What’s Presbyopia?
Human’s eyes are vulnerable and susceptible to many vision problems and eye diseases such as myopia, hyperopia, glaucoma and cataract to name but a few. Even though you have healthy eyes and never have any of diseases before, you are not excepted from having a vision problem known as “Presbyopia” or age-related farsightedness, which means “old eye” in Greek word. To put this simple, your eyes become weary and gradually lose the ability to see things clearly in a close distance. But don’t worry. It is normal, it is a part of aging. Let’s discuss more this issues and possibilities for prevention of Presbyopia.
Causes of Presbyopia
The working mechanism of a human eye is simple, the lens placed inside the eye which helps to focus light onto the retina so that we can be able to see is soft and flexible when we are young. But over time, it becomes more stiff and rigid. Its shape cannot be able to change as easy as it was before. Therefore, Presbyopia occurs and it makes it harder for you to read, see or thread a needle. This process is inevitable. There is no way to stop or reverse this because aging is a part of a human being.
However, like myopia, you can temporarily slow down the progress and correct it with some treatments. don't ignore if you want to bear some headaches, eyes strain frequently.
Treatments for Presbyopia
The first step you should do is to visit an eye doctor for a comprehensive dilated eye examination. Even though when you don’t have any problem before with your eyes, the American Academy of Ophthalmology recommends that adults should conduct an eye check every two to four years between ages 40 and 54, one to three years between ages 55 and 64 and one to two years beginning at age 65.
An eye care professional can diagnose your vision condition and recommend the best solution for your problem. Patients with presbyopia have several options to correct their vision including
- Eyeglasses (reading glasses and multifocal lenses)
- Contact lenses (monovision and bifocal lenses)
- Laser surgery
- Other refractive surgery types
Eyeglasses for Presbyopia
When you are sometime after age 40, you will probably notice some symptoms of presbyopia. People report that they experience the feeling of their arms “aren’t long enough” to hold a book at a distance where you can read it clearly. This is a sign telling that you should make an appointment with an eye doctor.
For most adults, wearing eyeglasses is probably the easiest way to correct refractive errors. This method offers you a chance to opt for different types of lens options, even different frame designs, and lens colors. However, before going down to the style and design, people with presbyopia need to know there are two types of eyeglasses lens. One with a single vision and other with multifocal. While the first one only can help you to correct distance vision, the latter one can correct both distance and near visual acuity.
Single Vision Lenses
Single Vision Lenses are probably the most common type among many types of lens in the world, and their benefit is obviously to help you correct your vision. For people under the age of 40, this is always the best choice. It’s available in many options and you can choose the material, thickness, and coating. However, single vision lenses can be very expensive if you have a strong prescription.
Multifocal Vision Lenses
Eyeglasses with multifocal lenses can come with many types of lenses such as bifocals, trifocals, progressive multifocal and office progressive. They are all basically used to correct presbyopia, however, they are slightly different in the lenses itself and for various purposes. These lenses typically reserved for those that are over 40 years old or near. Because around this age, you start to experience presbyopia
Bifocals
Bifocals have two different corrections for your distance prescription. One placed on the bottom half and the other half on the top of the lens. A visible line in between to separate the lens into two correctional part.
The instant benefit of this type of lens is that it provides 2 solutions in 1 lens. Your vision can be corrected for both close-up and distance vision. Moreover, the price is relatively cheap compared to progressive lenses.
However, Bifocal Lenses often caused bouncing image when switch from distance to near vision and vice versa. The distinct line that separates the corrections is visible too.
Weighing the pros and cons, Bifocals should suitable for:
+ Anyone who want to correct their vision for multiple purposes at a reasonable price
+ People who need correction for reading but don’t want to purchase a second pair
Progressive multifocal lenses
This is a type of glasses lens used for different correctional purposes. Not like Bifocal lenses, this lens does not have a distinct line separating the corrections. Different areas on the lens give you different corrections and the transition between prescriptions is smoother without the obvious visible line. That’s why it’s called a progressive lens
Advantages of progressive multifocal lenses include:
- The design of the lenses blends in the description. It means you won’t see any image jump or separate line on the lens, which makes more comfortable and offers more safety for driving.
- No more switching between using on a computer and driving a car. LCD or LED screen can be harmful to your eyes, not only a computer screen. A progressive lens can offer you the intermediate correction and other correction for other purposes. So 3 in 1, isn’t it great?
But we should consider its disadvantages:
- Problem can occur with lens when you are walking up and down the stairs. Since it contains 3 corrections on the lens especially with the near vision on the bottom, you may feel like the stair is bouncing up and down. However, the more you become familiar, the issue should disappear in no time.
- Other problems can be seen in the material, coating or adjustment. Progressive lenses are not for everyone. Some people don’t like it and complain they are too hard to get used to.
With regards to the pros and cons, Progressive multifocal lenses should suitable for:
- Anyone age 40 to 50 who desire for different vision corrections. Doing multi-tasks such as working up-close on a computer, driving or anything in between.
- Those don’t want a visible line on the lenses.
- Anyone who need correction for reading but don’t want to purchase a second pair.
A quick comparison of Single vision Vs. Multifocal vision lenses
| Single Vision Lenses | Multifocal Vision Lenses |
Pros: | |
| + Most affordable + Effective in correcting nearsightedness and farsightedness + Easy to adapt and no adjustment period needed | + Ability to multitask without switching glasses + Can maintain the depth perception since there are two correctional areas that help to correct from far to near |
Cons: | |
| + Only correct for one vision, you can only choose either near or far + Can be costly depending on the material and degree | + Night vision get worse when driving + Glare or halos appear around lights + The adjustment period takes longer |
Price range: | |
| + From $5 to $450 depending on lens material, prescription, lens coating and brand | + From $50 to $500 depending on prescription. For example, a progressive digital lenses costs around $225 while the one with Photochromatic lenses cost $345 + Price are often $20-$50 higher than single vision lenses |
Best for/ tips: | |
+ Best for adult under 40 who don’t need a reading glasses early in their age.
| + Best for adults over 40 who desire to have a different correction for their eyes but don’t want to purchase or carry a second pair. + It is common to have an adjustment period to get used to these multifocal lens. You will experience some bouncing images from the beginning while walking up and down the stairs because of the transition between two prescription areas. This can be risky while driving too. + For bifocal lenses, the visible line between near and far sight sometimes can be annoyed, but progressive lenses can fix this problem. |
+ Where to buy eyeglasses?
Vint & York offers high quality Progressive Lenses from ZEISS, VARILUX and many more, visit the website or drop by the store to find your perfect glasses
LensCrafters offers a wide range of eyeglasses with prescription built for you, they have many locations, check out their website to find your nearest store.
Contact Lenses for Presbyopia
Contact lenses are one of another viable alternative for adults over the age of 40 who have blurry vision. At this age, some of my friends prefer to wear multifocal eyeglasses, while I personally like contact lenses. If you are over 40 years old and you think it’s time to shop for a pair of reading glasses or presbyopia eyeglasses, you should know this. Depending on many factors including your prescription, lifestyle, personality and your eye’s anatomy, one lens type does not work for everyone. Most people will need to have a different correctional area on their lens. Just like eyeglasses, contact lenses are available in two types including Monovision Contact Lenses and Multifocal Contact Lenses
Monovision Contact Lenses
Monovision Contact Lenses come with 2 different corrections including one for near and one for far on each lens. Since our eyes are actually not the same. We all tend to have a dominant eye that we mainly use for looking at distance objects. Therefore, the distance vision lens will be usually worn in the dominant one. It might sound difficult to adjust to, but you probably won’t even notice the difference when wearing monovision contact lenses
Multifocal Contact Lenses
These lenses include multifocal contacts and bifocal contacts. They both aim to create a natural vision for your eyesight. However, multifocal contact lenses have a smooth transition between two correctional areas. They are available in many different types but they all come down two 2 main groups: soft contact and rigid gas permeable contact.
Soft contacts are extra thin and very comfortable to use because they made of water, which is why they are soft. This group divided into 4 basic categories including spherical (normal) contact lenses, contact lenses for astigmatism, contact lenses for presbyopia and color contacts.
Rigid gas permeable contact lenses are made of hard plastic. This type gives you a clearer vision and can correct most vision issues. And because they are made out of plastic, so they can last longer soft contacts.
A quick comparison of Monovision Vs. Multifical Contact Lenses
| Monovision Contact Lenses | Multifocal Contact Lenses |
Pros: | |
+ Offering the clearest, sharpest vision for most of the basic tasks. People who require precise vision can usually do better while wearing this. + Near vision seems to be clearer because each eye meets their prescription | + Multifocal lenses don’t decrease your depth perception much. If they fit you successfully, you don’t have to wear eyeglasses over the contact lenses for most of daily activities + Great visual acuity from up close to far, they offer a natural vision correction for your eye + Convenient in any situations without carrying an extra eyewear |
Cons: | |
+ Some people notice their vision slightly decrease especially at night + Depth perception is also decreased a bit which is somehow a problem for people who play sports like golf, tennis or Ping-Pong + It is impossible for pilots or athletes to wear monovision because it may give a certain area of vision to be blurred | + Some complain of blurred vision while doing certain tasks. Ghost images or double images can occur when wearing for the first time. Although it’s a part of adaption progress, it still bothers some people to the point when they discontinue using them + Contrast sensitivity in some cases + Complex design and prescription can induce high cost |
Price range: | |
| + Popular retail price from $22 to $26 for a box (6 lenses). If you replace every two weeks, you will need about 5 boxes per eye or 10 boxes per year. This cost roughly from $220 to $260 annually | + Costs roughly from $50 to $70 per box for a prescribes disposable bifocal lenses. If you wear them everyday and replace every 2 weeks, it will cost around $500 to $700 annually |
+ Where to buy contact lenses?
ACUVUE offers premium contacts lens with different choices for your desire, find out about their offer and nearest location.
Surgery For Correction
For most adults over age 40, I know surgery sounds very threatened. But thankfully, with the advent of advanced technology, the process is less painful and a lot shorter. Your vision can be corrected almost 100% and delay the process of aging for another 5 or 10 years or even permanent depending on many factors. Presbyopia surgery currently has a variety of options including
- Corneal Inlays
- Nearvision CK
- Monovision LASIK
- Refractive Lens Exchange
Corneal Inlays
When it comes to eye surgery, corneal inlays are a new alternative for presbyopia correction. Basically, tiny lenses will be implanted in the cornea of the eye to improve near vision without affecting on distance vision. This procedure usually only takes around 10 to 15 minutes. A laser beam called femtosecond will create a pocket on the corneal, then the experienced surgeon will adjust the inlay over the center of the pupil. The pocket on the corneal will later seal itself without stitches. Corneal inlays can be replaced or removed if the results are not as expected.
Types of Corneal Inlays:
Corneal inlays include 4 types: Kamra Corneal Inlay, Raindrop Near Vision Inlay, Presbia Flexivue Microlens, and Corneal Onlays.
Currently, in the United State, only two types: Kamra Corneal Inlay and Raindrop Near Vision Inlay got approved by FDA (Food and Drug Administration).
Kamra Corneal Inlay developed by AcuFocus first gained approval in April 2015 in the United States. It’s now available commercially in almost 50 countries around the world. This surgery is aimed to eliminate the need for reading glasses among adults between the ages of 45 and 60. The Kamra inlay is a very small and extremely thin with only 3.8 mm in diameter and 6 microns thick. The inlay has an opaque outer ring with 1.6 mm diameter opening in center. This opening will be placed on top the pupil of the eye and create a “pinhole camera effect”, which helps to bring near objects into better focus without causing significant loss of distance vision. This inlay is typically implanted in the non-dominant eye. No stitches needed after the surgery and healing may differ from person to person.
Raindrop Near Vision Inlay is the second type of corneal inlays that got approved by FDA later in June 2016. The material that made for this inlay is similar to that used for soft contact lenses. Its optical characteristics is almost identical to the human corneal. This inlay is also implanted in the nondominant eye. However, the company (ReVision Optics) had announced that this inlay is no longer sold to distributors or eye doctors.
best candidates:
If you are from 41 to 65 years old and you have clear distance vision without wearing any eyeglasses but still need reading glasses
- Duration: about 15 minutes
- Result: clear vision at all distances, no glasses or contact lenses needed
- Recovery period: several days to several weeks
- Cost: around $1,800 to $6,000
Corneal Inlays can:
- Correct near vision for people with presbyopia with high acuity
- Provide correction for people between the age 45 and 60 who are not ready for intraocular procedure
- Inlays can be adjusted if the result is not as expected
However, the disadvantages of this method are:
- It is not suitable for everyone.
- Complications can occur such as dry eye or inflammation
- Vision may be decreased due to complications
NearVision CK
Conductive keratoplasty (CK) is a non-laser eye surgery designed to correct vision problem for presbyopic people who desire to reduce the need for reading glasses. This type of surgery is trademarked under Refractec Inc.
The procedure uses low energy radio waves to reshape the cornea of the eye and regain near vision. It takes only a few minutes. During the CK procedure, your experienced eye surgeon will use a tiny probe that is smaller than a human hair to shoot low-level, radio frequency energy on the outer part of the cornea in order to create a circular pattern. Numbing eye drops are applied before the procedure.
You will feel only a little discomfort under NearVision CK. But you might notice some discomfort when the drops wear off. During the process, connective tissues on the cornea will shrink wherever the radio frequency goes. It causes the circular band to play as a belt that tightens and steepens the cornea. This affects the way lights enter the eye to correct near vision.
BEST CANDIDATES: If you are over 41 and you have a good distance vision need reading glasses
- Duration: about 20 minutes (both eyes)
- Result: can see the computer clearly and read without glasses
- Recovery period: several weeks for adjustment
- Cost: around $1,500 to $2,500 per eye
NearVision CK can correct near vision and eliminate the need for reading glasses. In addition, it helps to save time because the healing time only takes some weeks.
However, this method still has its thumb down that the near sigh might be still blurry in the distance at an acceptable level.
Monovision Lasik
Monovision Lasik is a surgical technique used for correcting one eye with distance vision and another with near vision. This can help old people to reduce or eliminate the need of eyeglasses. Actually it works well for those have already used monovision contact lenses for a long time. Depending on the eye prescription, professional eye care will decide if you are eligible for this type of surgery. The reason why it works best for this certain group because monovision contact lenses will take a while to get accustomed to so does Monovision Lasik.
BEST CANDIDATES: If you are over 40 and you already wear monovision contact lenses before for a long time
- Duration: about 10 – 15 minutes
- Result: can correct near sight and distance sigh
- Recovery period: quick for those who already use monovision contact lenses before
- Cost: around from $2000 per eye
Pros of Monovision Lasik:
- The process takes very quick and less painful
- Result come quickly after the surgery within 48 hours
- Eyeglasses or contact lenses are no longer needed
Cons of Monovision Lasik:
- Not everyone is eligible for Lasik
- Complications such as dry eyes can last for up to 3 months.
- Night time glares or halos also occur
- The flaps can be injured easily during the process of healing
Refractive Lens Exchange
Refractive lens exchange (RLE) is a surgical procedure used for presbyopia correction. During the procedure, the natural lens of your eyes will be taken out and then replaced with an intraocular lens. This type of lens is similar to the one used in cataract surgery.
BEST CANDIDATES: If you are over 40 and you have presbyopia and desire for eliminating the need for reading glasses
- Duration: about 15 minutes per eye
- Result: a clear vision for all distances without glasses or contact lenses
- Recovery period: several weeks or a day or two
- Cost: around $4000 per eye
Pros of Refractive Lens Exchanges:
- Work effectively for most types of vision problem (cataracts, astigmatism, presbyopia, long-sightedness, short-sightedness)
- An alternative for those who are not eligible for laser eye surgery
- Reduce headaches and eye strain by heavy glasses
Cons of Refractive Lens Exchanges:
- Treatment can be costly up to $4,000 per eye
- Risk of complications but rare
+ Where to take correctional surgery?
ClearSigh LASIK is one of the best place for you to get vision correction. Founded in 1994 with the purpose of using the most advanced technology to help people regain their vision.
Another place for you to correct your vision is Laser Eye Centers. They offer a wide range of LASIK treatments and help you to find out what’s the best for you.
Tips To Live With Presbyopia
As a part of the aging process, you will start noticing some decrease in your vision when you are over 40 or more. Presbyopia is inevitable and no one is immune from it. But the good news is that you can practice some exercises to improve your eye health better apart from other methods or apply natural treatments. The trick is, you will have to practice your eye regularly to start noticing changes in it.
Eye exercise
This technique requires you to cross your eyes and concentrate on the top of your nose, then turn your gaze to a far distant object, and then return to the same point. Keep the focus while you are breathing in and switch to the other object while you are breathing out.
Diet – food
Diet food is a powerful source of nutrients for the eyes. Eat a lot of foods that contain Omega 3 and Vitamin E can improve your eye health significantly.
Regular eye examinations
You should always get your eye checked even if you never have any vision problems before. The American Academy of Ophthalmology recommends that adults should conduct an eye check every two to four years between ages 40 and 54, one to three years between ages 55 and 64, and one to two years beginning at age 65.
By doing this, we can notice significant changes in our vision and make proper action in order to prevent any risk occurred. You can find out more information and make appointment with your eye doctors as soon as you start experiencing any problems at these recommended centers: Meyer Eyecare, Eye Care Dallas and American Optometric Association (AOA).