What is presbyopia?

Article

Sean W. Smolenyak, OD, gives a brief overview of presbyopia, including the cause and available treatments.

The gradual loss of your eyes ability to focus on near objects is called presbyopia (pronounced prez-by-opia). It typically occurs as a person enters their 40s, making it one of the most common aging conditions of the eye. For some it is very annoying and can negatively impact their daily activities.

The primary reason this occurs is because the natural lens inside the eye becomes less flexible with time. This loss of flexibility reduces the eye’s ability to change focus both in terms of speed (changing focus from far away to up-close quickly), as well as overall focusing power (maintaining clarity on an object up close). Since the lens does not flex as well as it did, light is not focused properly on the retina (the lining on the back of the eye that absorbs light).

For most people, it is a gradual process that worsens over time, typically years. However, I have had a few patients over the years report it seemed to happen almost overnight.

There are several things that we do to compensate for these difficulties including increasing font size on screens, increasing ambient lighting and screen brightness, as well as holding things farther away (or not so close). In addition, many patients turn to either over-the-counter reading glasses or change their distance prescription glasses to bifocal, trifocals, or progressive lenses.

Recent advances in managing presbyopia have revolved around lens implants and eyedrops. Lens implantation, typically at the time of cataract surgery, offers patients the ability to choose an implant that helps not only with distance vision but allows for an extended depth of focus with near tasks, including computer and reading.

Even more recently, the FDA approved the first eyedrop, VUITY (Allergan) to help mitigate the effects of presbyopia on a patient’s daily activities. Studies show VUITY can improve computer and reading ability with less dependency on glasses. Not every patient is a candidate for an implant or VUITY, so it is best to consult with your eyecare provider during a comprehensive, dilated eye exam. More advances in eyedrops are expected in the coming years as more companies bring products to market.

Aging changes to the eye can be scary and negatively impact daily activities. With recent advances—and more to come—presbyopia is proving not to be as difficult to manage as in years gone by.

Recent Videos
Nora Lee Cothran, OD, FAAO, details a real-world study that found IOP-lowering benefits when switching patients with glaucoma to latanoprostene bunod treatment.
Mile Brujic, OD, FAAO; Nate Lighthizer, OD, FAAO; Brianna Rhue, OD, FAAO, FSLS; Ben Casella, OD; and Ben Gaddie, OD, FAAO shared their insights from the conference.
Agatha Sleboda, OD; Arti Shah, OD, FAAO; and Kent J. Nozacki, OD provide the best tips that they give to their patients during natural disasters events in light of the recent Greater Los Angeles wildfires.
Optometrists local to the Los Angeles area overview their efforts to continue providing support to patients affected by January's wildfires.
Brianna Rhue, OD, FAAO, FSLS, reviewed key takeaways from The Future of Myopia Management: Perspectives from Leading Experts talk from SECO 2025.
Robert L. Stamper, MD, overviews his optometric track talk titled Objective Perimetry - Can you see it? at this year's Glaucoma 360 meeting.
Yvonne Ou, MD, outlined lifestyle modifications for glaucoma management that have proven beneficial, including yoga and cycling.
Robert L. Stamper, MD, weighs in on what he think more optometrists should know about glaucoma and current misconceptions concerning glaucoma testing.
John Berdahl, MD, overviews the new FYXS Ocular Pressure Adjusting Pump and HERCULES trial at the Glaucoma 360 meeting.
Ashley Wallace Tucker, OD, FAAO, FSLS, Dipl ABO, weighs in on what's on the horizon for pediatric myopia management, and provides some tips for diving into scleral lens fitting.
© 2025 MJH Life Sciences

All rights reserved.