There are some natural problems that come with age. Joints get a little creaky, hair loss sets in and your eyes don’t work like they used to. Your optometrist tells you that you have presbyopia – but what is presbyopia and why does it happen?
 

What is Presbyopia?

Presbyopia is the natural age-related deterioration of the eye’s focusing ability. Within the eye is the crystalline lens, which sits behind the coloured iris. At birth, a developed lens is optically transparent to allow the transmission of light and is also quite flexible. Attached to fibres and controlled by a ring of muscle called the ciliary muscle. This lens can change its shape to focus on near objects – a process called accommodation.
 
As we age, the lens grows less flexible. As we approach our mid-40s, we begin to find that we can’t focus on near objects as we once could – this is early presbyopia.
 
Although there are several options to correct presbyopia, in the early years you may find easy ways of getting around it. Such as holding your reading material further away or enlarging the font on a digital device. However, presbyopia is progressive and unrelenting. Eventually, you will find that your arms are not long enough to easily read your books.
 
There is currently no cure for presbyopia or any way to slow it down. Some international research is looking into the use of pharmaceuticals. But currently, this age-related deterioration of near vision is something to accept as part of getting older and wiser.
 

How Do You Correct Presbyopia?

Now that we’ve identified presbyopia and come to accept that it’s natural with age, we can look into available solutions.
 
The most popular way to correct presbyopia is with glasses. There are several designs of spectacle lenses suitable for different lifestyles and activities.

Spectacle lens designs

  • Single vision reading spectacles: The entire lens contains the reading, or near vision, script. To look at distant objects, you’ll need to remove the glasses or peer over them.
 
  • Extended focus spectacles: Due to the progressive nature of presbyopia, at some point, one reading script will stop being clear. For both intermediate arms-length distance and a closer reading distance. Extended focus spectacles contain your intermediate script in the top half of the lens and a stronger near script at the bottom half. This means you don’t need two pairs of near vision glasses for different activities.
 
  • Multifocal glasses: Multifocals contain your script from far-distance vision to up-close reading vision. The change in the script throughout the lens is progressive and gradual. With long-distance at the top, an intermediate vision in the middle, to near vision at the bottom.
 
  • Bifocal glasses: Bifocals contain a visible line on the lens. Below the line is the near vision script while every other area of the lens is for long-distance vision. There is no intermediate script in a bifocal.

Advancement of contact lens design has also made it viable for presbyopia correction.

  • Monovision: One eye corrected with a contact lens for distance vision, the other given a contact for near vision.
 
  • Multifocal contacts: Both eyes corrected for some degree of distance and near vision. The dominant eye given preference for distance viewing. The brain learns to adapt to the concept of simultaneous vision.
 

Certain refractive surgical procedures may be suitable to correct presbyopia. Dependant on factors such as, prescription and adaptation to different visual experiences.

Refractive surgical procedure options

 
  • Multifocal intraocular lenses (IOL): Like a multifocal contact lens. A multifocal IOL is an implantable lens. Containing a correction for both distance and near viewing. Inserted during a refractive lens exchange (RLE) procedure or during cataract surgery.
 
  • Monovision IOLs: During an RLE procedure or cataract surgery, you may opt to have an IOL implanted. For distance vision in one eye and one for reading in the other eye.
 
Whether you are experiencing the early or later stages of presbyopia, we assure you, it’s a normal part of ageing. And you have a multitude of corrective solutions available to you.
 
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from a qualified health practitioner.

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About the expert

Dr Anton van Heerden, MBCHB; FRANZCO
Ophthalmologist & Laser Eye Surgeon

Based in Melbourne, but with a reputation that transcends borders, Dr Van Heerden sets the highest bar for laser vision correction surgery in Australia. While his skills and experience are second to none, it is his fun, caring and down to earth nature that truly set’s him apart from the rest. You can sit back and enjoy the journey knowing every detail has been carefully considered.

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