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Presbyopia Treatment

Middle-aged man with Presbyopia, wearing prescription reading glasses looking down

As we reach middle age, particularly after age 40, it is common to start to experience difficulty with reading and performing other tasks that require near vision. This is because with age, the lens of our eye becomes increasingly inflexible, making it harder to focus on close objects. Unlike a true eye disease, this condition is so common, it eventually happens to almost everyone who reaches old age to some extent. It’s called presbyopia.

To avoid eyestrain, people with untreated presbyopia tend to hold books, magazines, newspapers, and menus at arm’s length in order to focus properly. Trying to performing tasks at close range can sometimes cause headaches, eye strain or fatigue in individuals who have developed this condition.

Causes of Presbyopia

During our youth, the lens of our eye and the muscles that control it are flexible and soft, allowing us to focus on close objects and shift focus from close to distant objects without difficulty. As the eye ages however, both the lens and the muscle fibers begin to harden, making near vision a greater challenge.

Presbyopia is a natural result of the aging process and not much can be done to prevent it. Its onset has nothing to do with whether you already have another vision impairment such as nearsightedness, farsightedness or astigmatism. Everyone will notice some degree of loss of near vision focusing power as they age, although for some it will be more significant than others.

Symptoms and Signs of Presbyopia

Presbyopia is characterized by:

  • Difficulty focusing on small print
  • Blurred near vision
  • Experiencing eyestrain, fatigue or headaches when doing close work or reading
  • Needing to hold reading material or small objects at a distance to focus properly
  • Requiring brighter lighting when focusing on near objects

Presbyopia can be diagnosed in a comprehensive eye exam.

Treatment for Presbyopia

There are a number of options available for treating presbyopia including corrective eyewear, contact lenses or surgery.

Eyeglasses

Reading glasses or “readers” are basically magnifying glasses that are worn when reading or doing close work that allow you focus on close objects.

Eyeglasses with bifocal or multifocal lenses such as progressive addition lenses or PALs are a common solution for those with presbyopia that also have refractive error (nearsightedness, farsightedness or astigmatism). Bifocals have lenses with two lens prescriptions; one area (usually the upper portion) for distance vision and the second area for near vision. Progressive addition lenses or PALs similarly provide lens power for both near and distance vision but rather than being divided into two hemispheres, they are made with a gradual transition of lens powers for viewing at different distances. Many individuals prefer PALs because unlike bifocals, they do not have a visible division line on the lens.

Bifocal and Multifocal Contact Lenses

For individuals that prefer contact lenses to glasses, bifocal and multifocal lenses are also available in contact lenses in both soft and Rigid Gas Permeable (RGP) varieties.

Multifocal contact lenses give you added freedom over glasses and they allow you to be able to view any direction – up, down and to the sides – with similar vision. People wearing progressive lenses in glasses on the other hand have to look over their glasses if they want to view upwards or into the distance.

Another option for those who prefer contact lenses is monovision. Monovision splits your distance and near vision between your eyes, using your dominant eye for distance vision and your non-dominant eye for near vision. Typically you will use single vision lenses in each eye however sometimes the dominant eye will use a single vision lens while a multifocal lens will be used in the other eye for intermediate and near vision. This is called modified monovision. Your eye doctor will perform a test to determine which type of lens is best suited for each eye and optimal vision.

Surgery

There are surgical procedures also available for treatment of presbyopia including monovision LASIK eye surgery, conductive keratoplasty (CK), corneal inlays or onlays or a refractive lens exchange (RLE) which replaces the hardened lens in the eye with an intraocular lens (IOL) similar to cataract surgery.

Since it affects so much of the older population, much research and development is going into creating more and better options for presbyopes. Speak to your eye doctor about the options that will work best for you.

PROTECTING OUR COMMUNITY

We have been working very hard to prepare to re-open for normal "routine" preventive eye care, taking every precaution to ensure the safety of everyone involved. We are pleased to announce as of Monday May 18th we'll be seeing patients for all types of eye care, including routine annual eye exams.

But, things will be very different than they were prior to the pandemic.

1. Our front door will be locked at all times. We will be allowing only 1 person at a time in the office and by appointment only, so please enter alone, or with no more than l other person accompanying you. Others may wait in the car.

2. Masks will be required for both patients and us while in our office.

3. Upon entering, we will be checking your temperature and screen you for COVID symptoms or possible exposure. If your temperature is 100 F or higher, or you have symptoms or may have recently been exposed to COVID, we will reschedule you.

4. We will need you to respect the 6 feet personal distancing while outside the exam room

5. We will have you wash your hands for 20 seconds or use hand sanitizer when you enter. We will be using hand washing and hand sanitizer constantly and will be disinfecting everything you and we touch. Please don't touch anything that isn't absolutely necessary.

6. For frame selection or picking out glasses, please let us help you, and don't just browse and try on frames by yourself. We have to disinfect the frames every time they are touched or worn, and we need to know which frames need to be disinfected.

We are doing all these things to protect you and all of our other patients as best we can. We will need and depend on your cooperation on this during this very difficult time. Doing so will protect your fellow patients-many of whom are at extremely high risk if they contract COVID - and to protect us. All healthcare providers are putting themselves in harm's way every day during this pandemic - the more we all cooperate and take appropriate precautions, the better off we all will be.

We are all in this together. Thank you for your patience, understanding, and cooperation.

Please stay safe.

Dr. Jim Hutchins and staff

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We are pleased to announce as of Monday, May 18th we’ll be resuming providing routine annual eye care and eyewear for our patients: LEARN MORE