Presbyopia is the loss of clear close-up vision that happens when your eye’s lens becomes less flexible. Healthcare providers consider it a natural part of aging that usually begins in your 40s. Symptoms include blurry close-up vision, headaches and eye strain. Eyeglasses, contacts and surgery are all options that can help you see more clearly.
Presbyopia is the medical term for your eye losing the ability to change its focus. This affects how well you can see close-up objects. It occurs as your eye’s natural lens grows less flexible with aging.
Presbyopia generally starts to develop around age 40 and gets worse until your mid-60s. You’ll notice that reading or other close-up tasks are harder than they used to be. You might need to hold your book or phone out at arm’s length to see the words clearly. You may also have symptoms like headaches or sore, tired eyes.
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Presbyopia is very common. Globally, about 1.8 billion people had presbyopia in 2015. Researchers estimate this number will rise to 2.1 billion by 2030.
The main signs and symptoms of presbyopia include:
Age-related changes to your eyes cause presbyopia. During the first few decades of life, your eye’s lens is soft and flexible. It easily changes its shape when you shift your vision from something far away to something close-up. This ability (accommodation) allows light to land on your retina so you can see objects clearly.
As you get older, your lens grows less flexible and has trouble focusing light as it should. This leads to symptoms of presbyopia that begin in your 40s and level off in your mid-60s.
Think of your eye like a camera. The lens in a camera can autofocus on objects that are near or far. Your lens works together with your cornea (your eye’s clear, outer “window”) to do this job and help give you clear vision. To understand presbyopia, it helps to know a bit about this process:
Your lens continues to grow as your eye ages. New layers of cells form (picture an onion). This process thickens your lens and makes it less flexible. As a result, light can’t land properly on your retina, and your close-up vision grows blurry.
The main risk factor is being older than 40. However, certain medications and medical conditions can cause presbyopia to appear in people younger than 40. This is called premature presbyopia.
Risk factors for premature presbyopia include:
An important part of this exam is a refraction assessment to measure how well you see objects at specific distances. This assessment tells your provider whether you have presbyopia and/or astigmatism and also whether you’re nearsighted or farsighted.
Depending on your health, lifestyle and preferences, your eye care specialist may suggest any of the following methods to correct presbyopia:
Whether or not you’ve been wearing eyeglasses for other vision issues, now may be time to switch to a more comfortable type for your changing eyes. Options include:
There are a variety of contact lenses that can help you see better with presbyopia. Choose the contacts that help you see most comfortably:
Discuss your eye health, family history and lifestyle with your provider before you decide if surgery is right for you. People who only wear readers may find surgery has more risks than rewards for them.
The following three laser procedures correct presbyopia by using monovision (one eye corrected for distance, the other corrected for near vision):
Eye drops are a good option for some people with presbyopia. Pilocarpine eye drops (Vuity®) make your pupil smaller to improve your depth of focus and give you clearer close-up vision. These are the first eye drops the U.S. Food and Drug Administration (FDA) has approved for presbyopia. Red eye and headaches are the most common side effects, and you may also have trouble with night vision.
Some research links the use of these eye drops with retinal detachment. If you’ve had this condition or have risk factors for it, talk to your provider about your risks and if this is a good treatment option for you.
You can’t prevent presbyopia since it’s a part of the natural aging process. But you can take steps to protect your eye health. Tips include:
Talk to an eye care specialist about your symptoms and their impact on your daily life. They’ll help you find the most suitable corrective methods. You may need to try several different methods before finding one that works well for your needs and lifestyle.
See an eye care specialist if you have symptoms of presbyopia or other trouble with your vision. Blurred vision can be a sign of many issues. So, it’s important for a specialist to evaluate your eyes and identify the cause.
Even if you don’t have symptoms, you should have your eyes and vision checked regularly. How often you need an eye exam usually depends on your age, eye health and underlying medical conditions. Most adults need an exam every one to two years. Ask an eye care specialist what’s appropriate for you.
Presbyopia and farsightedness (hyperopia) are both refractive errors that cause blurry close-up vision. But they have different underlying causes. Presbyopia occurs when your eye’s lens loses its flexibility. Farsightedness occurs when your eyeball is too short or your cornea is too flat.
Yes, and it’s very common. Nearsightedness (myopia) means your eyes are naturally over-focused, causing clear close-up vision but blurred distance vision. However, if you’re nearsighted and over age 40, you’ll still feel the effects of presbyopia while wearing your glasses or contacts. Your eye care specialist can update your lens prescription to correct for both presbyopia and myopia.
A note from Cleveland Clinic
Presbyopia is a common part of aging, but that doesn’t mean you have to accept its impacts on your daily routine. Talk to an eye care specialist right away if you notice blurred vision or other eye symptoms. Presbyopia isn’t a disease, but it shares symptoms with conditions that are more serious and require immediate treatment. Your provider will get to the bottom of the issue and give you the care you need.
Last reviewed by a Cleveland Clinic medical professional on 07/06/2023.
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