Presbyopia is normal and is an age-related condition that causes us to lose our near vision or accommodation just after 40 years of age.
You may have seen some people move their arms away with a book to read or even back their head up when using their phones; these are examples of presbyopia. When we are young, the lenses in our eyes are clear, and at age 40, Dysfunctional Lens Syndrome (DLS) occurs.
There are 3 types of DLS.
DLS Stage I is when the human lens begins to stiffen and loses its natural ability of changing shape to increase the magnification of the eye to see closely. Typically, young children can read something very closely.
As we age, especially after age 40, the lens hardens and our focusing power to see up close lessens each year. By age 60, we cannot see anything up close without glasses.
The exception to this rule is if we are nearsighted: the ability to see near without glasses. Have you seen someone taking their glasses off to read, perhaps? This is indicative of being nearsighted.
Presbyopia occurs naturally as we age. Once we reach around 50 years of age (DLS Stage II), the lens hardens even more, small opaque spots begins to develop and our nighttime vision begins to be affected, similar to seeing through a windshield with micro-pits or subtle scratches.
This, of course, occurs gradually, and most people do not recognize negative symptoms until around 60 years of age, when a cataract (cloudy lens) is noticed (DLS Stage III).
Once a cataract develops, nighttime issues usually affect us first, then reading and then day-time vision.
Treatment for DLS in the 40s and 50s includes glasses (bifocals or progressive lenses), over-the-counter reading glasses, contact lenses and refractive lens exchange (surgical replacement of the lens). LASIK surgery typically is not the best option after age 40 because you will still need reading glasses.
With refractive lens exchange from the 40-60s, we have new lens-replacement technology to allow patients to see near and far with both eyes. Some individuals use monovision, where one eye is focused near with a contact lens, while the other eye is focused at distance.
After the age of 60, cataract surgery is the recommended option once your vision is affecting your daily activities.
(Dr. Robert Melendez is an area ophthalmologist, and founder and CEO of Juliette Eye Institute in Albuquerque. He has also been a clinical assistant professor at the University of New Mexico Health Sciences Center since 2005. He lives in Corrales.)