It is estimated that 128 million Americans suffer from presbyopia, and the number is growing.

Presbyopia is a completely natural part of aging and it causes a decrease in our ability to see clearly up close due to normal changes to the eye's structures. Presbyopia can be treated with reading glasses, multifocal contact lenses, refractive surgery, monovision modality, prescription eye drops called Vuity, and implantable surgery.

How does presbyopia occur?

Our eyes have a structure called the lens. At a young age, it is very clear, thin, and flexible. The lens changes shape when we need to see something up close, and it has a higher focusing ability, allowing us to see clearly at close range. Over time, this lens's flexibility decreases, and it becomes thicker, so it becomes more difficult to change its shape when we need to focus on something up close, therefore we can't see things up close as clearly anymore.

What are the common symptoms of presbyopia?

There are a number of symptoms you may experience:

  • You may experience blurry vision up close
  • You may start to notice you have to hold things further away from you
  • You may notice you have difficulty switching between tasks.

If you experience any of these symptoms, please visit our eye doctor. In order to address any symptoms you may have, our eye doctor will discuss a thorough case history with you. Afterwards, you would undergo a refractive eye exam, which determines what is the correct power lens you need to see clearly up close. After your eye exam, our eye doctor will discuss the various options that are available including reading glasses, multifocal and bifocal glasses, multifocal contact lenses, Vuity eye drops, and surgery.

What are the different treatment options for presbyopia?

This condition can be treated in a variety of ways. The following are some of them:

  • Reading glasses  - One of the treatment options would be to simply get a pair of reading glasses so you can see clearly when performing any sort of near tasks.
  • Bifocal or multifocal eyeglasses - Our eye doctor may also recommend you wear bifocal glasses or progressive lenses. If you already wear glasses for distance vision our eye doctor may recommend new lenses that are composed of two or three different powers within the same lens so that you can then see clearly both up close and far away.  A bifocal lens is a pair of glasses that has two distinct sections, one for near and one for far. They are available with a line on it as well as without a line that distinguishes between the two sections.  A progressive lens does not have a line, but is composed of multiple zones for near, far, and intermediate viewing. It allows you to see clearly when reading a book at near, when looking at signs while driving for distance, and at an intermediate range, such as looking at a computer.
  • Bifocal and Multifocal contact lenses - Contact lenses are another treatment option. Those who wear contacts could wear reading glasses on top of their regular distance vision lenses, or they could get a multifocal or bifocal contact lens.  Bifocal contact lenses will have two powers built into the lens, a zone that corrects near vision and a zone that corrects far vision.  A multifocal lens design is much like progressive glasses, but with contact lenses. It has three different powers within one lens, allowing you to see clearly far away, at intermediate distance, and up close.
  • Monovision contact lenses and glasses - Mono vision is another option that is available in both contact lenses and eyeglasses, where one eye is corrected for distance, while the other is corrected for near, allowing you to see clearly far away and up close with one pair of glasses or contact lenses. The major drawback of monovision lenses is that we use two eyes to create stereo vision (depth perception), however monovision only uses one eye for the visual task, which impairs our ability to use both eyes for the visual task.
  • Laser refractive surgery monovision - Monovision refractive surgery is another treatment option. It's also similar to the monovision modality we discussed with contact lenses, but this is a more permanent solution. You should try out the monovision modality before undergoing refractive surgery to see if you like it before you undergo anything permanent.
  • Laser refractive surgery blended - This is a newer technique that corrects for both near and distance in each eye, therefore limiting some of the depth perception problems of monovision refractive surgery. Before considering surgery it is important to discuss the available solutions with our eye doctor and fully understand the options available.
  • IOL-Intraocular lens implants - You can also undergo other implantable surgeries. This option was originally used for cataract whereby the surgeon replaces the lens with a new implanted lens. However over recent years there have been many advances in IOL technology and there are now multiple options available in monovision, bifocal and multifocal for patients with presbyopia. While IOL surgery is extremely common and generally safe, with any invasive surgery there are risks associated as well as common side effects that are reported in 20-30% of implants. Common side effects include glare and halos.
  • Vuity eye drops - Recently, a prescription eye drop came out that allows you to see clearly up close without even wearing reading glasses or contacts. This is the first eye drop for presbyopia with FDA approval. Basically, this prescription eye drop constricts your pupil and allows you to see clearly up close for six to ten hours. This treatment is best suited for patients in their early 40s and mid 50s. Usually, presbyopia begins at around 40, sometimes a little later and these eye drops provide clear vision for a couple of hours. Studies have shown that it improved near vision by three lines without affecting distance vision much. It only reduced your faraway vision by one line. It is extremely important to undergo a comprehensive eye exam prior to starting Vuity eye drops, as this correction method can lead to severe complications for people with certain conditions. If you are interested in this and would prefer not to wear glasses or contacts, you can speak with our eye doctor. Our eye doctor will check if you have any kind of retinal condition before prescribing these drops.
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