If you’re around the mid-40s and have recently been finding you can read more clearly if you push your book a little further away, it’s likely that you’re experiencing presbyopia. Whether you realise it or not, we all know someone with presbyopia. So, what is it and can presbyopia be corrected?
What is Presbyopia?
The word presbyopia is rooted in the Greek for “old eye”. It refers to the natural age-related deterioration of the eye’s focusing ability, a process called accommodation.
Accommodation is a function of the crystalline lens of the eye. It involves the lens altering its shape to bring the eye’s focus onto nearby objects, such as when we read or use our digital devices. When we’re young, the lens is nicely flexible. However, with age, it slowly loses its flexibility, making it more difficult to focus on closer objects. Typically around 45 years of age, we begin to notice this difficulty, which is considered the onset of presbyopia. It’s important to know that presbyopia is not considered a disease of the eye. Treatment options for correcting presbyopia are varied but currently, none are able to restore the accommodative ability of the lens. Instead, options for correcting presbyopia are centred around providing artificial near focus through optical means.
Can Presbyopia be Corrected with Glasses?
Spectacles are the most common form of correcting presbyopia. There are several types of spectacle lenses that can be used:
- Single vision reading glasses. These are lenses that correct for one focusing distance for reading. These are the cheapest option but come with the drawback in that there may be several near distances that you have difficulty with. For example, your desktop computer monitor is usually set at a further distance than where you hold your phone, but a pair of single-vision reading glasses can only be made to one of these distances. Another disadvantage of single-vision reading glasses is that as there is no portion in the lens for clear long-distance vision, your frames will be constantly on and off, which can predispose them to wear and tear.
- Extended focus glasses. These are similar to reading glasses in that they will need to be removed for long-distance viewing. However, extended focus lenses contain two focal lengths – one area for near vision and one for intermediate distances. This makes them the optimal lens choice for correcting presbyopia in people who spend a lot of time at the desk, switching their focus between a computer monitor and laptop or documents on the table.
- Multifocals. Multifocal glasses contain a prescription for long-distance vision at the top of the frame all the way to reading at the bottom. They are good all-purpose presbyopic eye treatment options, though tend not to be well-designed for prolonged computer use. Compared to single-vision reading glasses, multifocals are a more expensive option.
- Bifocals. Bifocals are lenses with a visible line in the lower third. Above this line is long-distance vision while below the line is for near vision. They are useful for those who have difficulties adapting to the graded prescription found in multifocals. However, they have a similar drawback to single vision lenses in that they correct for only one focal length for near vision and are not suitable for computer use.
Can Presbyopia be Corrected with Contact Lenses?
There are a couple of contact lens options for presbyopia.
- Monovision. In a monovision contact lens arrangement, one eye is prescribed its long-distance prescription while the other eye is prescribed a lens that corrects for reading vision. Typically, the dominant eye is given the distance prescription. Monovision can take some time to adapt and is not suitable for people with advanced presbyopia, as the discrepancy between the two eyes is often too great for comfortable vision.
- Multifocal contact lenses. Multifocal contacts are designed to provide functional distance, intermediate, and near vision in both eyes. Similar to monovision contacts, they may take some adaptation, but offer the advantage of permitting clear vision at intermediate distances and better depth perception.
Can Presbyopia be Corrected with Surgery?
For those who are looking for a more permanent solution and are not deterred by an operation on the eye, treatment options for presbyopia are available through refractive surgery techniques. Traditionally, refractive surgery procedures have aimed to correct for long-distance vision, leaving the patient still dependent on reading and computer glasses afterwards, however, there are now surgical solutions for correcting near vision as well as far vision.
- Presbyond laser blended vision. This is a modification of the traditional LASIK laser eye surgery technique. Where LASIK uses a computer-guided laser to reshape the cornea for clear far-distance sight, Presbyond involves reshaping the cornea to include areas for both sharp long and near sight. Typically, your dominant eye is primarily corrected for far sight with some near vision and vice versa for your non-dominant eye.
- Multifocal or extended depth of focus intraocular lenses. During cataract surgery, or a procedure called refractive lens exchange, an artificial lens implant replaces your eye’s natural crystalline lens. This implant may be designed to provide some near and intermediate vision as well as offering clear far-distance sight.
If presbyopia is bothering you or hindering your lifestyle, speak to your local optometrist or ophthalmologist about which presbyopia correction solution is most suited to you.
Call us on 03 9000 0389 today.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.