Presbyopia: Age-Related Vision Loss
Age related vision deterioration
Presbyopia is the progressive loss of vision experienced by everyone as they age. It feels and seems like farsightedness, but has a different cause. Nearsightedness, farsightedness, and astigmatism are caused by the shape of the cornea (clear front part of the eye). But people with perfectly shaped eyeballs who have had 20/20 vision their entire lives will experience some degree of presbyopia if they live past the age of forty-five or fifty, and may notice it coming on around age 40.
Symptoms of Presbyopia
Presbyopia is creeping up when you find yourself holding the newspaper at arm’s length, or when you get headaches doing close work such as sewing. You might also have a general feeling of eye fatigue when performing any close-up task.
There are a number of theories as to what causes presbyopia, and research and experimentation are ongoing. Traditionally, the favored theory has been that presbyopia is caused by a gradual loss of flexibility in the eye’s crystalline lens. Along with this, some also include the possibility that the muscles controlling the lens weaken with age.
Another theory is that the lens continues to grow throughout life and by mid-life is intruding on the space needed by the muscle that encircles and controls its shape. The FDA is currently testing some new presbyopia treatments based on this theory.
If you are over the age of forty or so, your optometrist or ophthalmologist will have presbyopia in mind, and will pick it up with vision exams. The condition worsens as we age, so presbyopia correction may have to be adjusted periodically.
The most common treatment for presbyopia is prescription eyewear, either glasses or contact lenses. Glasses can be:
- Reading glasses, to provide simple magnification for close vision
- Bifocals, improving vision both close and far
- Trifocals, improvement middle-distance vision as well as close and far
There are special contact lenses designed for presbyopes, called multifocal lenses, and monovision contacts.
Other Presbyopia Treatments
Conductive Keratoplasty (CK) is used to correct presbyopia with monovision. The eye surgeon uses radio energy to increase the corneal curvature in one eye and may adjust the other eye for better distance vision or may leave it as it is. CK gives improved vision almost immediately.
Both cataracts and presbyopia can be successfully treated by replacing the natural lens with an intraocular lens (IOL). There are several to choose from, each designed using different proprietary technology. Please see Clear Lens Exchange for more details on how this is done.
Because all of us will develop presbyopia if we live past 40 or 45, ophthalmologists are very interested in finding new and better ways to treat it or perhaps even prevent it. Research is ongoing. Please see our page on Presbyopia Correction: Surgical Reversal.
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