Presbyopia Insight Into Age-Related Farsightedness

PRESBYOPIA

INSIGHT INTO AGE-RELATED FARSIGHTEDNESS

BY DR. MACKENZIE DZIEDZIC

Presbyopia is one of the most common eye conditions, af-

fecting 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 gradu-

ally worsen with time for 15-20 years. The lens in the eye

begins to harden and becomes less flexible, making it harder

to read and focus on up close objects.

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.

The 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 intimidating, but having your lenses customized and fitted correctly by your optometrist and optician will help reduce the adjustment time.

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-

dition related to the hardening of the lens, refractive lens exchange replaces your natural lens with an artificial one. This surgery is similar to cataract surgery, yet done for a refractive purpose, rather than removing a cloudy lens due to a cataract. Depending on your eyes and goals post-surgery, there are different types of artificial lenses available. Monofocal lenses provide clear vision at one range – distance, intermediate, or near. A multifocal lens provides clear vision at multiple ranges, similarly to the multifocal contact lens previously discussed. Full recovery after surgery takes a few weeks, but most resume their normal daily activities within a week.

VUITY

The newest option to treat presbyopia is an eye drop called Vuity. Vuity is the first and only eye drop to treat near vision and was recently FDA approved in 2021. The once daily drop begins working in 15 minutes and can last up to six hours. The drop is designed to reduce the pupil size, which improves near vision without affecting distance vision. Most people tolerate the drop well, while some may notice minor side effects such as a mild headache, eye redness, and reduced room lighting. These side effects should improve with use of the drop, and for most, subside after one to weeks of consistent use. If interested in trying this new drop, schedule an appointment with your optometrist to see if you would be a good candidate for Vuity based on your prescription, lifestyle, and ocular health.

Presbyopia is a normal part of aging that can be frustrating as our dependence with digital devices increases. Thankfully, today there are many different treatment options available to ease the stress of blurred near vision. 

Mackenzie Dziedzic, OD, is a doctor of optometry with McPherson Family Eye Care, located at 3150 Rogers Road, Suite 100 in Wake Forest. For more information and to learn more about presbyopia and available treatment options, call 919-2639163 or visit mcphersonfamilyeyecare.com.