Presbyopia Symptoms and Treatments

Treatments

If untreated, presbyopia can inhibit your quality of life, and there are many options to help correct your vision.

Reading glasses

It’s a good idea to schedule a yearly eye exam to understand both your vision changes and your overall eye health. Your eye doctor might recommend that you get reading glasses. But this doesn’t mean you need to buy an expensive pair. You may be able to simply buy readers, which increase the close-up fonts and images. If your eyes have very different prescriptions, however, you may need prescription glasses, but when considering cost, you don’t have to buy them from the storefront at your eye doctor. Instead, ask for your prescription so that you can use it online or at discount stores.

Contact lenses

Contact lenses can be a good option for people who don’t want to keep glasses on hand. Lens types include:

• Bifocal: The lens has a line between the up-close and distance prescriptions
• Diffractive: The lens focuses light by diffraction, which is bending light to two focal points
• Monofocal: One lens corrects one eye for distance, and the other lens for up close
• Multifocal: Also called simultaneous vision, this lens has prescriptions for both up close and distance, but without the distinctive line of bifocals.

You can choose lenses that you change daily or once per month. Daily lenses cost between $20 to $40 for a 30-day pack. Costs for monthly lenses range from $40 to $120 for lenses, but you can get them at a discounted bulk rate at big box stores. Many vision insurance plans cover eye exams and contact lenses, but may not cover them in full.

Eye drops

In 2021 the U.S. Food and Drug Administration (FDA) approved Vuity, prescription eye drops to treat presbyopia. You use them once daily, you can expect to get six to eight hours of clearer vision, according to Wong.

“I have some patients that will use it just on the weekends, when they're out and about. If they're running errands or going to a kid's game, so that they don't have to keep bringing around their glasses,” says Wong.

The drops are a low dose of a medication that makes the pupils smaller and increases the focal range, similar to a camera’s aperture, a fancy word for “opening,” according to Lisa Park, an ophthalmologist and associate professor of ophthalmology at Columbia University Irving Medical Center in New York. However, Park says the drops are not without risks, including, in rare cases, retinal detachment.

You can expect to pay between $80 and $100. Insurance companies do not generally cover eye drops.

Types of surgery

There are several surgical options available, which greatly depend on each person’s vision needs, according to Shahzad I. Mian, M.D., professor of ophthalmology and director of W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI.

Cataract surgery

Mian says surgery to correct cataracts, when an aging eye lens becomes cloudy and hinders vision, can also correct presbyopia. This involves removing the lens and replacing it with a plastic lens. It creates monovision, which means one eye is corrected for up close and the other eye is corrected for distance. It may take some time for your brain to adjust.

“People who have cataracts also have issues with their reading vision as well, but cataracts tend to become functionally visually significant more when you're in your 60s or older, on average,” Mian says.

LASIK

LASIK, short for laser-assisted in situ keratomileusis, is another option. LASIK surgery involves an ultraviolet laser to reshape the curvature of the cornea, the clear covering of the eye that refracts light. This procedure is also very quick and can create multifocal, bifocal, or other types of vision corrections. Side effects can include temporary fuzzy vision, dry eye or a halo effect.

Be proactive with your eye health

“Don’t ignore eye strain,” says Wong. With more and more people working from small screens on laptops and their smartphones, eye strain can worsen. If you’re struggling with eye strain or need to “reset” your eyes often, like every 15 minutes, it’s time to see an eye doctor.