Opinion

The restaurant had tablecloths, minimal lighting and large, leather-bound menus with a fancy script describing the fare. But these attractive features forced me to hold the large menu above the table at arm’s length to make my choice. My tablemates laughed as they reached for their reading glasses.

Doctors call it presbyopiaIt’s a Greek word that means “old eye” and it happens to everyone at some point. Some people notice that their near vision begins to blur in their 40s, many of us experience this in our 50s, and practically everyone experiences it after age 60.

“Your chances are 100 percent,” says Peter McDonnell, director of the Wilmer Eye Institute at Johns Hopkins University in Baltimore.

The good news is that there are many ways to manage presbyopia. But first, let’s look at what causes blurred vision.

The lens of your eye sits behind the colored iris. In young people, the lens is soft and flexible and can change shape to shift a person’s focus from distance to near. But as people age, “the inner lens loses its elasticity,” says Brian Boxer-Wachler, MD, founder of the Boxer-Wachler Vision Institute in Beverly Hills, Calif.

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The change happens gradually, McDonnell says, and the process starts when you’re still young. People don’t notice until they’re middle-aged because “we have a buffer to deal with,” he said.

This means that we start life with internal lenses that are so flexible that people can manage changes in focus even after hardening begins. The age at which people first experience vision changes varies greatly and can affect a person’s activities. For example, people whose jobs require close attention are more likely to notice their deficits than people who don’t experience such demands.

“We can compensate with things like longer arms and larger letters,” says Carolyn Rocha, MD, an ophthalmologist at the Storm Eye Institute in Charleston, South Carolina. Rocha recently reviewed various treatments presbyopia.

Working or reading in bright light can also help. “It’s giving more light to the retina at the back of his eye,” Boxer said. Bright light also causes the pupil to constrict, creating the pinhole effect, which reduces distortion by limiting your eyes to direct, highly focused light rays.

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A bag of other lifestyle and environmental issues: The high contrast between text and page (or screen) helps readability compared to the yellow pages or restaurant lighting. Fatigue plays a role; People may find it difficult to concentrate first thing in the morning or when they are sick. Distance matters, naturally, which means you might need those reading glasses when you’re reading a novel but working on the computer.

There are also a number of technological and medical fixes. Reading glasses, of course, called “readers” or “readers”, are the first choice for many. They are cheap, available at drugstores and come in different strengths. Levels of +1, +1.25, +1.5 are in dipter intensity units. (Diopter refers to the focal length of a lens.)

McDonnell recommends trying a few glasses of different strengths and reading something—perhaps on your phone or a magazine.

Choose the lowest reading power that allows you to focus while reading, says Boxer-Wachler.

Presbyopia, Rocha says, “can be the first sign of aging in people with perfect vision.” People with farsightedness may notice the need for reading glasses, while those with nearsightedness will pick up their regular glasses for reading.

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If you already wear corrective lenses – glasses or contacts – you may want to consider bifocals or progressive lenses. These are lenses with distance adjustment on the top and reading adjustment on the bottom, which allows people to change their focus by adjusting the part of the lens they see.

Another option is the monovision approach. That means correcting one eye for distance (usually the dominant eye) and correcting the other for reading. It can take some getting used to as the eyes and brain get used to giving each eye a different job.

“Ninety percent of the people we test in the office adapt well,” says Boxer Wachler. In the remaining 10 percent, it does not work.

In addition to reading glasses or corrective lenses, corrective lenses are prescription eye drops, sold under the brand name Vuity and approved by the Food and Drug Administration in 2021. Drops intended for use once a day contain a drug called pilocarpine, which causes the pupil to create a pinhole effect, restricting external light rays from entering the eye through their external information.

In the study, the drops showed improvement Near sight For six hours without affecting distant vision. Some people report headaches as a side effect.

But Boxer Wachler says the benefits were limited. Among those who used the drops daily for a month, 30 percent were able to read three more lines on the near vision assessment chart.

“That means 70 percent of people saw no improvement or less than three lines of improvement,” he says.

This modest effect may be most beneficial for people in the early stages of presbyopia, who do not need much corrective help.

One second Eye drop treatmentIt is still under investigation, to soften the lens itself.

Ophthalmologists may offer surgical procedures to correct presbyopia, such as corneal inlays, LASIK, photorefractive keratectomy, and lens implants.

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If you experience changes in your vision, you can buy a pair of reading glasses. But McDonnell says a visit to an eye doctor can be beneficial.

“As you start to reach the age of wisdom,” he says, meaning the 60s, it’s worth getting screened for age-related eye diseases like cataracts, macular degeneration and glaucoma. Ophthalmologists can advise you on several options for pre-myopia.

It’s a universal problem that hurts. Quality of life — a subject which MacDonnell had studied some years before. But with all the options out there, you should be able to make the adjustment that works for you.



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