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Presbyopia: Managing the Inevitable

man wearing glassesHaving a hard time seeing what you're reading is a common problem at about age 40.  Why is this so?  Let’s talk about the anatomy of the eye to explain.  The eye has a lens on the front surface called the cornea and another lens behind the pupil of the iris called the crystalline lens.  This lens is flexible in youth and automatically focuses on near objects without us even giving it a thought.  As time passes, the lens grows more rigid, decreasing your ability to focus on handheld objects.  The clinical term for this is presbyopia.  It's something that eventually happens to us all.

Early on all you need to do for presbyopia is to hold printed text at arm's length to focus properly, since an object farther away requires less focusing.  In addition to reading, other close-range activities, such as sewing or writing, may lead to eyestrain and discomfort.  There are a number of solutions available, regardless of whether you are a glasses or contact lens wearer.

Reading glasses are an easy choice, but are generally best for those who wear contacts or who don't need to wear glasses for distance vision.  These are readily available, but it is not recommended to get a pair until you have been examined by your eye doctor.  Remember that over the counter reading glasses may help with presbyopia, but a yearly eye health exam is very important to catch eye diseases that may not have symptoms like cataract, macular degeneration and glaucoma. 
If you're already wearing glasses for distance on your eye exam our doctors will discuss with you and prescribe multifocals, which can be bifocals, trifocals or PALs (progressive addition lenses), which most commonly used these days. Multi-focals are glasses with multiple points of focus with the lower part of the lens containing a prescription to help you focus at close and intermediate distances

If you wear contacts, our doctors may prescribe multifocal contact lenses or a treatment approach known as monovision when one eye is fitted with a contact lens for distance vision and one eye with a lens for close vision.   This surprising concept works very well for most patients.  We use this approach often even in patients who have had refractive surgery like LASIK.

As the crystalline lens loses its ability to focus each year we need a bit more power in our reading lenses.  Schedule your yearly eye exam and ask our doctors about the treatment for presbyopia that’s just right for you.



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