Presbyopia Treatment Options to Restore Near Vision

Reviewed by: Selene A. Burke, OD

Vision Tips & Prevention Vision Tips & Prevention

If you are between the ages of 35 and 60, you may have noticed that fine print is more difficult to read, that you have trouble focusing on up-close tasks, or that you experience eye strain when viewing screens – all of which are symptoms of presbyopia. Trusetd Source Checkbox Trusted Source Presbyopia Fact Sheet & Adult Vision: 41 to 60 years of Age National Eye Institute & American Optometric Association Go to Source 1,2 Presbyopia is a naturally occurring loss of near vision that is a result of age-related changes to the eye’s lens. Presbyopia affects everyone eventually, and symptoms are gradual. Trusetd Source Checkbox Trusted Source Presbyopia American Optometric Association Go to Source 3 You may hold your phone or book further from your face in an attempt to see more clearly. When that tactic is not enough to put things in focus, you have several options for near vision loss treatment.

Reading Glasses to Treat Presbyopia

Eyeglasses are the most common treatment option for presbyopia. There are several types of glasses that can be used to improve near vision:

Reading glasses

Generally considered the simplest presbyopia solution, readers are available without a prescription. Trusetd Source Checkbox Trusted Source Presbyopia Fact Sheet National Eye Institute Go to Source 1 While they are easy to pick up at your local pharmacy, many people get frustrated with the “on, off, on, off” problem that can arise when using readers. You may find yourself taking them off while walking, putting them back on to check a text, taking them off to drive, putting them back on at work, and often searching for them when you need them.

Bifocals

Intended for people with nearsightedness (myopia) or farsightedness, bifocals support presbyopia by having two lens powers within one pair of eyeglasses. The bottom portion of the lens is designed to support near vision, or reading up-close. Then the top part of the bifocal lens is created to support distance vision.

Progressive addition lenses

Also called PALs, these glasses treat presbyopia for patients who do not like the look or feel of bifocals. The lenses are more blended, meaning the prescription change from distance, intermediate to near is progressive and not as abrupt as with bifocals.

While glasses are an accessible choice for many people with presbyopia, some patients do not like the way they look. Others may seek a presbyopia solution that allows them to avoid the hassle of taking glasses on and off for different tasks.

Contact Lenses to Treat Presbyopia

Multifocal contact lenses

These contact lenses have multiple lens powers, similar to the progressive or bifocal lenses in eyeglasses and are used to help with improving vision at all distances.

Monovision contact lenses

These contacts, in which one eye wears a distance prescription and the other a near vision prescription, may be an option if you already wear contacts and don’t want to be dependent on glasses. However, a monovision approach doesn’t work for everyone and some patients find that they cannot comfortably adapt to monovision.

While these contact lenses are designed to treat presbyopia, they are not as popular as glasses. Reasons people cite for not choosing contacts as a treatment for presbyopia include dry eye symptoms or the ongoing cost of contacts. Some patients are not able to get used to multifocal lenses and patients who try monofocal lenses sometimes experience a loss of depth perception or diminished visual acuity. Trusetd Source Checkbox Trusted Source Presbyopia: What causes it and how to treat it. All About Vision Go to Source 4

Are There Surgical Options to Treat Presbyopia?

Although there are off-label procedures available for the treatment of presbyopia, there are currently no FDA approved treatments that are widely used by ophthalmologists in the United States that have an indication to treat presbyopia.

Monovision LASIK

This modified LASIK procedure is a refractive surgery that corrects one eye for distance vision and one eye for near vision. Similar to monovision contact lenses, this method requires the brain to adapt to relying on different eyes for different distances. A LASIK surgeon will typically trial the monovision approach with contact lenses before surgery, as not everyone will adapt well. Monovision LASIK carries a risk of visual abnormalities and glare, which can cause difficulty driving. LASIK can also cause persistent dry eye symptoms. Trusetd Source Checkbox Trusted Source Monovision LASIK in emmetropic presbyopia patients. Clin Ophthalmol Go to Source 5

Refractive Lens Exchange

RLE is a surgery in which each eye’s natural lens is replaced with an advanced intraocular lens (IOL). This surgery can correct a variety of refractive errors and reduce or eliminate the need for reading glasses, but not everyone is a candidate. Any surgery carries some risk and RLE risks include an increased likelihood of retinal detachment. Trusetd Source Checkbox Trusted Source Updates and Challenges In Refractive Lens Exchange US Ophthalmic Review Go to Source 6

Which is the Best Presbyopia Treatment for You?

If you are experiencing any vision changes, it is important to see an experienced eye doctor for a comprehensive eye exam. If you are diagnosed with presbyopia, your eye doctor can discuss which treatment options may be able to restore your near vision. Your eye health, medical history, lifestyle, and personal preferences are all factors in determining the best presbyopia treatment plan for you.

Trusetd Source Checkbox  Sources


1 National Eye Institute. Presbyopia Fact Sheet. https://nei.nih.gov/sites/default/files/health-pdfs/Presbyopia.pdf Accessed October 9, 2019.
2 American Optometric Association. Adult Vision: 41 to 60 Years of Age. https://www.aoa.org/patients-and-public/good-vision-throughout-life/adult-vision-19-to-40-years-of-age/adult-vision-41-to-60-years-of-age Accessed October 9, 2019
3 American Optometric Association. Presbyopia. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/presbyopia Accessed October 9, 2019
4 All About Vision. Presbyopia: What causes it and how to treat it. https://www.allaboutvision.com/conditions/presbyopia.htm Accessed October 8, 2019.
5 Levitt AE, Galor A, Weiss JS, Felix ER, Martin ER, Patin DJ, et al. Chronic dry eye symptoms after LASIK: parallels and lessons to be learned from other persistent post-operative pain disorders. Mol Pain. 2015; 11: 21.
Published online 2015 Apr 21. doi: 10.1186/s12990-015-0020-7

6 Dhaliwal DK. UPDATES AND CHALLENGES IN REFRACTIVE LENS EXCHANGE. US Ophthalmic Review, 2018;11(1):17–18 DOI: https://doi.org/10.17925/USOR.2018.11.1.17

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