Age-related farsightedness, medically known as presbyopia, is a common condition affecting over 80% of Americans by age 45. While certain eye exercises and lifestyle changes may slow its onset, treatments often include reading glasses, prescription eyewear, or corrective surgeries like monovision LASIK and refractive lens exchange. The condition typically begins around age 40 and can progress until about age 65, requiring ongoing management and potentially surgical interventions.
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. It can become difficult to focus clearly on things up close, causing farsightedness, which is called presbyopia when related to aging.
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. 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.
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.
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
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.
Presbyopia has multiple possible triggers that may cause eye lenses to harden and lose the ability to focus. Here are the main factors that put you at a higher risk for developing presbyopia:
- According to the American Optometric Association, presbyopia develops between ages 41 and 60 in most people. When farsightedness is an outcome of the natural aging process, there isn’t much you can do to prevent it once your lenses have began losing their original elasticity.
- The condition may worsen as you get older, making it necessary to start treatment and management. However, not everybody requires presbyopia treatment due to the normal aging process.
- Diabetic people are at a higher risk for developing farsightedness including at below the age of 40.
- Heart Diseases
- Complications of the heart are linked to several vision problems, including presbyopia.
- Multiple Sclerosis
- MS causes damage to the central nervous system and the brain, leading to vision loss and other health problems.
- You can also develop premature presbyopia because of side effects from medications for treating depression. People using allergy drugs (antihistamines) and diuretics are also at a higher risk for developing eye focus problems not related to the normal aging process.
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.
Managing Presbyopia for Life
Age-related loss of eyes’ focusing power begins in childhood. If you’re like most people, you won’t realize you have this visual problem until after the age of 40.
You don’t have to panic after a positive presbyopia diagnosis. You can still read a newspaper, a Kindle or a computer, and you should be able to navigate a smartphone and social media if you manage the condition well.
Besides accepting treatments like wearing corrective glasses or lens implants, there are lifestyle changes you may need to make. Keep in mind that presbyopia will be advancing as you grow older, so you’ll want to protect your vision as a lifelong commitment.
Embrace these self-care measures to protect your vision:
- Have an eye exam at regular intervals throughout your life (at least once every two years between the age of 18 and 39 and 40 through 60 and annually when you’re 65 or older)
- Get treated for any heart problems or diabetes if present
- Use protective eyewear to prevent injury during risky activities like sports or lawn mowing
- Improve your vision with a proper diet, including fruits, leafy vegetables and meals rich in antioxidants and vitamins
- Wear anti-UV glasses when spending long hours in the sun
- See an ophthalmologist once you start experiencing fluctuating visual power
Other Treatment Options
Often, people decide that they either do not want to deal with glasses or do not 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.
- 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 Do Not Need Reading Glasses. (March 2017). The New York Times.
- Presbyopia. (December 2017). Mayo Clinic.
- Facts About Presbyopia. (October 2010). National Eye Institute.
- 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.