Presbyopia is the gradual loss of your eyes' ability to focus on nearby objects. It's a natural, often annoying part of aging. Presbyopia usually becomes noticeable in your early to mid-40s and continues to worsen until around age 65.

You may become aware of presbyopia when you start holding books and newspapers at arm's length to be able to read them. A basic eye exam can confirm presbyopia. You can correct the condition with eyeglasses or contact lenses. You might also consider surgery.

Symptoms:

Presbyopia develops gradually. You may first notice these signs and symptoms after age 40:

• A tendency to hold reading material farther away to make the letters clearer
• Blurred vision at normal reading distance
• Eyestrain or headaches after reading or doing close-up work

You may notice these symptoms are worse if you are tired or are in an area with dim lighting.

Causes:

When you’re young, the lens in your eye is flexible and relatively elastic. It can change its length or shape with the help of a ring of tiny muscles that surround it. The muscles that surround your eye can easily reshape and adjust your lens to accommodate both close and distant images.

With age, your lens and the muscle fibers surrounding your lens slowly lose flexibility and stiffen. As a result, your lens becomes unable to change shape and constricts to focus on close images. With this hardening of your lens, your eye gradually loses its ability to focus light directly onto your retina.

Risk Factors:

Certain factors can make you more likely to develop presbyopia, including:

• Age. Age is the greatest risk factor for presbyopia. Almost everyone experiences some degree of presbyopia after age 40.
• Other medical conditions. Being farsighted or having certain diseases — such as diabetes, multiple sclerosis or cardiovascular diseases — can increase your risk of premature presbyopia, which is presbyopia in people younger than 40.
• Drugs. Certain drugs are associated with premature presbyopic symptoms, including antidepressants, antihistamines and diuretics.

Treatment:

Eyeglasses

Eyeglasses with progressive lenses are the most popular solution for presbyopia for most people over age 40. These line-free multifocal lenses restore clear near vision and provide excellent vision at all distances.

Another presbyopia treatment option is eyeglasses with bifocal lenses, but bifocals provide a more limited range of vision for many people with presbyopia.

Contact Lenses

People with presbyopia also can opt for multifocal contact lenses, available in gas permeable or soft lens materials.

Another type of contact lens correction for presbyopia is monovision, in which one eye wears a distance prescription, and the other wears a prescription for near vision. The brain learns to favor one eye or the other for different tasks.

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• Sarah Rose
• Journal Manager Journal of Eye Diseases and Disorderss
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