Presbyopia

Reading Vision Problems

What is presbyopia?

Presbyopia or reading vision problems is a condition that affects everyone as they get older. It is caused by changes in the crystalline lens, which is located inside the eye. When we are young we have a crystalline lens that is very flexible and the muscles within the eye can manipulate it so that it changes its shape, and therefore its power, so we can focus over a range of distances. This is a reflex and is done automatically without thought or effort. It is called accommodation. As we age, the lens becomes a stiffer, more rigid structure and it becomes harder for the muscles to get the lens to increase in thickness to become more powerful. As such, focusing up close becomes more problematic.

Presbyopia symptoms

The decrease in accommodating capability starts very early on in life but presbyopia symptoms are not noticed until patients can no longer read without holding items further away. Presbyopia symptoms include:

  • needing to hold reading material further away in order to be able to read
  • eye strain or headaches when reading over long periods of time.

Patients often first notice the deterioration in the winter months when lighting is worse. There is no cure for presbyopia, and no way of slowing its progression. Without intervention it results in blurred near vision.

Causes of presbyopia

Presbyopia is caused through changes in the crystalline lens that occur over time. It is a different condition to hypermetropia or long sightedness, which it is often confused with. Long sightedness is a refractive error that when corrected will allow clear vision at all distances, whilst presbyopia is a “near vision” only eye condition and any correction given will result in clear near vision but will blur the distance vision.

 

Presbyopia treatment options

Traditional correction: Reading glasses can be prescribed to help patients read clearly, but with them on, distance vision will be blurred. Patients with presbyopia can also be prescribed glasses that have either 2 (bifocal) powers (one for distance and one for near), or multiple powers (varifocals) to allow a more blended vision.

Surgical correction:

  • Laser eye surgery: Monovision or laser blended vision: This presbyopia treatment is when the dominant eye is surgically corrected to focus at distance and the non-dominant eye is corrected to focus close up. The brain can adapt to zone into the eye with the clear vision dependent upon the task being done. This is a successful procedure for many patients and contact lens trials can be carried out first to ensure you are suited to this type of treatment option.
  • Conductive Keratoplasty. This is a non-invasive surgical procedure that uses radio wave energy to alter the shape of the cornea in order to treat presbyopia.
  • Clear Lens Extraction. This involves inserting an intra-ocular lens, similar to cataract surgery.

It is important to discuss the surgical options with your eye surgeon, who will explain which presbyopia treatment option may be best for you. This will depend on a number of factors including the severity of your presbyopia and any other eye conditions you may have.

More information

To discuss possible treatments for presbyopia, call us on 0808 133 2020 to book an appointment.