Eye Diseases & Conditions


Presbyopia (prez-bee-OH-pea-uh) is a type of refractive error. It is the slow loss of your eyes’ ability to focus on objects up close. Presbyopia is a common condition that occurs with age, and usually becomes noticeable in the early to mid-40s and continues to worsen until around age 65. You may become aware of presbyopia when you need to start holding reading material- such as your smartphone, book, or menu- out further away to be able to read them. Sometimes, it can occur with other types of refractive error, like hyperopia or myopia.

Why is presbyopia a problem?

Presbyopia affects your near vision beginning in your 40s. It is a natural part of the aging process, but there are options available to improve your vision

What causes presbyopia?

Presbyopia is caused by changes in the eye due to aging.  Presbyopia results from the lens (disc in the middle of the eye behind the pupil that brings rays of light into focus on the back of the eye) in the eye becoming stiffer with age. This results in the lens not focusing light correctly on the retina in the back of your eye (innermost layer of the eye which receives what you see and sends it to the brain) leading to blurred vision at close distances.

Regular eye examinations will help you take charge of your vision health. Presbyopia occurs with age, so it is important you get regular eye check-ups and work with your eye doctor to build a schedule.

Presbyopia Diagnosis

An ophthalmologist (an eye doctor with a medical degree: MD or DO) or an optometrist (an eye doctor with an optometry degree: OD) will conduct a dilated eye examination to find out if you have presbyopia.

During the eye exam, the eye doctor will conduct the following tests, among others:

  • Visual acuity: This test will find out how well you can see through your central vision in each eye. This is the part of the exam when you read an eye chart with shapes or letters that get progressively smaller.
  • Refraction test: This test will find out if you need eyeglasses or lenses by measuring how your eye focuses light on the back of your eye. By using a phoropter (a device which can switch between specific lenses) and having you read the eye chart with different lenses, the eye doctor can understand your specific vision needs. The eye doctor will also measure your specific prescriptions for eyeglasses and contact lenses using a device called a retinoscope.
  • Dilated eye examination: The eye doctor will dilate (widen) the pupils of the eyes with eye drops to allow a better view of the back of your eyes (retina and macula).

Presbyopia Treatment

A range of treatments are available. This may include eyeglasses, contact lenses, or other treatments to help you see clearly. Your eye doctor will work with you to identify the right treatment for your specific needs.

Eyeglasses: Glasses for presbyopia focus light on the back of your eye correctly. It is important to talk about your vision needs to your eye doctor, since eyeglasses can be made for computer work, reading, hobbies, sports, or all-around needs. Some examples of glasses for presbyopia include:

  • Reading: These glasses help with vision “up close”, but will only fix presbyopia, not myopia or hyperopia.
  • Bifocals and Trifocals: Bifocals are glasses which have both a correction for reading and distance. These lenses are separated by a line on the glasses. Sometimes, a third lens is added – these glasses are called trifocals.
  • Progressive: Progressive lenses provide the benefits of bifocals and trifocals, without lines dividing each “zone”. The lens provides correction from distance to near one continuous lens.

Contact lenses: Contact lenses also work by focusing light correctly on the back of your eye so that you can see more clearly, but are worn directly on the surface of your eye. Contact lenses require a different prescription than eyeglasses and additional measurements of the eyes.

Refractive surgery: If you are a good candidate for surgery, your ophthalmologist or optometrist may recommend surgical reshaping of your cornea (clear part in the front of the eye).

Eye drops: Eye drops prescribed by your eye doctor may be an option for some people with presbyopia.

Your prescription may change over time, so it is important to have regular dilated eye exams and review treatment options based on your changing needs.

Questions to Ask Your Eye Doctor About Presbyopia

  1. How does presbyopia affect my vision?
  2. Should I consider contact lenses or glasses?
  3. What happens if I do not treat my presbyopia?
  4. Is there any way to stop my vision from worsening with age?
  5. Am I a good candidate for corrective surgery?
  6. Should I consider glasses specifically for using the computer?