Presbyopia

What is Presbyopia?

Presbyopia is a natural age-related change that affects virtually everyone from their mid-40s onwards. It occurs as the crystalline lens inside the eye gradually loses its flexibility, reducing the eye's ability to change focus between near and distant objects. Although it is entirely normal and not a disease, presbyopia can significantly affect daily life — particularly for reading, using a smartphone or working at a computer. Various optical and surgical options can reduce or eliminate the need for reading glasses.

Symptoms

• Difficulty reading small print at normal reading distance
• Need to hold books or menus further away to see them clearly
• Eye strain and headaches after prolonged reading or close work
• Needing brighter light for reading
• Difficulty with the transition from near to distance vision

Causes

• Age-related loss of elasticity of the crystalline lens
• Reduced contractile ability of the ciliary muscle with age
• A universal change that begins in the 40s and progresses through the 50s

Diagnosis

Standard near vision testing and refraction assessment confirm presbyopia. The degree of near addition required is measured precisely.

Treatment

Reading glasses are the simplest solution. Varifocal or bifocal lenses provide both distance and near correction in a single spectacle lens. Monovision contact lenses (one eye for distance, one for near) suit some patients. Surgical options include multifocal or extended depth-of-focus (EDOF) intraocular lenses at the time of cataract surgery or refractive lens exchange, which can significantly reduce spectacle dependence.