What Is Presbyopia?
Presbyopia is a gradual loss of the eye’s ability to focus on nearby objects—a condition that becomes more noticeable with age. While it is often described as an age-related visual impairment, it can affect individuals to varying degrees depending on their lifestyle and visual needs.
As the eye’s accommodative power decreases, tasks that once felt effortless—such as reading, sewing, or using a smartphone—become more difficult. Though not incapacitating when corrected, unaddressed presbyopia can significantly reduce one’s visual comfort, productivity, and overall quality of life.
Why Presbyopia Happens
Presbyopia is caused by a natural loss of flexibility in the eye’s lens, making it harder for the eye to adjust and focus on close objects. This process typically begins in the early to mid-40s and continues to progress over time.
It has been described as “an irreversible optical failure, an unexplained evolutionary blunder that comes as a psychological shock.” In reality, it is a normal physiological change, but one that carries social and clinical implications, especially in modern societies where near and intermediate tasks are essential in daily life and work.
Common Signs and Symptoms
Presbyopia often develops gradually, with early symptoms being subtle. Over time, individuals may experience:
- Blurred near vision, particularly in low light
- Delays in focusing when shifting from near to distance
- Eye strain or fatigue during reading or close work
- Squinting or increased working distance when viewing fine print
- Headaches, particularly after prolonged near tasks
- Asthenopia (eye discomfort)
- Diplopia (double vision) in some cases
- A greater need for brighter lighting during reading
Why Treatment Matters
While presbyopia doesn’t pose a direct threat to eye health, it can negatively impact day-to-day function and often signals the point at which patients first seek professional eye care.
This initial contact provides optometrists with a valuable opportunity to not only manage presbyopia but to screen for other systemic and ocular conditions—some of which may be serious or sight-threatening.
Under- or uncorrected presbyopia may also lead to frustration, reduced work performance, and avoidance of visually demanding activities.
Treatment Options for Presbyopia
Optical correction is the mainstay of treatment, and selecting the right solution depends on the patient’s occupation, hobbies, ocular health, and daily visual demands.
Spectacle Lens Options:
- Single vision reading glasses – ideal for occasional near work
- Anti-fatigue lenses – for pre-presbyopes or those with early symptoms
- Bifocal lenses – for near and distance clarity in one lens
- Multifocal lenses – smooth transition between near, intermediate, and distance vision
- Near progressive lenses – ideal for close-up tasks
- Occupational lenses – tailored to specific workplace requirements
Each option comes with trade-offs in comfort, field of vision, and task suitability. Education on lens expectations is key to successful adaptation.
Contact Lens Options:
- Monovision contact lenses – one eye corrected for distance, the other for near
- Multifocal/bifocal contacts – multiple zones for different distances
- Enhanced monovision – modified for specific visual goals
- Combination of contact and spectacle lenses – commonly used for flexibility
Some patients wear distance contacts with reading glasses, while others choose near-focused lenses with distance glasses. Those with specific task requirements may supplement their contacts with spectacles to sharpen performance during precision work or reduce residual astigmatism.
A Personalised Approach Matters
Managing presbyopia isn’t just about handing out reading glasses. It’s about understanding the unique visual profile of every patient—what they do, how they use their eyes, and how best to support their lifestyle with the right solution.
Through comprehensive care, optometrists help restore near vision function while also screening for other potential visual risks, reinforcing the importance of routine eye exams even for age-related changes like presbyopia.
Finding it harder to read up close or focus on your phone?
Book a consultation at Davida van der Merwe Optometrist and get tailored advice on restoring your near vision with comfort and style.
📍 30 Victoria Road, Newcastle | 📞 034 312 4602 | 💬 Request Appointment
