The Journey of Aging Eyes  

What just happened to my vision? Presbyopia did.

Presbyopia (noun): A condition, typically occurring in middle age, in which the lens of the eye gradually loses its flexibility, making it difficult to focus on close objects. 

A friend of mine was concerned about her husband’s recent vision changes. She knows I work for a group of eye doctors and wanted to make sure nothing was wrong. I was eager to help.  

“I’m really worried about Dan**,” she confided.  

I braced for the worst – maybe her husband was having symptoms of a retinal detachment, corneal abrasion, or ocular migraine. She described his symptoms – headache, blurry vision, trouble reading.  

“How old is Dan?’, I asked, hoping to appear more clinical than nosy. I already had a good idea about what Dan’s troubles were and what an eye exam might reveal.  

She confirmed that Dan recently turned 50 and was not experiencing any other visual symptoms that would signal a more worrisome problem. Examples of an eye emergency would be: flashes of light, vanishing areas of vision, or severe pain.

We arranged an appointment with Dr. Rana, board-certified ophthalmologist at St Lucie Eye, and awaited his findings from a comprehensive eye exam.    

The final analysis and culprit for Dan’s vision changes? Presbyopia and the normal resulting vision changes of aging.  

Age is more than a number when it comes to eye health.

Although it’s never fun to realize we’re getting older, it can be comforting to know that presbyopia will affect nearly everyone as they reach their 40s and beyond.  

• Whether you’re nearsighted, farsighted, or have always had crystal clear vision, presbyopia won’t discriminate. It’s simply a part of the aging process, much like gray hair or laugh lines.  
• If you are like our patient Dan and suddenly find yourself struggling to read fine print or accurately focusing on detail, it’s probably just your eyes aging gracefully.   

What Causes Presbyopia? 

Presbyopia occurs due to the gradual loss of flexibility in the natural lens of the eye making it harder to focus on nearby objects. This can be a new development even if you have never had vision issues before.  

• The clear lens of your eye sits behind the colored iris. It changes shape to focus light onto the retina so that you can see. When you’re young, the lens is soft and flexible. It easily changes shape to accommodate vision near and far. Around age 40, the proteins within the lens begin to alter and become less malleable. This makes it harder for the lens to change shape and focus on near tasks such as reading.  
• As you get older, the lens becomes thick and cloudy, forming a cataract (that’s a whole article for another day!) 
• In addition to changes within the lens, presbyopia also involves a weakness of the muscles surrounding the lens. Usually, these muscles expand and contract to help the eye focus, but as they weaken, they don’t work as efficiently as before. 

What to do about Presbyopia Loss of Near Vision.

Embrace Reading Glasses

If you struggle and squint to read or perform close-up tasks, you might find a pair of reading glasses to be an easy solution. Readers are an inexpensive solution for an age-old problem. Many people own several to always a pair within easy reach!   

• Reading glasses are simple convex lenses that help your eyes focus on near work by magnifying text or objects.  Non-prescription readers are only designed to view objects at close range and do not correct other existing vision problems.  
• Bifocals or progressive lenses are required for you to shift between short range and distance vision or to correct astigmatism. Reading glasses are not designed to be worn all the time, as they will make your distance vision blurry. Wear readers to protect your eyes from strain and fatigue and when you need to see clearly up close. 

Will my eyes become dependent on reading glasses? 

There’s a persistent myth about wearing glasses, the more you wear them, the weaker your eyes become.  The opposite is actually true. The dependence you’re worried about is largely a matter of perception.  

• Before people admit the need for glasses or readers, they often tolerate a great deal of considerable blurriness as ‘normal’ vision. Once someone becomes accustomed to the improved clarity from wearing glasses, they conclude their eyes are weaker because past levels of blurriness are no longer accepted as normal. 

Can I improve presbyopia without wearing glasses?

Beyond improving near vision from presbyopia with readers, prescription glasses or contacts, there are some other options.  

• Surgery: If you don’t want to wear corrective eyewear, you may consider laser eye surgery. Laser procedures such as LASIK or RK (refractive keratotomy) permanently reshape the cornea to achieve better vision at one distance. For people older than 50, this procedure is not a permanent solution.   Other conditions or the presence of eye disease can still change your vision as you age.    
• Eye Drops: The FDA has recently approved a presbyopia-correcting eye drop that work by contracting parts of the eye to help it focus on near objects. The drops are used once daily for six hours of near vision. A second dose can be used after six hours if desired. Reported side effects include headache and stinging and burning sensations. Ask your ophthalmologist if presbyopia correcting drops might work for you.   

Is presbyopia the same as astigmatism?

Astigmatism and presbyopia are both big words that cause similar vision problems, but they are different things.

• Astigmatism is a structural irregularity in the shape of the eye or the outer curvature of the cornea. Presbyopia occurs with age when the lens inside the eye is no longer able to change shape. 

Caring for Your Aging Eyes beyond Presbyopia.

It’s never been more true – lifestyle choices matter for both eye health and overall wellbeing. Here are the Seven Magnificent Habits for a lifetime of visual, physical and mental good health! 

1. Annual eye exams: The cornerstone of eye health for those over forty is committing to regular eye exams. These appointments are not just for prescription updates; they’re a comprehensive health checkup for your eyes. Comprehensive eye exams detect early signs of eye disease such as glaucoma or macular degeneration, which are more common with age.  
2. Smoking is the #1 controllable risk factor for eye disease. You are twice as likely to develop macular degeneration if you smoke, and 2-3 times more likely to develop early cataracts compared to people who don’t smoke.
3. Digital Eye Strain is a relatively new phenomenon in our modern world. The average American spends 7 hours and 4 minutes looking at screens each day. Digital eye strain is characterized by symptoms of dry eye, headache, and blurred vision. Combat digital eye strain by following the 20-20-20 rule: every 20 minutes, take a 20-second break to look at something 20 feet away.  4.
4. Sunglasses help protect your eyes from harmful UV rays that can cause early cataract development or cancers of the eye and eyelid. 
5. Adequate hydration helps maintain the proper moisture balance within your body, reducing the risk of dry eye symptoms. Start by drinking the recommended 8 to 10 glasses of water a day.
6. Regular physical activity improves blood circulation, which is vital for maintaining eye health. The eye is nourished by an extensive network of blood vessels within the retina. Any activity that benefits heart health such as walking, swimming, cycling, or jogging, are all great choices.
7. A balanced diet featuring a variety of colorful fruits and vegetables is a key to overall health, including the eyes. Fresh nutrients benefit the vital oxygen supply network of the circulatory system. Healthy fats and omega oils also nourish the ocular system.   

Healthy Vision is a Life Long Journey.

Aging is a natural part of life. Regular eye checkups and a healthy lifestyle can make all the difference. 

So, wear those reading glasses with pride and keep your eyes focused on a healthy future for years to come!

Looking for a Good Eye Doctor? 

St Lucie Eye has been providing comprehensive eye care for over 75 years (and counting!). Our team of board-certified ophthalmologists help detect early signs of eye disease so that you can experience a lifetime of healthy vision. To learn more, visit our CONTACT PAGE.   

** Not the patient’s real name. But Dan’s vision changes were real and easily solved with a new super-cool pair of glasses! He wears them all the time and no longer struggles with blurry vision or seeing details up-close.