Presbyopia Treatment

What is Presbyopia?

As people approach middle age—usually beginning in their 40s—they often experience blurry vision at near tasks, such as when reading or working on the computer. This is called presbyopia and it happens to everyone at some point in life, even those who have never experienced vision problems before. Currently, an estimated 90 million people in the US either have presbyopia or will develop it by 2014.


As people develop presbyopia, they discover that they need to hold books, magazines, newspapers, menus and other reading materials at arm's length in order to focus properly. When they perform near work, such as sewing or handwriting, they may have headaches or eye strain.

Causes of Presbyopia

Presbyopia is believed to be caused by an age-related process. It is different from astigmatism, nearsightedness, and farsightedness, which are related to the shape of the eyeball and caused by genetic factors, disease or trauma. Presbyopia is generally believed to stem from a gradual loss of flexibility in the natural lens inside your eye.

Age-related changes occur within the proteins in the lens of the eye, making it harder and less elastic with age. Similarly, such changes take place in the muscle fibers surrounding the lens, reducing elasticity and making it harder for the eye to focus up close.

Treatment Options


EyeGlasses |  New York Vision GroupEyeglasses with bifocal or progressive addition lenses (PALs) are the most common correction for presbyopia. Bifocal means two points of focus: the main part of the spectacle lens contains a prescription for nearsightedness or farsightedness, while the lower portion of the lens holds the stronger near prescription for close work. Progressive addition lenses (PALs) are similar to bifocal lenses but offer a more gradual visual transition between the two prescriptions, with no visible lines between them.

Reading glasses are another choice. Unlike bifocals and PALs, which people generally wear all day, reading glasses are typically worn just during close work. If you wear contact lenses, we can prescribe reading glasses that can be worn to wear while your contacts are in your eyes.

Multifocal Contact Lenses

There are also multifocal contact lenses for people suffering from presbyopia; these lenses can be obtained in either gas permeable or soft lens materials. Another type of contact lens correction for presbyopia is monovision, in which one eye wears a distance prescription, and the other wears a prescription for near vision. Our skilled optometrists can help determine if this is an option for you. Over time if patients are happy with the freedom of monovision but tired of using contact lenses, the same effect can be achieved through monovision LASIK. You should also note that the human lens continues to change as you grow older. Consequently, your presbyopic prescription will increase over time as well and it is likely that you may need a stronger correction for near work as time goes by.


New surgical options to treat presbyopia are being researched and are already available in many countries, including the United States. One example is presbyopia-correcting multifocal lenses, such as the ReSTOR, Tecnis, and Tecnis Symfony implants. These implant options enable some people undergoing cataract surgery to achieve clear vision over a range of distances. Also, an elective procedure known as refractive lens exchange may enable patients to replace their eyes’ natural lens with an artificial one using presbyopia-correcting lenses. Dr. Koster and NY Vision Group are at the forefront of utilizing these new technologies and can help patients determine if they are good candidates for such treatments.