Your eyes after 40

If you've been lucky enough to have perfect vision, it can be a real shock if you begin to struggle to see the world around you in sharp focus....


Sometime in our forties, most people begin to experience difficulty with reading and close focus tasks such as threading a needle. At first it's easy to accommodate our changing vision, by simply holding the book further from our eyes. Eventually though our arms will be too short and we will be forced to face the fact that we can't read the small print on the back of packets, and worse still choosing a meal from a menu becomes pot luck!

The technical name for age related decline in close focus vision is Presbyopia. It's a condition that virtually everyone will encounter with increasing age, usually beginning some time in their forties or early fifties. Presbyopia is different from other vision problems such as astigmatism, nearsightedness or farsightedness. These conditions are related to the shape and length of the eyeball itself, and are usually caused by genetic factors or environmental factors, or occasionally can be the result of trauma to the eye. Presbyopia has nothing to do with the eyeball shape and length, but everything to do with the lens inside your eyes. The lens is attached to focusing muscles, and situated just behind the coloured part of your eye (called the iris).

With the passing of years, the lens gradually becomes less and less flexible, resulting in hardening and decreased lens elasticity. A hardened lens has a much harder time with close up vision. To begin with, the focusing muscles work harder and harder to counteract this effect, but eventually even this compensation is not enough to maintain clear close range vision. All this extra muscle work can cause a lot of eye strain and fatigue after extended periods of close visual work. In fact, this is often an early symptom of developing presbyopia.

From your forties through to your mid sixties your close vision is likely to decline and any optical prescription for presbyopia will need to be reviewed regularly to accommodate the change and prevent eye strain. Some health conditions such as cardiovascular disease, diabetes and multiple sclerosis will hasten the development of presbyopia. Prescription drugs can also effect the flexibility of your eye lens, especially antidepressants, antihistamines and diuretics. Periods of intense stress can also hasten the development of presbyopia, and it's not uncommon for people to notice a significant eye sight deterioration over a short period of time when stressed or generally unwell. In fact the rate at which lens flexibility changes can actually be a good barometer for your overall state of health.

So, if surgery to lengthen your arms is not an option, what solutions can your optometrist offer you to bring the small print of life back into sharp focus?

Enhanced Readers

If you're working at a computer and reading hard copy documents, the frustration of taking reading glasses on and off can drive you crazy! Or what about the frustration of trying to focus to read a recipe and also be able to clearly see the kitchen bench as well? Enhanced readers are the perfect solution. Ordinary reading glasses focus your eyes clearly at a specific distance of about 40-50cm from the tip of your nose. The problem here is that the computer screen is likely to be about 60-70cm from your nose.

Enhanced reading glasses allow you to focus clearly anywhere from 40cm to 2m from the tip of your nose. That means no more taking reading glasses on and off a million times during your typical working day.

Progressive Lenses

Available since the 1960's progressive lenses have a progressive change in prescription throughout the lens, allowing your eyes to focus from distance to intermediate to near. This offers the utmost convenience.... one pair of glasses for all general viewing requirements. Visionplan optometrists offer you the very latest in progressive lens design, customised for your individual prescription and frame choice. By offering you the latest and most sophisticated progressive lens technology, they are able to create a progressive lens with wider clearer areas of focus and less distortion than ever before. This makes adjusting to wearing the glasses easier than ever.

Contact Lenses

There are also contact lens options for presbyopia. If you already wear contacts when you develop presbyopia, you have the option of wearing reading glasses over your lenses as required. Alternatively, multifocal contact lenses (which are either gas permeable or soft) have a range of different scripts in each lens. With these lenses, your eyes learn to select the proper prescription for the moment.

Some people prefer the option of monovision contact lenses.  With monovision contacts, one eye is fitted with a contact lens with a distant vision prescription; while the other eye wears a contact made for perfect near vision. Gradually, the brain retrains itself learning to favour one eye or the other depending on the distance of the required task.

Ready Readers

These over the counter glasses are fitted with magnifying lenses which allow you to read small print. While they can be handy for certain tasks with mild presbyopia, they are not generally recommended by optometrists, without first having an eye examination. Most people require a different degree of correction in each eye, so wearing a prescription with the same degree of correction for each eye may not provide the most comfortable clear vision for detailed near work. Lens technology has also moved on and there are so many options that can be customised to suit your lifestyle and provide far less frustrating answers to your presbyopia problems.

Simply buying ready readers without having an eye examination may result in serious eye problems remaining undiagnosed and untreated. Macular degeneration and glaucoma are both age related degenerative eye conditions which can cost you your eye sight if not diagnosed early enough. In the early stages of both conditions damage can occur gradually and not cause noticeable symptoms until it's too late.

Written by Lynda Wharton BA, ND, D.Ac, MINZRA