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Presbyopia

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Often referred to as the “aging eye condition”, presbyopia is a vision error that results in the inability to focus up close objects. Presbyopia is commonly combined with other vision errors such as: hyperopia (farsightedness), myopia (nearsightedness), and astigmatism.
It is a common type of vision disorder that occurs with age.

Causes of Presbyopia

Presbyopia is a naturally occurring vision error that happens with age. Near print and objects are blurred because the lens within the eye is affected in two ways-decreased focussing flexibility and muscle fibers attached to the lens are weaker. This results in light being focused behind the retina.

What is Considered “With Age”?

Anyone over the age of 40 is at risk of developing presbyopia. Although everyone will experience a loss of up-close focusing power, some are affected more than others.

Diagnosis

Presbyopia can be diagnosed during a comprehensive eye exam. Contact your optometrist if any changes in vision are noticed. Adults should have eye exams every one to two years; senior citizens should have eye exams annually.

Signs and Symptoms

The following are signs and symptoms of presbyopia, but not limited to:

  • Difficulty seeing close objects
  • Having to hold reading material farther than arm’s distance
  • Difficulty reading small print
  • Headaches
  • Eyestrain

If you already wear contact lenses or eyeglasses and still experience these symptoms, a new prescription might be needed.

Treatment

Presbyopia can be treated through corrective lenses, laser eye surgery, and inlays/outlays.

Eyeglasses and Contact Lenses

Bifocal, trifocal or progressive addition lens (PALs) eyeglasses are the most common treatment for presbyopia. Bifocal and trifocal lenses offer two to three points of focus through separate prescriptions: one for distance vision, midrange, and one for close up. PALs are similar to bifocal lenses, but do not create a visible line between the two prescriptions. Instead, they consist of a more gradual visual transition.
Contact lenses are another effective treatment for presbyopia. Both multifocal contact lenses, and monovision are available to patients who suffer from presbyopia. Monovision consists of two prescriptions: one for distance, and one for near vision. The brain will learn to favour one eye for each task. While some enjoy this method of treatment, others claim that wearing two different prescriptions reduce visual acuity and depth perception.

Laser Eye Surgery and Inlays/Outlays

Opposed to contact lenses, LASIK can be used to create monovision. One eye will be corrected for near vision while the other eye is for distance.
AcuFocus, the Kamra inlay, is another treatment option. It is surgically implanted under the top layers of the cornea in one eye. It works by controlling the amount of light that enters the eye and increases the range of what you see in focus. AcuFocus was recently approved by the FDA in 2015 and is currently the only inlay/outlay approved.

Written by Dr. Kent Prete

An active member of the Canadian Association of Optometrists, the Alberta Association of Optometrists, and the Alberta College of Optometrists, Dr. Prete lives his passion every day when he sees his patients. Dr. Prete has spoken at over 100 professional events over the last almost 20 years. A keen educator and confident doctor, Dr. Prete is nearly as passionate about educating other eye care professionals as he is about caring for and educating his patients!
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