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Definition

Presbyopia is a vision problem that makes it hard to focus on and clearly see objects that are at a normal reading distance or closer.

Causes

Presbyopia is caused by a slow loss of flexibility in the lens of the eye as people age. This makes it hard for the lens to change its shape to focus on objects at close distances.

Anatomy of the Eye
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Risk Factors

Presbyopia is more common people over 40 years of age.

Symptoms

Problems may be:

  • Holding items at arm's length to focus on them
  • Blurred vision when reading
  • Headaches and eye strain from close work, such as:
    • Reading
    • Sewing
    • Computer work

Diagnosis

A vision specialist will ask about your symptoms and health history. An eye exam will be done. This is enough to make the diagnosis.

Treatment

This problem is treated with corrective lenses.

Glasses

A person may choose to wear:

  • Eyeglasses for close-up vision
  • Bifocals that have distance vision in the upper half of the lenses and close-up vision in the bottom half of the lenses
  • Trifocals that are like bifocals but have a medium range lens in between the distance and close-up vision portions
  • Progressive lenses that have a gradual increase for close-up vision as a person looks down on the lens

Contact Lenses

Contact lens options are:

  • Bifocal contacts that have distance vision in the upper half of the lenses and close-up vision in the bottom half
  • Monovision contacts where a lens is worn in one eye for distance vision and a lens is worn in the other eye for close-up vision

Surgery

Some people may choose to have surgery. Options are:

  • Conductive keratoplasty (CK) to place a small probe in one eye to reshape the cornea for close-up vision and allow the other eye to be used for distance vision
  • Laser-assisted in situ keratomileusis (LASIK) to use laser beams to reshape the cornea and correct problems with focus
  • Multifocal intraocular lenses to replace the eye's natural lenses with lenses that focus on both distant and near objects

Prevention

There are no current guidelines to prevent presbyopia.

RESOURCES

American Optometric Association  http://www.aoa.org 

National Eye Institute  http://www.nei.nih.gov 

CANADIAN RESOURCES

Canadian Association of Optometrists  http://opto.ca 

Canadian Ophthalmological Society  http://www.cos-sco.ca 

References

Comprehensive geriatric assessment. EBSCO DynaMed website. Available at:  https://www.dynamed.com/prevention/comprehensive-geriatric-assessment . Updated November 26, 2018. Accessed April 29, 2020.

Presbyopia. American Optometric Association website. Available at: http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/presbyopia. Accessed April 29, 2020.

What is presbyopia? American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/diseases/presbyopia.cfm. Updated January 13, 2020. Accessed April 29, 2020.

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