The Common Eye Condition You May Unknowingly Have
This eye problem can contribute to headaches, make you squint, and interfere with concentration—yet most people have never heard of it.
You probably accept that your joints will lose flexibility as you hit middle age, but you might not expect the same from your eyes. Unfortunately, it happens. The lenses in your eyes must bend to focus on print in an article like this, for example. Once you hit 40, those lenses stiffen, resisting the flex, and reading small print becomes more difficult. It’s called presbyopia, and it’s irreversible.
In a 2019 survey by Alcon, an eye-care company, eye doctors reported that 92 percent of their patients 40 and over didn’t know what presbyopia was, yet nearly all of them—99 percent—had symptoms of the condition. “A lot of people don’t understand what’s going on with their eyes and think something is wrong, even though it’s completely normal,” says Brenda Pagan, MD, clinical spokesperson for the American Academy of Ophthalmology. Through an evolutionary blunder of sorts, “we lose the accommodative ability of our eyes to focus up close.”
It’s no small thing. Researchers estimate that nearly two billion people around the world have presbyopia. Not treating the issue is leading to nearly $25 billion in lost productivity, according to research published in the journal Opthalmology. The good news is that presbyopia is easy to recognize—and treat. Here’s what you need to know.
What is presbyopia?
The root of the word is Greek for “old eye.” Normally, the lens in your eye is flexible, bending so you can focus on things close-up and far away, says Michelle Andreoli, MD, a comprehensive ophthalmologist at the Wheaton Eye Clinic in Wheaton, Illinois, and clinical spokesperson for the American Academy of Ophthalmology. “The lens in the eye almost universally fails beginning in your 40s,” she says. “Rarely do people make it to their 50s without a change in their lens.”
Most people only begin to notice the change as they lose the ability to perform tasks such as reading or needlework. The lens continues to harden until about age 65.
Even if you’ve never had a vision problem before, you can’t escape presbyopia, though for some the onset is delayed or the symptoms are milder. If you find you’re holding menus further away or squinting at your computer screen, it’s a sign that your lenses are losing flexibility.
Does vanity interfere with treatment?
Most people delay seeking professional help until the focusing problems interfere with daily life. (No one likes the idea of reading glasses.) A common ophthalmologist’s joke is that their patients only seek help when their arms become “too short”—they’re unable to hold their phones far enough away to focus on the screen. “Reading glasses force people to admit they are getting older,” says Dr. Pagan.
Signs and symptoms
These are the signs worth discussing with an eye-care professional:
In addition, certain drugs such as antidepressants, antihistamines, and diuretics can accelerate presbyopia, says Dr. Andreoli. “Anything that causes systemic fatigue or sedation makes the muscles weaker,” she says. “It’s hard to focus for a long period of time if your eyes are strained, stressed, or fatigued.”
“Getting better light makes it easier to live with presbyopia,” says Dr. Andreoli. “But the actual dysfunction is biochemical, so there’s nothing you can do to push it off.”
Although nothing can stop or reverse presbyopia, these 36 easy tips can help protect your eyes, and possibly delay troubles. If you do a lot of knitting, reading, or spend hours staring at a computer screen, take a 10-minute break every few hours to relieve eye strain. To rest your eyes, allow them to focus on objects at a middle or long distance away.
What are the best ways to treat presbyopia?
“Presbyopia can be fixed in a number of ways,” says Dr. Pagan. The simplest is drugstore reading glasses, though you also can get special contacts or even opt for vision surgery. If you already wear glasses, then bifocals, trifocals, or progressive lenses can correct presbyopia. Eye doctors can fit you for contact lenses to help in one of two ways: monovision contacts in which one contact lens helps with distant sight, the other for closeup work; there are also multifocal contacts (similar to bifocal glasses).
If wearing glasses or lenses bothers you, you could ask about refractive surgery. A relatively recent kind of surgery, called corneal inlay, has emerged as a faster, easier way to treat presbyopia than standard surgical procedures.
- Brenda Pagan, MD, clinical spokesperson for the American Academy of Ophthalmology
- Alcon: “Presby-What? New Alcon Surveys Show Patients Have Fuzzy Understanding of Presbyopia; Eye Care Professionals Agree”
- Ophthalmology: “Global Prevalence of Presbyopia and Vision Impairment from Uncorrected Presbyopia: Systematic Review, Meta-analysis, and Modelling”
- Ophthalmology: “The Global Burden of Potential Productivity Loss from Uncorrected Presbyopia”
- Michelle Andreoli, MD, comprehensive ophthalmologist at the Wheaton Eye Clinic in Wheaton, IL, and clinical spokesperson for the American Academy of Ophthalmology