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Long-sightedness with ageing (presbyopia)

Kanohi kāhu o te pakeke

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Presbyopia, or long-sightedness that begins in middle age, makes it hard to focus on things that are up close. It is not a disease but a normal part of getting older. It affects everyone, even people who have never had any eyesight problems before.

Presbyopia usually affects people who are 40 or older. It's different from hyperopia, another form of long-sightedness, which makes it difficult for younger people to focus on things up close.

Causes of presbyopia

In young healthy eyes the lens changes shape to focus light onto the retina. In presbyopia this doesn't happenNormal healthy, young eyes can focus from far in the distance to just a few centimetres from the eye. This is because the lenses in young eyes are very flexible and can change shape to focus on different things. This happens so quickly that we do not even know our eyes are refocusing.

As we get older, the lenses in our eyes thicken and slowly lose their flexibility, making it difficult to see things that are very close.

Presbyopia doesn't happen suddenly, and it doesn't affect your distance vision. The process that causes presbyopia starts in adolescence, and we cannot stop it.

Symptoms of presbyopia

People usually start noticing the symptoms of presbyopia in their early to mid-40s. Symptoms are:

The symptoms continue to get worse until around age 60.

Treating presbyopia

Glasses

Many people find over-the-counter or ready-made glasses help at first, but they often fail to give comfortable or relaxed vision. These glasses do not correct astigmatism (blurring caused by an oval shaped eye) or any difference in the prescription between your eyes. To find out what prescription you need, you'll have to have a professional eye exam. Your glasses will also need to be carefully fitted to make sure they're in the right position for your eyes.

Some people who need to wear glasses for seeing in the distance choose to use two different pairs of single-vision glasses – one for reading and another for looking in the distance.

You can ask for lenses that help you to focus close up and in the distance – this is possible with either bifocal or multifocal (progressive) lenses. Talk to your optometrist about your options.

Contact lenses and surgery

Some people prefer contact lenses to glasses. There are also surgical options to correct presbyopia.

Ongoing checks

Between the ages of 45 and 55, your vision changes rapidly and you might need to change your prescription quite regularly. It's best to have regular eye exams to make sure your eyes are healthy and give you efficient and comfortable vision.

Have an eye examination every two years after the age of 40 unless your optometrist or ophthalmologist (specialist eye doctor) suggests otherwise. After 65 you may need to have them more often, so your optometrist can diagnose and treat any sight-threatening conditions, such as glaucoma and age-related macular degeneration (ARMD) as soon as possible.

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Written by Canterbury optometrists. Adapted by HealthInfo clinical advisers. Last reviewed March 2023.

Sources

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Review key: HIVIP-134077