What changes
To focus up close, small muscles inside the eye change the shape of the natural lens, making it rounder and stronger. This ability, called accommodation, starts to fade slowly in childhood. By the mid-forties the lens has stiffened enough that most people notice.
Presbyopia is not a disease, and it is not the same as farsightedness, although the two are often confused. It happens to everyone, including people who have always had perfect distance vision.
The signs
- Holding books, menus and your phone further away to read them
- Needing brighter light to read
- Blurred near vision, especially early in the morning or late in the day
- Tired eyes or headaches after reading
- Small print doubling or running together
- Difficulty with fine close work such as threading a needle
The options
Reading glasses
Simple plus (+) lenses, usually between +1.00 and +3.00, work well if you see clearly at distance without glasses.
Bifocals and progressives
If you already wear glasses for distance, the reading power can be added to the lower part of the lens. Progressive lenses change strength smoothly from top to bottom, with no visible line.
Taking glasses off
People with mild nearsightedness often find they can read best by taking their distance glasses off, because the eye is naturally focused up close.
Contact lenses
Multifocal contact lenses, or one lens set for distance and the other for near (monovision), suit some people.
PRESBYOND laser blended vision
PRESBYOND reshapes the corneas with a laser so that one eye is set mainly for distance and the other slightly for near, with a range of clear vision in between. The brain blends the two images. It does not suit everyone, and a trial with contact lenses is often used first to see how you adapt. See PRESBYOND.
Lens surgery
If a cataract is starting, replacing the natural lens with a multifocal or extended-range implant may treat both problems at once.
Things that can make reading harder
Some medicines can make near focus harder, including some eye drops that widen the pupil and some medicines that act on the nervous system. If your reading suddenly worsens after starting a new medicine, mention it to your doctor.
This guide explains; it does not diagnose. Your doctor’s advice about your own eyes comes first.