Presbyopia is a refractive error, meaning a condition that makes vision blurry or unclear. Specifically, presbyopia makes it difficult to see things up close. All refractive errors are caused when the shape of your eye is not conducive to properly filtering and processing light onto your retina. The three other types of refractive errors are myopia, hyperopia, and astigmatism.

While both hyperopia and presbyopia cause up-close objects to be blurry, they are classified as separate refractive errors because they are not caused by the same underlying issue. Hyperopia is similar to myopia in that it generally presents early in life, whereas presbyopia does not present until middle age.

But what causes presbyopia, and can it be treated?

What causes presbyopia?

Unlike other refractive errors, presbyopia is something that comes with age. As the lens of the eye ages, it becomes harder and thicker. This occurs as natural aging changes in the proteins of the eye lens, causing it to lose elasticity. All these changes make focusing on close objects more difficult. A youthful eye lens can easily change shape to properly handle light, but an older, more rigid lens is unable to bend in this way.

Besides the obvious difficulty reading small print, there are a few symptoms of presbyopia:

  • Hazy or blurry vision
  • Increased squinting
  • Headache
  • Tired or strained eyes
  • Halos

These symptoms may not always indicate presbyopia. If you experience symptoms that concern you, contact your eye doctor and schedule an exam. Other times, symptoms may appear so gradually that they are not immediately noticeable.

Presbyopia is incredibly common

Everyone experiences some degree of presbyopia as they enter middle age. Levels of presbyopia may vary depending on initial levels of myopia, but it is safe to say that presbyopia comes for everyone eventually. LASIK eye surgery and other treatments for astigmatism and myopia do not prevent or treat presbyopia. People who wear prescription eyeglasses for other refractive errors will still eventually develop presbyopia.

Is presbyopia treatable?

Presbyopia cannot be reversed or prevented. But vision lost to presbyopia can be restored. There are three options for treating presbyopia: eyeglasses, contact lenses or corrective surgery.

Finding the right eyeglasses

The most common treatment for presbyopia is corrective lenses. Some people buy “cheaters”, or cheap reading glasses, from the drug store. If you find these don’t work well for you, then consider getting a special prescription from your eye doctor.

For people with presbyopia and myopia, bifocals can correct both near and far vision at once. However, bifocals can cause minor discomfort when the eyeline “jumps” from near to far. Many people also dislike bifocals because they are an obvious sign of aging.

Fortunately, there are other options. Progressive lenses offer a smooth progression of lens strengths from top to bottom, which gives them the same effect as bifocals without the noticeable lens jump. You can shop for online deals on progressive lenses here.

Bifocal contact lenses

Another option for treating presbyopia is contact lenses. For those with myopia as well, bifocal contact lenses can be prescribed. These contacts function like bifocal eyeglasses. Corrective lenses for presbyopia can also be fitted with “monovision”. This involves correcting one eye for distance and the other for up-close vision. The brain will begin to favor one eye for each task, resulting in simultaneously corrected distance and up-close eyesight.

Presbyopia surgery

Presbyopia can be corrected by the creation of surgical monovision. This procedure involves implanting a corneal inlay in the non-dominant eye. The result is one eye that is corrected for close vision and another that remains better-suited for distance viewing. In time, the brain learns to favor each eye for different tasks.

With one eye being dominant for up-close focusing and the other dominant for distance vision, a person’s sight is returned to nearly what it was before the presbyopia set in. However, it is not uncommon for distance vision to be minorly weakened by presbyopia surgery.

Catching presbyopia early

You will likely start noticing the effects of presbyopia sometime after age 40. The first sign is usually a difficulty reading font on your phone or in books. If you find yourself holding the fine print out at arm’s length, then you should bring it up with your eye doctor. When you notice signs of presbyopia, you should consult with your optometrist in a timely manner to rule out any other potential causes.

Your eye doctor will be able to give you an accurate prescription for corrective lenses. They will also be able to tell you whether or not you are a candidate for presbyopia-correcting surgery.

Presbyopia cannot be prevented, but by catching it early, you’ll spend less time squinting and more time with clear vision.