Presbyopia in focus: Why our close-up vision gets blurry after 40.
Photo by Antoni Shkraba on Pexels
My vision has been pretty stable for the last couple of decades. But then I turned 40. Something changed. I am short-sighted and, until now, I kept my specs on all the time. But this no longer works. For the first time, I have to take my specs on and off - depending on what I’m doing. I’ve become one of those people who have to lower their specs onto their nose to read, do my daughter’s hair… or anything up close. As I spoke to friends and colleagues, I realised I was not alone. Mr Benedict Vella Briffa, consultant ophthalmic surgeon at Saint James Eye Clinic, took some time to explain what’s going on.
It seems like, at a certain age, something shifts in terms of eyesight. Is this the case?
Indeed, this is a phenomenon called presbyopia which makes it difficult to focus our eyes on things that are close up such as a phone or book.
To some extent, this happens to everyone throughout their lifetime, even those who had perfect vision when they were younger. Most people start to experience it in their 40s, and it gets progressively worse over the decades.
Why exactly is this happening? What’s going on with the eyes?
Our eyes contain a lens, similar to a camera. When we are young, this lens is flexible and can easily change shape, which enables us to focus effortlessly on things that are close up.
With age, this lens begins to stiffen and lose flexibility (along with the rest of our body!) so we gradually lose this ability to focus close up. Reading starts to require more effort and eventually becomes too difficult since text appears blurred and we might even get headaches from straining our eyes.
At that point, our eyes need some sort of assistance to focus, such as by putting on a pair of reading glasses. It is considered a normal part of ageing, and unfortunately there is no way to prevent it from happening.
Does this impact men and women equally?
This is an interesting question because presbyopia afflicts everyone as they age, regardless of gender. However, it impacts people differently depending on their occupation, hobbies and other factors.
For example, people with office-based jobs need to constantly focus on screens and paperwork so they notice the effects much more than those who work outdoor jobs.
Taller people feel it less because they have longer arms and can hold their phone further away from their face. Therefore, statistically some gender differences do come into play, and women are somewhat more likely to suffer the effects.
“Statistically some gender differences do come into play, and women are somewhat more likely to suffer the effects.”
What should one do when they start noticing these changes?
Buying a pair of inexpensive ready-made reading glasses can be a handy 'quick fix' in some cases. However, whenever we notice deterioration in our vision it is a much better idea to have an eye test.
This will determine the exact prescription of glasses or contact lenses we might need for the clearest vision without eye strain. Very importantly, it can also detect other eye conditions that might be affecting our vision at the same time - such as cataracts or even diseases like macular degeneration or glaucoma.
These diseases can cause serious damage to our eyes as we get older if they are not diagnosed and treated at an early stage. Our sight is extremely precious and we shouldn't take it for granted.
Anything else to add?
For most people, presbyopia is simply a nuisance and an unwelcome reminder that they are getting older. The traditional way of coping with it is by wearing glasses, and many people do adapt to it quite well over time.
For those who prefer not to wear glasses, nowadays there is also the option of vision correction surgery which is becoming increasingly popular.
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