Presbyopia

Presbyopia is the eye's diminished power of accommodation that occurs with aging. The most widely held theory is that it arises from the loss of elasticity of the crystalline lens, although changes in the lens' curvature from continual growth and loss of power of the ciliary muscles (the muscles that bend and straighten the lens) have also been postulated as its cause.

Presbyopia is not a disease as such, but a condition that affects everyone at a certain age. The first symptoms are usually noticed between the ages of 40-50. For those with good distance vision, it may start with difficulty reading fine print, particularly if the lighting is poor, or with eyestrain when reading for long periods. Many advanced presbyopes complain that their arms have become "too short" to hold reading material at a comfortable distance.

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Treatment

Presbyopia cannot be cured, but the loss of focusing ability can be compensated for by corrective lenses including eyeglasses or contact lenses. In subjects with other refractory problems, multifocal lenses (such as bifocal or trifocal lenses) or progressive lenses are used. In some cases, the addition of bifocals to an existing lens prescription is sufficient. As the ability to change focus worsens, the prescription needs to be changed accordingly.

Around the age of 65, the eyes have usually lost most of the elasticity. However, it will still be possible to read with the help of the appropriate prescription. Some may find it necessary to hold reading materials further away, or require larger print and more light to read by. People who do not need glasses for distance vision may only need half glasses or reading glasses.

In order to reduce the need for bifocals or reading glasses, some people choose contact lenses to correct one eye for near and one eye for far with a method called "monovision". Monovision sometimes interferes with depth perception. There are also newer bifocal or multifocal contact lenses that attempt to correct both near and far vision with the same lens.

New surgical procedures may also provide solutions for those who do not want to wear glasses or contacts.