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  • Writer's pictureAtanas Bogoev M.D. and Maria Cholakova


Presbyopia is a gradual loss of the eye's ability to focus on close objects. This is our patient's guide to this natural and unavoidable age-related condition. We cover presbyopia's epidemiology, causes, symptoms, diagnosis, treatment modalities, and preventive measures.

We'll break it down in simple terms so you can understand what's going on with your eyes and how to deal with it. Everything you need to know about navigating presbyopia - in this Ophthalmology24 article.

Understanding Presbyopia

What is Presbyopia?

Presbyopia is a normal process that comes with getting older. It's when your eyes have a bit of trouble focusing on things up close. Thus, making reading or texting a bit harder. So, if you've noticed you're holding your favorite book or your phone at arm's length, presbyopia might be to blame.

Presbyopia affects individuals typically around the age of 40 and older.

Hyperopic (farsighted) individuals often experience its onset at an earlier age.

Why Does it Happen?

Over the years, your eye's lens becomes less flexible. So it's harder for your eyes to switch between near and far vision. Various factors contribute to this aging process. From shifts in the composition of the lens proteins to changes in the eye muscle function.

It's not something you did, nor something you need to worry about. Just a part of the aging process!

What are the Risk Factors?

Age and genetics are the determining factors responsible for the condition.

The secondary risk factors for presbyopia, which may affect how early you get it, are:

  • Diabetes

  • Cardiovascular diseases

  • Neurological conditions

  • Menopause and hormonal changes

  • Eye trauma or injury

  • Medication side effects

Older individuals with diabetes may experience eye lens changes due to variations in blood sugar levels. That's potentially contributing to the early onset or the severity of presbyopia.

Cardiovascular diseases, such as hypertension (high blood pressure) and atherosclerosis, may impact the blood vessels that nourish the eyes. Poor blood circulation may affect the eye's lens health.

Neurological conditions like multiple sclerosis (MS) and myotonic dystrophy may influence the coordination between the brain and eye muscles. Potentially affecting the ability of the eyes to focus on close-up objects.

Hormonal swings, especially in women during menopause, influence eye lens flexibility. Thus contributing to earlier presbyopia onset.

Some medications have side effects that could affect vision, cause dry eyes, or even trigger presbyopia in older individuals.

If you have severe eye trauma or head injury that impacts the eye lens, the incident can speed up the onset of presbyopia.

Signs and Symptoms of Presbyopia

Difficulty reading small print, eyestrain, headaches, and needing to hold reading material at arm's length are the first signs of presbyopia. Let's gain a deeper understanding of these symptoms:


  • What it means: If you find yourself squinting when trying to read a menu or a text message, your eyes might be signaling they need help focusing up close.

  • Why it happens: Squinting is an instinct. When you unconsciously do it, your eyes are trying to create a smaller opening to bring things into better focus.

squinting symptom of presbyopia


  • What it means: Struggling to focus can give you a mild headache because your eyes are working extra hard. Your head is letting you know about the overtime.

  • Why it happens: Having difficulty focusing may strain your eye muscles. This extra effort may lead to those pesky dull headaches.

Eye Strain

  • How it feels: If your eyes feel tired, achy, or uncomfortable after doing close-up tasks, you may have eye strain.

  • Why it happens: The muscles in your eyes are overworked, leading to fatigue and discomfort. Think of it as a gentle reminder from your eyes to take it easy or have a break from digital screens.

Arm Stretching

  • Caught in the act: Do you catch yourself holding your phone or a book at arm's length? Just to see things better? That's a classic when presbyopia comes knocking.

  • Why it happens: Your eyes are trying to find the sweet spot for focusing. By stretching your arms, you create a bit more distance. Think of it like manual adjustment of the focus.

arm stretch symptom of presbyopia

Getting a Presbyopia Diagnosis

If you are over 40 and suspect you have presbyopia, go for an eye checkup. Your eye doctor will do a few tests to figure out what's going on. For a conclusive diagnosis, the eye specialist should perform visual acuity and refraction tests.

All eye exam procedures are painless.

Preventing Presbyopia

You can't escape presbyopia forever, it's a natural part of aging we are all facing sooner or later. But if you want to try, adopting these lifestyle changes can potentially delay the onset:

Treatment Options

Presbyopia treatments range from noninvasive (corrective lenses) to surgical options. Here is what you need to need to know about them:

Glasses for Presbyopia

Glasses are the best solution for older folks. They are like superheroes for your eyes. Eyeglasses with bifocals or progressive lenses can make reading and seeing things up close a breeze. On top of that, they are affordable and require minimum maintenance and care. When you need them, you put them on. Quick and easy!

Even if your diopter changes, which is likely to happen with presbyopia, you can go to an eye doctor, get a new prescription, and switch up your old glasses with new ones. After all, you only need glasses for reading and scrolling on your phone. It's not like you are committing to wear them full-time.

Presbyopia Contact Lenses

In case glasses aren't your thing, contact lenses are a nice alternative. They sit right on your eyes and help you see clearly without anyone knowing. There are some downsides to using presbyopia contact lenses though. If you are an elder, contact lenses may not be the best choice for you.

There are too many tasks that may be harder to do as elders. From regularly cleaning the contact lenses to safely putting them on and off. Some older individuals with memory problems might even forget they are wearing contacts. And that's never a good thing, as it may lead to infections and severe eye diseases.

When using contact lenses hygiene should be a main priority to avoid potential complications.

contact lenses vs glasses

Laser Intervention

For those looking for a permanent fix, there are refractive surgeries like PresbyLASIK. It's like magic for your eyes! But you have to discuss with your eye doctor if it's an option for you first. And even if it is, there are a few things to know.

Your presbyopia prescription may naturally change again, after the treatment. So it may or may not be 100% effective in the long run. Also, there are some risks with LASIK. Before undergoing the procedure, you need to discuss them with your eye doctor.

Surgical Treatment

There is another option for treating presbyopia which involves eye surgery (refractive lens exchange). The eye surgeon replaces the natural lens in your eye with a clear artificial implant in a 15-minute outpatient surgery. It can help you see better without glasses, especially if you have trouble with both near and far vision.

A surgeon holdin a clear intraocular lens implant with a surgical forceps and the background is a sugical table iwth instruments


Presbyopia is just a small part of the adventure of aging. With the right glasses, contacts, or even laser surgery, you can continue enjoying the things you love up close. Stay healthy and check out our blog to learn how to take better care of your eyes.

Checked by Atanas Bogoev, MD.

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