately, a natural part of the aging process. Symptoms will include blurred vision up close, a tendency to hold reading material further away, or eyestrain after reading or computer work.

There are several ways to combat presbyopia, and the good news is, your optometrist can help!

1. Glasses

There are multiple glasses options available for our presbyopic patients. First, a simple pair of prescription reading glasses may help. With reading glasses in place, close objects will appear more in focus. However, since the distance prescription is now different than the near prescription, these glasses that were specifically designed to help with near, will unfortunately make vision in the distance significantly more blurry. This will result in a constant on and off with the glasses depending on the task at hand. Or, if there is also a need for distance correction, constant switching between distance and near glasses. For those who find this highly frustrating – enter multifocal glasses.

Multifocal glasses simply mean that both distance and near can be seen through the lenses; the top part is designated for distance, and the bottom for near. Even these come in two styles: blended or non-blended. The blended style is the most common and referred to as a progressive lens. The progressive lens gives clear vision at all ranges (far, intermediate, and close) and is more ideal for those who spend several hours on the computer throughout the day. The non-blended style is referred to as a bifocal. This style still gives distance in the top but has a small box in the bottom nasal corner of the lenses for reading. There is no intermediate/computer area in these lenses.

2. Contact Lenses

Several contact lens options exist for presbyopic patients as well! There are multifocal contact lens options which incorporate distance prescription as well as near prescription into the lenses. There is also an option referred to as monovision, where the dominant eye is set to see far and the nondominant eye is set to see close. Both multifocal and monovision contact lenses can take some getting used to, but after adapting, most patients do well with one of these options.

3. Surgery

Although traditional LASIK does not correct for presbyopia, LASIK can be performed in the monovision format – where one eye is corrected for far and the other eye is corrected for near. Since not all patients adapt well to monovision, it is wise to test this out for several months in contact lenses before opting for surgery. Furthermore, when it is time for cataract surgery, there are multifocal implant options now available.

4. Other Options

Hold tight for other presbyopic treatments in the pipeline! Vision focused pharmaceutical companies are working on clinical trials for the development of eyedrops to treat presbyopia, like Vuity. Vuity™ (pilocarpine hydrochloride ophthalmic solution) is an FDA-approved eye drop to treat age-related Blurry Near Vision (presbyopia) in adults. VUITY™ works by reducing your pupil size. It contracts certain muscles in the eye to help you see up close.

8 Ways Your Eyes Change With Age

Our eyes and vision change with age. Your eye doctor can monitor these changes — some of which are a natural part of the aging process — and identify any eye conditions or diseases early enough to treat them and prevent vision loss. Read on to learn more about the different types of eye changes one may encounter with age.

Age-Related Eye Conditions and Diseases

Cataracts

If your vision is starting to get blurry, you may be developing cataracts. There are a few types of cataracts, but the one usually caused by aging is known as a “nuclear cataract”. At first, it may lead to increased nearsightedness or even a temporary improvement in your reading vision. But with time, the lens gradually turns more densely yellow and clouds your vision. As the cataract slowly progresses, the lens may even turn brown. Advanced yellowing or browning of the lens can lead to difficulty distinguishing between shades of color and left untreated, it can eventually lead to blindness. Luckily, cataract surgery, where the cloudy lens is replaced with a clear lens, is an extremely safe and effective treatment option. 

Blepharoptosis

Blepharoptosis or ptosis is a drooping of the upper eyelid that may affect one or both eyes. The eyelid may droop only slightly or may droop enough to cover the pupil and block vision. It occurs when there is a weakness of the eye’s levator muscle that lifts the eyelid. This condition is usually caused by aging, eye surgery, or disease affecting the muscle or its nerve. Fortunately, blepharoptosis can be corrected with surgery.

Vitreous detachment

This occurs when the gel-like vitreous fluid inside the eye begins to liquefy and pull away from the retina, causing “spots and floaters” and, sometimes, flashes of light. This occurrence is usually harmless, but floaters and flashes of light can also signal the beginning of a detached retina — a serious problem that can cause blindness, and requires immediate treatment. If you experience sudden or worsening flashes and increased floaters, see Lance I. Alpert O.D. immediately to determine the cause.

Other Age-Related Changes

In addition to the above eye conditions and diseases, the structure of our eyes and vision change as we get older. 

Presbyopia

Why do people in their 40s and 50s have more difficulty focusing on near objects like books and phone screens? The lens inside the eye begins to lose its ability to change shape and bring near objects into focus, a process is called presbyopia. Over time, presbyopia, also known as age-related farsightedness, will become more pronounced and you will eventually need reading glasses to see clearly. You may need multiple prescriptions – one prescription to enable you to see up close, one for intermediate distance, and one for distance vision. In that case, people often get bifocals, multifocals or PALs, and they can be combined with contact lenses as well.

Reduced pupil size

As we age, our reaction to light and the muscles that control our pupil size lose some strength. This causes the pupil to become smaller and less responsive to changes in ambient lighting. The result? It becomes harder to clearly see objects, such as a menu, in a low-light setting like a restaurant.  

Dry eye

Our tear glands produce fewer tears and the tears they produce have less moisturizing oils. Your eye doctor can determine whether your dry eye is age-related or due to another condition, and will recommend the right over-the-counter or prescription eye drops, or other effective and lasting treatments, to alleviate the dryness and restore comfort.

Loss of peripheral vision

Aging causes a 1-3 degree loss of peripheral vision per decade of life. In fact, one may reach a peripheral visual field loss of 20-30 degrees by the time they reach their 70s and 80s. While peripheral vision loss is a normal part of aging, it can also indicate the presence of a serious eye disease, like glaucoma. The best way to ascertain the cause is by getting an eye exam. 

Decreased color vision

The cells in the retina responsible for normal color vision tend to decline as we age, causing colors to become less bright and the contrast between different colors to be less noticeable. Though a normal part of aging, faded colors can at times signal a more serious ocular problem. 

Beyond the normal changes that come with age, the risk of developing a serious eye disease, such as age-related macular degeneration and glaucoma, increases. Routine eye exams are essential to keeping your eyes healthy. Your eye doctor can determine whether your symptoms are caused by an eye problem or are a normal byproduct of aging. 

If you or a loved one suffers from impaired vision, we can help. To find out more and to schedule your annual eye doctor’s appointment, contact TotalVision Eyecare in Manchester today.