Presbyopia: age-related farsightedness, causes and signs

After forty, many people notice that a book or a phone screen has started to blur, and to make out small print they have to hold it farther from their eyes. This is a common complaint, and it has a name — presbyopia, or age-related farsightedness. Below we calmly and step by step explain what this condition is, where it comes from, and how it differs from ordinary farsightedness.

What presbyopia is

Presbyopia is a refractive error, that is, a disorder of how the eye focuses, in which a person of middle and older age has difficulty seeing objects up close. It occurs because the lens — the internal part of the eye that helps it focus — stops properly converging light on the retina, that is, on the light-sensitive layer of tissue at the back of the eye.

Presbyopia is a normal part of aging. It appears in all people as they grow older, usually after the age of forty-five. Over time it worsens, but as a rule it stops worsening after the age of sixty-five. Many people have another refractive error in addition to presbyopia, that is, a second cause of blurred vision.

Why age-related farsightedness occurs: the role of the lens and accommodation

With age, the lens becomes denser and less flexible, so it stops properly focusing light on the retina, and near objects look blurred. Simply put, accommodation suffers — the ability of the eye to refocus from a distant to a near distance.

The causes of age-related farsightedness, if speaking of farsightedness in general, vary: the shape of the eye itself, the shape of the front layer of the eye — the cornea, as well as thickening of the lens with age. Farsightedness is often passed down from parents, and it cannot be prevented. In rare cases it is caused by other diseases, such as diabetes mellitus or an eye tumor, but this happens very rarely.

How it manifests: why near vision is poor

With presbyopia, a person sees poorly up close, while distinguishing distant objects clearly. The signs that both people themselves and doctors describe look like this:

• difficulty making out near objects: words and pictures in a book or on a screen look blurred;
• to focus, one wants to hold the book or phone farther from the eyes;
• after reading or working at a computer, the eyes feel tired, that is, become fatigued or painful;
• after such work, a headache occurs.

Presbyopia and hypermetropia: what the difference is

Farsightedness, which doctors call hypermetropia, and sometimes hyperopia, is also a refractive error in which it is difficult to see up close. The difference is that farsightedness can appear at any age, although it often manifests in people over forty, and it is related to the shape of the eye or cornea. Presbyopia comes with age to everyone. It is related to age-related thickening of the lens and, unlike hypermetropia, does not depend on the shape of the eye or cornea; the doctor determines what exactly is happening.

How it is detected and when to see an ophthalmologist

Presbyopia is found during a complete vision examination. The vision specialist asks the person to look at lamps or read letters, and places different lenses in front of the eyes — this is how it is determined how well vision works. Usually the doctor shines a light into the eyes to check whether their posterior segment is healthy, and may instill drops that help examine the eye better. The examination is simple and painless. If near vision has worsened, the person is fitted with correction — glasses or contact lenses that help the eye focus properly.

You should see a doctor when you or your child notice signs of farsightedness. Without correction, farsightedness can lead to other vision problems: in young children with pronounced farsightedness, strabismus and "lazy eye", that is, amblyopia — reduced vision in which one eye does not receive a full load — develop more often.

Presbyopia itself is not a reason to call an ambulance. The numbers 103 and 112 are needed for life-threatening conditions — for example, for signs of stroke or heart attack, as well as for severe trauma.

This article is for reference: it explains what happens and why, but does not replace a doctor's consultation — the examination and selection of correction are carried out by a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer