Presbyopia – The Optician Says

Harry The Optometrist

Written by Harry


The Optician says…

Understanding presbyopia

As we get older, our bodies naturally struggle to do things that we once found easy. Many visual conditions can develop in older age, some more serious than others, but there are ways to mitigate the effects of declining sight. Between middle and old age, our eyesight naturally weakens and makes us unable to auto-focus on close up objects, a condition that’s known medically as presbyopia.

What is presbyopia?

Presbyopia is a naturally occurring decline in eyesight for older people, caused by the loss of elasticity in the eye lens. This causes the lens to harden, which makes the eye focus light behind the retina rather than on it. This should not be confused with long-sightedness, which presents similar symptoms (inability to focus) but is rather an issue with the shape of the eye than the age of it. 

The bad news is, presbyopia is unavoidable. The good news is, it simply requires a pair of reading glasses (or medically prescribed glasses in stronger cases) to help focus on objects close up. Middle-aged or older people may benefit from a pair of prescription reading glasses to read menus, newspapers and smartphones.

When buying sunglasses, look out for the label – a reliable pair will protect from 99-100 per cent of UVA and UVB rays. If you see labelling such as “UV 400”, this means that the glasses protect from wavelengths up to 400 nano metres.

What if I am already short-sighted?

Presbyopia is a refractive error, just like short-sightedness or astigmatism (a misshapen cornea which affects the way light is refracted onto the retina). For a person with perfect vision, light rays focus on the retina, whereas for a short-sighted person, they focus in front of the retina. Long-sightedness is the reverse, but this is known as hyperopia rather than presbyopia. 

This means that, unfortunately, people with short-sightedness (myopia) can also suffer from presbyopia in old age! Myopia does not offset the presbyopia – whereas hyperopia is a problem from a young age and affects objects close up, presbyopia is an inability to change focus. So, without glasses, a short-sighted person will struggle to see objects in the distance but equally will need corrective glasses to change focus on something close up.

Treating presbyopia

For those with short-sightedness and presbyopia, bifocals provide a multi focal solution which features a distance prescription at the top and a near-sight prescription at the bottom. They come in four types – D segment, Executive, Round Segment and C Segment, and your optician will advise you on the best option for your needs.

Another option is progressive lenses, which are becoming more popular than bifocals now due to their enhanced visual range. Some people with presbyopia also find that they are sensitive to light, in which case a photochromic coating can adjust to the light and can be used over progressive lenses and bifocals.


The Future

As science advances, more and more surgical options are becoming available, including ‘monovision’. This involves a different type of laser surgery for each eye – one to correct the dominant eye for short-sightedness and one to correct the eye for long-sightedness, which creates a ‘blend zone’, making the brain combine both images for a more focused picture.

Whatever your chosen treatment, it’s important to understand that presbyopia is perfectly normal and your optician is on hand to help. If you have any questions about presbyopia, speak to one of our team today.