Decoding the Numbers: Presbyopia

Welcome back for my final post of the “Decoding the Numbers” series.
Do you know of anyone who never needed glasses until they hit their mid-40s to early 50s?  Maybe it’s you.  Maybe it’s a friend.  Maybe it’s a family member.  Regardless of the relation, you’ve probably wondered, “what happened?!”
In a word?


  • Presbyopia, by definition, is: far-sightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age.

What causes presbyopia?

  • Rather than being from a true mismatch in length/power of the eye, presbyopia occurs as the lens of the eye naturally loses its ability to flex and change power.  It’s this change of power that, in children and younger adults, allows one to switch focus from distance to near.

Why do we need lenses?

  • Because the lens of the eye becomes more rigid, rather than being able to focus at any distance, generally only one place is clear at a time.  Lenses, either spectacle or contact, are then needed to clear up the other distances.

Who gets presbyopia?

  • Unfortunately, everyone ends up becoming presbyopic at some point.
  • However, presbyopia looks different for different prescriptions.  For instance, far-sighted people often start by just needing reading glasses, but often progress to needing glasses all the timeNear-sighted people, though, often find that they can take their glasses off and have clear vision at near.

When should I suspect presbyopia?

  • Presbyopia begins at different ages for different people.  Most commonly, the signs and symptoms of emerging presbyopia begin in someone’s mid-40s
  • Presbyopia may occur earlier in uncorrected far-sighted patients, and later in uncorrected near-sighted patients.
  • Some signs of becoming presbyopic are:
    • Squinting when looking at near objects or tiny font
    • Holding objects farther away
    • Needing additional light to see things at near (especially in restaurants!)
  • Presbyopia does progress, however, only to a certain stage.  Once someone reaches absolute presbyopia – this typically coincides with needing +2.50 readers, which often occurs around age 60 – it stays stable.

Are there any complications with being presbyopic?

  • As annoying as presbyopia is, thankfully there are no ocular complications associated with it!

    Can presbyopia be treated?

    • Unfortunately, there is currently no cure for presbyopia.  Rather, it is managed with spectacle and contact lenses that are designed to provide clear images at multiple distances.
      • Common spectacle treatment options include reading glasses, progressive lenses, or lined bifocals/trifocals.
      • Common contact lens treatment options include multi-focal contacts lenses, monovision, and single vision distance lenses with near readers.
    • Contrary to popular belief, LASIK does not prevent or treat presbyopia, as this only changes the curvature of the front surface of the eye, and does nothing to increase the elasticity of the lens.
    • Cataract surgery may help treat presbyopia.  In this procedure, the natural lens is removed and replaced by an implanted intra-ocular lens.  As technology continues to advance, the capabilities of intra-ocular lenses are improving, with the hopes of being able to provide clear vision for all distances.*
    *Unfortunately, I am not currently well-versed in all the intra-ocular lenses that are on the market, and so do not know lens specific capabilities.  If you’re interested in an accommodating lens, talk to your cataract surgeon about your options and see what lens they suggest for you!

    **To read the rest of the posts in this series, click on a link below!**
    If you have any questions or comments, please contact me!  If you’ve enjoyed this article, please subscribe, or like my page on Facebook!

    Leave a Reply

    Your email address will not be published. Required fields are marked *