Presbyopia is an age-related vision change that makes it difficult to see nearby objects clearly. It generally begins around age 40 as the eye gradually loses its ability to focus up close.
Common symptoms include blurry near vision, eye strain, headaches, and difficulty reading at a normal distance. People with presbyopia may need to hold books, menus, or other reading materials farther away to bring the text into focus.
Anyone experiencing symptoms of presbyopia should consult an ophthalmologist for an eye exam. Treatment may include eyeglasses, contact lenses, prescription eye drops, or, in some cases, surgery.
Main symptoms
The main symptoms of presbyopia include:
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Difficulty seeing nearby objects clearly
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Needing to hold reading material farther away to bring it into focus
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Blurry vision at a normal reading distance
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Headaches
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Eye strain
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Burning eyes when trying to read
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Heavy eyelids
Symptoms often become more noticeable when a person is tired or in low-light conditions.
Confirming a diagnosis
Presbyopia is diagnosed by an ophthalmologist based on symptoms and a comprehensive eye exam.
The doctor may use reading charts with letters or numbers in different sizes and at different distances to evaluate the eyes’ ability to focus.
A refraction test may also be performed using instruments such as a retinoscope to determine whether eyeglasses or contact lenses are needed.
Possible causes
Presbyopia develops mainly as a natural part of aging. Over time, the lens of the eye, which helps adjust focus, becomes harder and less flexible, making it more difficult to see nearby objects clearly.
In addition to age, certain factors may increase the risk of presbyopia or contribute to its earlier onset. These include the use of antihistamines, diuretics, and antidepressants.
Certain health conditions, such as diabetes, cardiovascular disease, and multiple sclerosis, may also influence the development of presbyopia.
Other contributing factors may include smoking, excessive alcohol consumption, prolonged screen use, and a family history of vision problems.
Presbyopia vs farsightedness
Presbyopia is an age-related difficulty focusing on nearby objects that generally develops after age 40.
Farsightedness, also called hyperopia, may be present from an early age. It occurs because of differences in the shape of the eye that cause nearby objects to appear blurry.
Presbyopia vs astigmatism
Unlike presbyopia, astigmatism is caused by an irregular curvature of the cornea or lens. It can cause blurry vision at both near and far distances and may be present from birth.
Treatment options
Treatment for presbyopia should be recommended by an ophthalmologist and may include:
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Vision correction with eyeglasses, including single-vision reading glasses, bifocals, trifocals, or progressive lenses
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Contact lenses, including multifocal, monovision, or modified monovision lenses
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Refractive surgery, which uses a laser to reshape the cornea and improve near vision
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Corneal inlay surgery, which involves placing a small implant in the cornea to change how the eye focuses without removing the natural lens
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Intraocular lens implantation, in which the eye’s natural lens is removed and replaced with an artificial lens
Prescription eye drops containing pilocarpine hydrochloride may be used to treat presbyopia. According to the US Food and Drug Administration (FDA), pilocarpine hydrochloride ophthalmic solution is approved for treating presbyopia in adults. It constricts the pupil, increasing depth of focus and improving near vision. Depending on the product, the effects may last for several hours.
Is presbyopia curable?
Presbyopia cannot be cured because it is a natural age-related change in the eye. However, its effects on vision can be corrected with eyeglasses, contact lenses, prescription eye drops, or surgery.