Do you have presbyopia?

Lesson 1

What is presbyopia?

Presbyopia refers to sight changes commonly occur­ring in people in their 40s and 50s. Small print and other fine details that could once be seen clearly now appear blurred.

One of the first signs is having to hold a news­paper or telephone book further away than usual to be able to read the print. Presbyopia is derived from the Greek term meaning 'an old man's eye'.

Though presbyopia is a normal change in our eyes as we age, it often is a significant and emotional event because it's a sign of aging that's impossible to ignore and difficult to hide.

What causes presbyopia

Presbyopia results from changes that occur in the eye with ageing. The shape of the lens is controlled by muscles which surround it. These help the eye to focus on an object by relaxing or contracting, thus changing the shape of the lens, depending on how far away the object is. 

The lens becomes less curved when the eye focuses on a distant object, and more rounded when looking at something near.

With ageing, the lens becomes less elastic, and therefore less responsive to the muscles around it, which makes close focus­ing more difficult.

The far-sightedness and other vision changes are likely to worsen with in­creasing age. 

The strength of corrective lenses pre­scribed to compensate for the defect may have to be regularly increased, per­haps as often as once a year. 

However, presbyopia does not lead to blindness or serious vision loss.


“Difficulty seeing close, as in reading, writing or sewing.

Needing to remove your glasses for close work, if short-sighted.

Eye strain, especially after focusing on near objects.


Difficulty in changing focus from one object to another.”

How is presbyopia diagnosed and treated

A simple vision test will diagnose changes charac­teristic of presbyopia. A thorough eye examination by an ophthalmic optician (a person who specialises in vision tests and pre­scribing lenses) or an oph­thalmologist (a doctor who specialises in eyes and eye

disorders) is necessary to establish that the problem is presbyopia and to determine the strength of lens correction needed.

The problem is easily remedied by wearing prescription glasses to assist the eyes in seeing close objects more clearly.

A new prescription may be needed as time passes, so regular visits to the optician are important in keeping the lens prescrip­tion up to date, as well as checking for other possi­ble eye problems.

Loss of focussing power is progressive up to the age of 65, therefore regular eyesight tests are essential. The strength of the lenses may need to be increased every few years until focussing has to be entirely done by prescription lenses.

People who already have glasses may need a new prescription, or a pair of bifocals or trifocals (lenses designed to correct more than one focussing defect), so that they can see close up and at a distance without changing glasses.

Presbyopia surgery

If you don't want to wear eyeglasses or contact lenses for presbyopia, a number of surgical options to treat presbyopia are available as well.

One presbyopia correction procedure that's gaining popularity is implantation of a corneal inlay.

Typically implanted in the cornea of the eye that's not your dominant eye, a corneal inlay increases depth of focus of the treated eye and reduces the need for reading glasses without significantly affecting the quality of your distance vision.

The first step to see if you are a good candidate for presbyopia surgery is to have a comprehensive eye exam and a consultation with a refractive surgeon who specializes in the surgical correction of presbyopia.

What can I do myself

You cannot treat the con­dition yourself, but there are things you can do to try to cope more easily with the changes in your vision:

Read with adequate light coming from over your shoulder.

Carry a pocket pen light or a small magnifying glass to help read menus, programmes, and other printing in situations in which the light is poor.

Keep a magnifying glass near your telephone book and also use it for close-up tasks like thread­ing a needle.

Use a magnifying mirror for applying makeup or shaving.

When should I see my optician

As soon as possible, if you are having difficulty seeing close up or experiencing eye strain or headaches. After the age of 35 you should have an annual eye examination to detect possible eye disease such as glaucoma (abnormally raised pressure in the eye). If eye disease is suspected you may be referred to an ophthalmologist.

What will the ophthalmologist do?

If you already wear lenses, the ophthalmologist will check them to discern your current prescription. You will also be asked 

about past and present eye problems that could be affecting you.

The ophthalmologist will want to know about any medications being taken, even if not specifically for the eyes.

A complete physical examination of the eyes will be carried out, since the ophthalmol­ogist will be checking for other conditions as well.

A few tests are involved, including read­ing letters on a chart and a sample page. A slit-lamp (a binocular microscope incorporating a very bright light) may be used to get a magnified view of the inside of the eye.

A test for glaucoma will be carried out with a tonometer (a device which is mounted on the slit-lamp and used for measuring the pressure within the eye).

Is presbyopia dangerous

Presbyopia is not danger­ous unless you are in­volved in close work that could lead to injury, such as using electric saws or other power machinery. Wearing corrective lenses at such times is essential.


Although reading glasses are on sale in chemists and other shops with facilities to test your own vision for reading, eyeglasses should be tailored to the individual by a special­ist optician who also looks for signs of other eye diseases.

A different correction may be required for each eye, and cor­rections may also be needed for other vision problems.