The Aging Eye

presbyopia causes, symptoms and treatment
presbyopia causes, symptoms and treatment
As we age, so do our eyes. Around the age of 40, you may start to notice that your near vision gradually becomes blurry. This is presbyopia. It is inevitable and eventually affects everyone(1). So what causes presbyopia and how can it be treated?
What is Presbyopia?
Presbyopia is a gradual, age-related eye condition that causes blurred near vision. (2)
Presbyopia differs from astigmatism, nearsightedness and farsightedness, which are related to the size and shape of the eyeball and are caused by genetic and environmental factors. (2)
Young Eye (3,4)
Retina: Near object focuses on the retina for a clear image.
The lens in the eye is soft and flexible which allows the surrounding muscles to easily reshape it when the eye needs to focus on objects at varying distances.
Aging Eye (2, 3,4)
As the eye ages:
The lens in the eye thickens and loses flexibility.
The surrounding muscles lose some elasticity.
Both of these make it harder for the lens to change shape like it once did.
Focal point of presbyopic eye: Near object focuses behind the retina causing a blurry image.
The Facts
0
the approximate age for when individuals begin using vision correction (i.e. contact lenses, eyeglasses) to treat presbyopia.(1)
0 billion
0 billion
0 billion
2005
2020
2050
People worldwide with presbyopia in 2005.(5)
This is expected to increase to 1.4 billion in 2020.(5)
And 1.8 billion in 2050.(5)
Uncorrected presbyopia is one of the leading causes of vision-related disability.(1)
Who is at risk?

Anyone approaching the age of 40 is at risk for developing presbyopia.(4)

Presbyopia eventually affects everyone.(1)

It is common to have presbyopia and another type of refractive error (nearsightedness, farsightedness and astigmatism) at the same time.(4)

Factors which may cause an earlier onset of presbyopia(6)

Gender:

Females, mainly due to menopause.

Occupation:

Jobs that require near vision demands.

Systemic disease:

Diseases like diabetes, multiple sclerosis and myasthenia gravis.

Drugs:

Certain drugs are associated with premature presbyopic symptoms, including antidepressants, antihistamines and diuretics.

Geography:

Proximity to the equator due to higher average annual temperatures and greater exposure to UV rays.

Stages & Symptoms (6,7,8)
Mild symptoms include:
Reading small print requires extra effort
Dim light makes it hard to read
Additional symptoms from ‘Advancing Presbyopia’ may be experienced on occasion
Because presbyopia is mild, patients may or may not receive a prescription for vision correction at this stage
Continue to visit your eye doctor at least every 1 to 2 years or as frequently as your eye care professional recommends so your symptoms and prescription can be monitored
Symptoms strengthen and become more bothersome. These can include:
Trouble reading small print
Difficulty seeing in dim light
Blurred vision at normal reading distance
Delays in focusing at near or distance
Eye discomfort
Headaches
Squinting
Eye strain
Tiredness while performing close-up tasks
Having to hold reading material at arm's length to try to see clearly
Loss of sharp near vision when putting on contact lenses or single-vision glasses to bring distant objects into focus
Patients require optical correction to be able to see clearly
Absolute Symptom:
Eyes are no longer capable of focusing on objects up-close without some form of optical correction
If untreated, a significant visual disability is likely to develop
Stages & Symptoms(6,7,8)
Mild symptoms include
Reading small print requires extra effort
Dim light makes it hard to read
Additional symptoms from ‘Advancing Presbyopia’ may be experienced on occasion
Because presbyopia is mild, patients may or may not receive a prescription for vision correction at this stage
Symptoms strengthen and become more bothersome. These can include:
Trouble reading small print
Difficulty seeing in dim light
Blurred vision at normal reading distance
Delays in focusing at near or distance
Eye discomfort
Headaches
Squinting
Eye strain
Tiredness while performing close-up tasks
Having to hold reading material at arm's length to try to see clearly
Loss of sharp near vision when putting on contact lenses or single-vision glasses to bring distant objects into focus
Patients require optical correction to be able to see clearly
Absolute Symptom:
Eyes are no longer capable of focusing on objects up-close without some form of optical correction
If untreated, a significant visual disability is likely to develop
Treatment Options (2, 9, 10)

As a person ages, their presbyopia continues to develop until it reaches the 'Absolute Presbyopia' stage. As such, the level of vision correction needed must be constantly adjusted to accommodate these changes.

If you already require vision correction prior to the onset of presbyopia, your current contact lenses or eyeglasses will gradually no longer provide clear vision at all distances.

It is important to visit your eye doctor every 1 to 2 years, or as frequently as your eye care professional recommends, to ensure your prescription is up-to-date.

Based on your previous vision correction needs, there’s a variety of treatment options available:

Misconceptions

There is a lot of misinformation about presbyopia. Let’s do some myth busting and get to the truth.

MYTH OR FACT?

MYTH

Presbyopia can lead to blindness.

FACT

Without treatment, it can lead to much poorer vision, which can be considered a vision-related disability, but not blindness.(10)

0%

of people believe this(10)

MYTH

Presbyopia
is a
disease.

FACT

Presbyopia is not a disease. It is simply a part of the aging process.

MYTH

I have perfect 20/20 vision. I won’t get presbyopia.

FACT

Unfortunately, presbyopia will affect everyone.(1)

MYTH

If I'm under 40,
I can't get presbyopia.

FACT

That's incorrect. If you're under 40, you can still develop presbyopia.
This is known as 'premature presbyopia'.(6,7)

SOURCES
  1. Hickenbotham A, Roorda A, Steinmaus C et al. Meta-Analysis of Sex Differences in Presbyopia. IOVS, May 2012, Vol. 53, No. 6.
  2. Bailey, G. Presbyopia. allaboutvision 2016.
  3. Boyd, K. What is Presbyopia? America Academy of Ophthalmology. Sep 2013.
  1. https://nei.nih.gov/health/errors/presbyopia
  2. Holden B, Fricke T, Ho M, et al. Global Vision Impairment Due to Uncorrected Presbyopia. Arch Ophthalmol. 2008;126(12):1731-1739.
  3. http://www.aoa.org/documents/optometrists/CPG-17.pdf
  4. http://www.aoa.org/documents/optometrists/QRG-17.pdf
  1. http://www.2020mag.com/story/9643
  2. Heiting, G and DePaolis, M. Multifocal Contact Lenses. allaboutvision 2015.
  3. Bonilla-Warford, N. What To Do With ‘New’ Presbyopes. Review of Optometry. Feb 2012.