Aging affects all parts of the body, including the eyes. Age causes the lens of the eye to harden and become less flexible which can impact vision. (Learn More) It can become difficult to focus clearly on things up close, causing farsightedness, which is called presbyopia when related to aging. (Learn More)
Presbyopia is a condition of aging that anyone over age 35 is at risk for. The New York Times publishes that by age 45, over 80 percent of Americans will struggle with presbyopia, and by age 50, nearly everyone will.
There are some methods of "training" you can employ to try and teach your brain, and therefore your eyes, to see better and therefore potentially slow the onset of presbyopia. (Learn More) Once presbyopia starts, it is progressive. While some special eye exercises might work to improve it, it will generally need to be treated with reading glasses, prescription glasses, or corrective refractive surgery.(Learn More)
Mayo Clinic reports that presbyopia typically begins in your 40s and can continue to progress up until about age 65. Presbyopia can be treated with laser eye surgeries, such as monovision LASIK (laser-assisted in-situ keratomileusis), PRK (photorefractive keratectomy), RLE (refractive lens exchange), or corneal inlays. (Learn More)
Results of Aging on the Eyes
In young people, the lens of the eye, which light travels through, is generally flexible. The muscle fibers that attach to the lens are strong and supple, and help to focus light directly onto the retina.
Aging causes the lens of the eye to harden. As the National Eye Institute explains, in addition to the muscles attached to lens not working as well as they used to, this causes light to be focused behind the retina, making it harder to focus clearly on things up close. Images and text will then appear blurry, and you may find yourself holding menus and newspapers further away from yourself in order to read them.
Causes of Presbyopia
In addition to aging, eye strain, headaches, and trouble seeing clearly in low light are symptoms of presbyopia, which can begin as early as 35. The American Optometric Association (AOA) reports that the first-reported incidence of presbyopia is typically between the ages of 42 and 44, and age is the most common risk factor for the condition.
Systemic disease, cardiovascular disease, trauma to the eyes, geographical factors (such as proximity to the equator and ultraviolet light exposure), eye strain due to occupational reasons, poor nutrition, gender (with females tending to develop it earlier, often related to menopause), untreated hyperopia (farsightedness), or drug side effects can influence early-onset presbyopia and increase the risk factors for this type of farsightedness as well.
Preventative Eye Care for Presbyopia
Taking care of yourself and your eyes can help to delay the onset of presbyopia. Eating balanced meals, protecting your eyes from the sun, not straining your eyes too much with a lot of close-up vision expectations all the time, and paying special attention to any drug side effects that may impact vision can all help to minimize the risk for early-onset presbyopia.
There are also some methods of training your eyes, which actually means training your brain, that may work as preventative methods for aging eyes. As published in Vision Research, improving perceptual learning can increase visual processing and increase reading speeds, which can also lower the risk for presbyopia occurring soon. There are some exercises you can do that help the way the brain processes visual information, which can then improve up-close reading functions and speed. They may help the brain to recognize what it is seeing quicker and therefore sharpen potentially blurry images and bring them into better focus.
The exercises include having a person look at images called Gabor patches with varied contrast for several minutes. This take places during many sessions on a weekly basis for months. There are also smart phone apps that promote visual-training and eye exercises as well.
Presbyopia cannot be completely prevented, but the onset may be able to be pushed out a bit with specific eye exercises and overall good health.
Options Once Presbyopia Begins
Presbyopia is a common affliction of middle age and also easily treatable. One of the most common ways of treating presbyopia is with reading glasses. In the beginning, these may not even need to be prescription strength, and you may only require "readers" for certain tasks.
Presbyopia can occur with other refractive errors as well like myopia (nearsightedness). In this case, you may need bifocals, which are glasses that can correct for both myopia and presbyopia with varying levels of prescription on the lenses in different places. As presbyopia progresses, you may need prescription eyewear in the form of either contacts or eyeglasses.
Often, people decide that they either do not want to deal with glasses or don't like the perception that it seems to age them. Laser corrective eye surgery is a permanent fix that can offer aesthetic and visual advantages. There are several surgical options for treating presbyopia.
- Monovision LASIK (laser-assisted in-situ keratomileusis): This form of LASIK uses specialized lasers to cut a small flap in the cornea that is then folded back to access the stroma underneath. The stroma is shaped and given more depth in one eye in order to correct for the farsightedness. The epithelial corneal flap is then replaced and allowed to heal on its own.With monovision LASIK, the eyes are corrected differently — one for nearsightedness and the other for farsightedness. It can take some time for your eyes to adjust to longer working together, and this method may not be ideal for everyone. LASIK is a noninvasive procedure that is safe and has a relatively quick healing time with most people being satisfied with the results.
- PRK (photorefractive keratectomy): When the cornea is too thin for traditional LASIK, PRK can be a good option, as it doesn't require as much of the epithelial tissue. Lasers are still used to ablate the stroma, and the epithelial cornea will grow back fairly quickly on its own.
- Corneal inlays: In contrast with LASIK and PRK, corneal inlays are actually adding to the tissue in the eyes instead of taking away. The journal Review of Ophthalmology publishes that corneal inlays are typically for people who have had relatively good vision most of their lives and do not wish to wear corrective reading glasses. This procedure places an implant into the nondominant eye — another form of monovision treatment — that still allows the other eye to maintain its distance vision.
- RLE (refractive lens exchange): The Review of Ophthalmology reports that intraocular lens (IOLs) are constantly evolving and often a choice for treating presbyopia. An IOL replaces the current lens of the eye, which can help to improve vision. The journal Optometry Times explains that a clear lens exchange procedure, or an RLE, can often be a good option for people who may not be ideal candidates for LASIK, PRK, or other laser surgery procedures.Lens replacement has traditionally been a procedure done to manage cataracts, or cloudy lenses, by replacing the natural clouded lens with a new artificial clear one. Specific IOLs are now being used to treat refractive errors, including presbyopia.
In order to be eligible for corrective laser eye surgery, your eye prescription needs to remain the same for at least a year. Since presbyopia is progressive, it may mean that you will need to wait a bit for surgery to be an option until your eyes stabilize. You will also need to be in good health and not suffering from cataracts or other eye-related illnesses or issues.
An eye exam can let you know if you are indeed suffering from presbyopia, to what degree, and what types of treatment options may be best suited for you.
Training Your Brain so That You Don't Need Reading Glasses. (March 2017). The New York Times.
Presbyopia. (December 2017). Mayo Clinic.
Facts About Presbyopia. (October 2010). National Eye Institute.
Care of the Patient With Presbyopia. (2011). American Optometric Association.
Making Perceptual Learning Practical to Improve Visual Functions. (October 2009). Vision Research.
Update on Corneal Inlays for Presbyopia. (February 2016). Review of Ophthalmology.
Presbyopic IOLs: Choosing Wisely. (January 2018). Review of Ophthalmology.
The Pros and Cons of Clear Lens Exchange. (August 2014). Optometry Times.