Over 40 Vision - Options for Presbyopia - Hoopes Vision

Over 40 Vision – Options for Presbyopia


At some point in our lives, we start holding newspapers, menus and cell phones at arm’s length in an effort to see small print more clearly. You may begin to notice changes in your early 40’s or you may not be troubled until your early 60’s, but everyone begins to lose the ability to see clearly at close distances. This naturally occurring loss of near vision is called Presbyopia, and it is a result of the eye’s lens becoming more rigid. Patients with Presbyopia should consider monovision or refractive lens exchange as a solution when over 40 vision takes over. 

While not everyone will experience the same symptoms, here are some of the most common age-related vision changes affecting many people.

  • Need for more light. As you age, you need more light to see as well as you used to. Brighter lights in your work area or next to your reading chair will help make reading and other close-up tasks easier.
  • Difficulty reading and doing close work. Printed materials can become less clear, in part, because the lens in your eye becomes less flexible over time. This makes it harder for your eyes to focus on near objects than when you were younger
  • Problems with glare. When driving, you may notice additional glare from headlights at night or sun reflecting off windshields or pavement during the day. Changes your eyes’ lenses causes light entering the eye to be scattered rather than focused precisely on the retina. This creates more glare.
  • Changes in color perception. The normally clear lens located inside your eye may start to discolor. This makes it harder to see and distinguish between certain color shades.
  • Reduced tear production. With age, the tear glands in your eyes will produce fewer tears. This is particularly true for women experiencing hormone changes. As a result, your eyes may feel dry and irritated. Having an adequate amount of tears is essential for keeping your eyes healthy and maintaining clear sight.


Many people resort to reading glasses, a common solution for Presbyopia, but they can be a hassle. People who rely on them get frustrated for many reasons. They are constantly misplacing them or must take them on and off while working throughout the day. There are many who hate the look of reading glasses and avoid them for cosmetic reasons. Outdoor enthusiasts find glasses a nuisance and make it difficult for them to enjoy an active lifestyle.  Monovision and Refractive Lens Exchange (RLE) are good options that can help you achieve a lifestyle where you are less dependent on glasses and readers.


Monovision or Blended Vision for Presbyopia

Monovision or blended vision is a popular treatment option for patients with presbyopia. We all have a dominant eye just like we have a dominant hand (although ocular dominance and hand dominance don’t correspond). With monovision, the dominant eye is usually corrected for full-distance, and the non-dominant eye is left nearsighted to enable it to see up close. The brain will adjust to this new way of seeing, which can take a few weeks. Over time, most patients become comfortable with monovision and don’t even realize the difference. Monovision works especially well with patients who have been doing monovision with their contact lenses because they have already adjusted to that way of seeing. It can also work well for those who have never needed glasses for distance vision but have noticed a loss of reading vision.  


Refractive Lens Exchange (RLE) for Presbyopia

Refractive Lens Exchange (RLE) can also be an effective solution for Presbyopia, while also treating pre-existing nearsightedness or farsightedness and preventing cataracts. In the RLE procedure, the eye’s natural lens is replaced with an artificial lens implant (IOL), customized to fit the measurements and vision needs of each patient. RLE can address a wide range of nearsightedness and farsightedness and may be an option for people who have been told they are not candidates for LASIK or PRK. Patients who have undergone RLE have a 96% satisfaction rate, with more than 80% reporting they have completely eliminated glasses from their lives1. With the advancement of technology, patients now have many options to choose from. Intraocular lens implants (IOLs), including multifocal, depth of focus and accommodating IOLs treat Presbyopia, while toric lenses address astigmatism. Patients seeking a permanent solution to greatly reduce or eliminate their need for corrective eyewear, including patients who lead active and busy lives, may want to consider RLE as an option. If you would like to learn more about RLE, please schedule an appointment with one of our experienced eye surgeons.

1. Journal of Ophthalmology Volume 2014 (2014), Article ID 458296, http://dx.doi.org/10.1155/2014/458296

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