Presbyopia Treatment
To avoid eyestrain, people with untreated presbyopia tend to hold books, magazines, newspapers, and menus at arm’s length in order to focus properly. Trying to performing tasks at close range can sometimes cause headaches, eye strain or fatigue in individuals who have developed this condition.
Causes of Presbyopia
During our youth, the lens of our eye and the muscles that control it are flexible and soft, allowing us to focus on close objects and shift focus from close to distant objects without difficulty. As the eye ages however, both the lens and the muscle fibers begin to harden, making near vision a greater challenge.
Presbyopia is a natural result of the aging process and not much can be done to prevent it. Its onset has nothing to do with whether you already have another vision impairment such as nearsightedness, farsightedness or astigmatism. Everyone will notice some degree of loss of near vision focusing power as they age, although for some it will be more significant than others.
Symptoms and Signs of Presbyopia
Presbyopia is characterized by:
- Difficulty focusing on small print
- Blurred near vision
- Experiencing eye strain, fatigue or headaches when doing close work or reading
- Needing to hold reading material or small objects at a distance to focus properly
- Requiring brighter lighting when focusing on near objects
Presbyopia can be diagnosed in a comprehensive eye exam.
Treatment for Presbyopia at Neuro Visual Performance
There are a number of options available for treating presbyopia including corrective eyewear, contact lenses or surgery.
Eyeglasses
Reading glasses or “readers” are basically magnifying glasses that are worn when reading or doing close work that allow you focus on close objects.
Eyeglasses with bifocal or multifocal lenses such as progressive addition lenses or PALs are a common solution for those with presbyopia that also have refractive error (nearsightedness, farsightedness or astigmatism). Bifocals have lenses with two lens prescriptions; one area (usually the upper portion) for distance vision and the second area for near vision. Progressive addition lenses or PALs similarly provide lens power for both near and distance vision but rather than being divided into two hemispheres, they are made with a gradual transition of lens powers for viewing at different distances. Many individuals prefer PALs because unlike bifocals, they do not have a visible division line on the lens.
Bifocal and Multifocal Contact Lenses
- We do not recommend multifocal contact lenses or monovision lenses for full time wear. This is because they negatively impact how the eyes work together and can lead to dizziness, headaches, migraines, fatigue, and/or difficulty concentrating.
For individuals that prefer contact lenses to glasses, bifocal and multifocal lenses are also available in contact lenses in both soft and Rigid Gas Permeable (RGP) varieties.
Multifocal contact lenses give you added freedom over glasses and they allow you to be able to view any direction – up, down and to the sides – with similar vision. People wearing progressive lenses in glasses on the other hand have to look over their glasses if they want to view upwards or into the distance.
Another option for those who prefer contact lenses is monovision. Monovision splits your distance and near vision between your eyes, using your dominant eye for distance vision and your non-dominant eye for near vision. Typically you will use single vision lenses in each eye however sometimes the dominant eye will use a single vision lens while a multifocal lens will be used in the other eye for intermediate and near vision. This is called modified monovision. A test will be performed by an eye doctor to determine which type of lens is best suited for each eye and optimal vision.
Surgery
While we commonly recommend refractive surgery, we do not recommend the approaches that use monovision, multifocal lenses, or accommodating IOLs for the same reasons as the multifocal contact lenses. This is because the human brain is not made to have multiple depths in focus at the same time, nor is it made to have each eye focused at a different distance. This can lead to headaches/migraines, dizziness, increase fall risk, balance problems, issues driving at night and more.
There are surgical procedures also available for treatment of presbyopia including monovision LASIK eye surgery, conductive keratoplasty (CK), corneal inlays or onlays or a refractive lens exchange (RLE) which replaces the hardened lens in the eye with an intraocular lens (IOL) similar to cataract surgery.
Since it affects so much of the older population, much research and development is going into creating more and better options for presbyopes. Speak to your eye doctor about the options that will work best for you.
Tennis/Pickleball
The speed and accuracy of your return, or your ability to read the spin of the ball, all depend on how your eyes and brain work together. Pros have known this for years and spend lots of time working on their depth perception and tracking. Vision therapy can take your tennis or pickleball to the next level.
Tennis/Pickleball
The speed and accuracy of your return, or your ability to read the spin of the ball, all depend on how your eyes and brain work together. Pros have known this for years and spend lots of time working on their depth perception and tracking. Vision therapy can take your tennis or pickleball to the next level.
Golf
Do you put it too short or too long? You’re using your depth perception to gauge how far the hole is and how hard to hit the ball. Many people have to routinely ‘look past the hole’ or aim for the front of the cup in order to be more accurate. This is usually because they are not judging the distance accurately to begin with. Another common pain point in golf is not being able to see your ball after you’ve hit it. Problems with how the eyes track and work together can create problems tracking your golf ball, but fortunately, these are easily remedied.
Reading and Hobbies
Getting tired when you read? Not able to read for as long or as quickly as you used to? It’s common for eye tracking or eye teaming (binocular problems) to cause problems with reading. This can show up as fatigue, falling asleep, headaches, strain, and reduced comprehension. Many people end up slowly avoiding reading, knitting, woodworking, or other hobbies that require sustained focus.
Computer Screens
Computers can be a really helpful tool for emails, research, and all sorts of amazing things. However, problems with how the eyes work together, or how glasses are set up, can create headaches, light sensitivity, difficulty focusing, and more with prolonged screen time.
Related Conditions
If you have been diagnosed with any of the following conditions, it may increase your likelihood of having problems with how your eyes work together:
- Vestibular neuritis
- Meniere’s
- Stroke
- Concussion
- Headaches
Our Approach
We go beyond the routine eye health testing to investigate how your eyes and brain work together. This includes eye tracking, binocular function (eye-teaming), visual-vestibular integration (eye and inner-ear), and more. We have a variety of tools we can use to get the improvement you’re looking for.
Specialized Glasses
We are able to design specialized prescriptions (Ergopathics™) that do more than allow you to see clearly. Ergopathics™ prescriptions can improve how efficiently your eyes and brain work together. This can significantly improve driving, balance, reading, and more.
Vision Therapy (Opto-mization Training)
You may also be a candidate for vision therapy. Our Opto-mization Training Vision Therapy recalibrates how your eyes and brain work together and enhances your performance.
If you’re struggling with driving at night, balance, dizziness, depth perception, reading, or just feel like your vision is affecting your daily life, please book an assessment.