PRESBYOPIA INSIGHT INTO AGE-RELATED FARSIGHTEDNESS BY DR. MACKENZIE DZIEDZIC
Presbyopia is one of the most common eye conditions, affecting approximately 128 million Americans. Do you find yourself holding reading material or menus further away, or reaching for more light? As we age, it becomes harder for our eyes to focus, causing nearby objects to be blurry. For most individuals, presbyopia begins around age 40 and will gradually worsen with time for 15-20 years. The lens in the eye begins to harden and becomes less flexible, making it harder
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to read and focus on up close objects. he most common symptoms during early presbyopia include blurred vision, eye strain, and headaches. Now more than ever we rely on our smart phones and computers which can be challenging if the screens on these devices are blurry. Americans spend approximately 6.3 hours a day looking at screens, and this trend is expected to increase each year. During the early stages of presbyopia, affected people may find themselves holding material further away, increasing the font size on phones and computer, and finding more light. Fortunately, there are many treatment options for presbyopia, depending on one’s lifestyle and preference.
GLASSES The most common treatment option for presbyopia is glasses. For those who have 20/20 distance vision, reading glasses may be a good option. These are to be worn while reading or on the computer and then removed while looking far away or driving. If you already wear glasses, a bifocal or progressive lens may be recommended. A bifocal divides the lens into a top distance portion and a bottom reading segment, separated by a visible line. The all-in-one glasses, also known as progressive lenses, provide distance, computer, and near vision assistance without the visible line. There are pros and cons to both the bifocal and progressive lens, but with time, most people adapt within the first few weeks of wearing either. Trying your first pair of progressive lenses may seem intimi44
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dating, but having your lenses customized and fitted correctly by your optometrist and optician will help reduce the adjustment time.
CONTACT LENSES For those who prefer another option besides glasses, contact lenses may be something to consider. While contacts will likely not provide as precise clarity in vision as glasses, they are great for active lifestyles. There are two options when it comes to presbyopia and contact lenses – monovision and multifocal. Monovision is designed for one contact lens to correct distance vision, usually the dominant eye, and the other contact lens for reading vision. There are limitations when it comes to monovision, including a slight decrease in depth perception. Although this setup may seem difficult to adjust to, most adapt within a couple weeks. The other contact lens option to help with near vision is the multifocal lens. This lens provides both distance and near vision in each eye. There are two different designs, one with a bullseye-like pattern, alternating distance and near correction, and the other, a blended transition between prescriptions which changes as you move from the center of the lens to the periphery. Similarly to monovision contact lenses, there may be an adaptation period – but when fit correctly, you should not need glasses for most of your daily activities.
SURGERY There are a couple of surgery options for presbyopia that are minimally invasive, but a more permanent decision. LASIK is a popular refractive surgery to correct distance vision. However, if LASIK is performed to give each eye 20/20 distance vision, one will then need reading glasses to see anything near. To reduce to the use of reading glasses, monovision LASIK may be a good option for presbyopic patients interested in surgery. Similarly to monovision contact lenses, monovision LASIK will correct one eye for distance vision and the other eye for reading vision. Most surgeons will do a trial period with contact lenses to mimic postsurgery vision. Refractive lens exchange is another procedure that can be performed to reduce the need for glasses. Since presbyopia is a con-
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