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Presbyopia

Pronounced: Prez-bee-OH-pee-ah

Definition

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

Causes    TOP

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    TOP

Ppresbyopia is more common in adults over the age of 40.

Symptoms    TOP

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    TOP

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

Treatment    TOP

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 set for close-up activities.

Bifocals combine 2 prescriptions into 1 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 eye wears a lens to correct near vision.

Conductive Keratoplasty    TOP

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.

LASIK    TOP

Laser-assisted in situ keratomileusis (LASIK) is a procedure that uses laser beams to reshape the cornea and correct focusing problems in the eye.

Multifocal Intraocular Lenses    TOP

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    TOP

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

RESOURCES:

American Optometric Association
http://www.aoa.org
National Eye Institute
http://www.nei.nih.gov

CANADIAN RESOURCES:

Canadian Association of Optometrists
http://opto.ca
Canadian Ophthalmological Society
http://www.cos-sco.ca

References:

The correction of presbyopia. Int Ophthalmol Clin. 2001 Spring.
Presbyopia. American Optometric Association website. Available at:
...(Click grey area to select URL)
Accessed January 13, 2015.
What is presbyopia? American Academy of Ophthalmology website. Available at:
...(Click grey area to select URL)
Updated September 1, 2013. Accessed January 13, 2015.
Last reviewed January 2015 by Eric L. Berman, MD
Last Updated: 5/11/2013