Dr. Crutchfield, I find it when I am reading the morning newspaper the words appear blurry, but if I extend my arms and place the newspaper farther away the text becomes clear again. What is going on?
The medical term for what you are experiencing is called presbyopia. Over time your eyes lose their ability to focus on close objects. This is a normal yet bothersome occurrence in life. Presbyopia begins anytime after age 40, gradually worsens over the years, and peaks around age 66.
Most people will first notice presbyopia when they have to extend their arms to read books, magazines or newspapers. As with any change in your vision, you should always consult an ophthalmologist.
In order to properly see an image of what you’re looking at, it needs to be focused on the back side of your inner eye. In order to accomplish this, two focusing objects are used. The clear front cover on the outside of your eye is called cornea. It will bend and help focus light on the back of your eye.
Just inside your eye, behind your iris, is the lens. The lens, about the size of a large pea, working with the cornea, will also help focus images on the back of your eye. The cornea on the outside of your eye does not move or bend. However, the lens is flexible. The lens is surrounded by a circular muscle that helps to bend the lens, producing a focusing effect. When you look at objects far away, the muscle relaxes. When you try to focus on objects up close, the muscle constricts, bends the lens, and focuses the light so you can see.
Over time, the lens becomes less and less flexible and more rigid. As a result, the muscle cannot bend and focus the lens as much as it did when you were younger. As a result, it becomes difficult to clearly see objects up close. Medical conditions such as diabetes and high blood pressure can make presbyopia occur earlier and/or become more severe.
Presbyopia can easily be diagnosed by a basic eye examination. During a complete eye examination, your eye doctor (ophthalmologist) will perform a series of different tests. Each one of these tests is designed to evaluate specific components of your vision and eye health.
According to the Mayo Clinic, the American Academy of Ophthalmology recommends that adults have a complete eye exam every:
- Five to 10 years under age 40.
- Two to four years between ages 40 and 54.
- One to three years between ages 55 and 64.
- One to two years beginning at age 65.
These are just general guidelines. Your eye doctor will recommend a more precise schedule based on your particular eye health needs.
The most common treatment for presbyopia is over-the-counter reading glasses. These work very well for many people. Sometimes specialized reading glasses are required, and an ophthalmologist can write a prescription for these or contact lenses. These may also include bifocals and trifocals. Your doctor can explain the difference and advantages of each.
Eye surgery can be used effectively to correct presbyopia. There are constant and new developments in the field of corrective eye surgery. This includes a new type of specialized lens implants that can virtually cure presbyopia.
Have a discussion with your ophthalmologist/eye surgeon to clearly review the risks and benefits of using glasses versus contact lenses versus corrective surgery to treat your presbyopia
You can’t prevent presbyopia, but you can do several things to maintain good eye health these include:
- Have your eyes checked on a regular basis.
- Control chronic health conditions, including diabetes and blood pressure, which can affect your vision.
- Protect your eyes from the sun. Wear sunglasses that block ultraviolet (UV) radiation. This is especially important if you spend a significant amount of time outdoors or if you are taking medicines that make you more sensitive to sunlight.
- Protect your eyes from injury. Wear protective eyewear when doing any activity where your eyes are exposed to injury. This includes sports and work activities.
- Take a daily multivitamin. Good nutrition is important to maintaining healthy eyesight. Your doctor can recommend a good multivitamin.
- Make sure your glasses are the correct strength and prescription for you. Regular visits to your eye doctor will keep you on track here.
- Use good lighting. Make sure that your reading materials are always well illuminated.
- Most importantly, see your ophthalmologist immediately if you notice any changes in your vision no matter how small. Changes may include sudden loss of vision, blurred vision, flashes of lights, dark spots, or halos around lighted objects. These could represent significant health concerns and need to be attended to immediately.
The bottom line is that presbyopia, although annoying, can be addressed quite effectively. For optimal eye health, make sure that you visit your eye doctor on a regular basis.
Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.