Woman facing age-related vision changes

Age-Related Vision Changes

Developing presbyopia and cataracts

Just like most things, the eye is not able to keep up perfect performance forever. Over time, parts of it wear out, which leads to a gradual worsening of vision with increasing age. The most common age-related changes are cataracts and presbyopia.

Put simply, everybody is confronted with one of them at some point sooner or later in their lives. These visual impairments can be very disruptive to everyday life. However, the changes are a normal part of aging and should not stop you from enjoying an active lifestyle or from maintaining your independence, because they can be treated.

Vision simulation with presbyopia

Presbyopia simulation

Presbyopia

When near vision becomes blurry with age

Presbyopia is part of the natural aging process of the eye and usually begins to occur around the age of 40. Technically, presbyopia is the loss of the eye’s ability to change its focus to see objects that are near. It is not a disease, it is as natural as having wrinkles at some point in life. People experience blurred near vision even if they have never had a vision problem before.

  • Causes of Presbyopia

    Presbyopia is a refractive error caused by an age-related process – this differs from other refractive errors such as astigmatism, myopia and hyperopia, which are all related to the shape of the eyeball.

    After the age of 40, the lens starts to become less flexible, causing a reduced capability to adjust and focus on objects at various distances. Objects up close become increasingly difficult to see clearly. Presbyopia often causes vision deterioration years before another age-related defect, a so-called cataract, develops.

  • Symptoms of Presbyopia

    One of the most obvious signs of presbyopia is the need to hold reading materials at arm’s length in order to focus properly.

    Even though the symptoms of hyperopia and presbyopia are similar, they are caused by different things. Presbyopia is caused by the loss of the lens’s flexibility due to advancing age, and hyperopia is caused by light not being properly refracted onto the back of the eye, one reason being because the eye is too short.

    Typical signs of presbyopia include:

    • The need for reading or progressive glasses
    • Difficulty with near range tasks such as reading, sewing, using a cell phone
    • Blurred vision: Objects must be held further away to see them clearly
  • Correcting Presbyopia

    Presbyopia cannot be cured. However, there are many options for people with presbyopia to treat the eye defect properly.

    Glasses

    Reading glasses are a very common and easy way to correct presbyopia symptoms. They are typically worn just for close work such as reading and sewing etc.

    Glasses with bifocal or progressive addition lenses (PALs) are the most common correction for presbyopia. Progressive glasses are multifocal lenses, which provide a more natural correction because of their line-free seamless progression of added magnifying power for intermediate and near vision.

    Contact Lenses

    If you prefer contact lenses instead of glasses you may opt for multifocal contact lenses, which are available in hard and soft materials. Another type of contact lens is monovision, in which one eye wears a distance prescription, and the other one for close vision. The brain adjusts to the change and learns to favour one eye for different tasks. While some people feel good with that option, others complain of reduced visual acuity.

    Surgery 

    There are also a few surgical options to treat presbyopia.

    • Keratoplasty: Radio waves are used to create more curvature in the cornea for a higher “plus” prescription to improve near vision. This correction is only temporary and is performed on one eye only for a monovision correction. 
    • LASIK: This treatment can also be used to create monovision, in which one eye is corrected.
    • Presbyopia-correcting IOLs: If you are undergoing cataract surgery or thinking about different lens options, and have presbyopia, a presbyopia-correcting lens for multifocal vision may be an option for you. With a multifocal intraocular lens you may be able to achieve clear vision at all distances. 

    Consult your ophthalmologist regarding the different treatment options to decide which is best for you.

Grandfather and grandson reading in a park

Cataracts

When vision becomes blurry

The lens of an eye is normally clear and transparent. If the lens becomes cloudy or is opacified, it is called a cataract. As people reach their mid-40s, biochemical changes occur in the proteins within the lens. That’s why the likelihood of developing cataracts increases with age. Cataracts develop slowly and symptoms appear gradually over time. They cannot be treated with glasses or medication. The only permanent solution is a surgical replacement of the natural lens with an intraocular lens. Read everything about the causes, risk factors, diagnosis of and treatment options for, cataracts on the following pages.

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