Presbyopia is the gradual loss of the eye's ability to focus up close. It is not a disease: it is part of the normal ageing of the eye and affects everyone, usually from 40 to 45. This guide explains what happens in the eye, how to recognise it and which solutions exist.
Orange dot: where the rays from a near object meet. Orange line: the retina.
Key points
- Presbyopia affects near vision: reading, phone, sewing, labels.
- It is caused by the gradual stiffening of the crystalline lens, the eye's natural lens.
- It starts around 40-45 and increases until about 60-65.
- Glasses, lenses, laser or implant: the solution is chosen with the ophthalmologist.
What happens in the eye
To see clearly up close, the young eye accommodates: the crystalline lens, a flexible lens behind the iris, becomes more curved under the action of a small muscle and increases its power. With age, the lens loses its flexibility. It can no longer curve enough: the image of a near object forms behind the retina and becomes blurred.
This process actually begins in childhood, but it only becomes bothersome when the remaining accommodation is no longer enough to read at the usual distance, around 40-45.
A gradual progression
Presbyopia increases in stages: first you hold the text further away, then a near correction becomes necessary and needs strengthening roughly every two to three years. It stabilises around 60-65. It is estimated to affect more than a billion people worldwide.
Good to know
Having arms that are "too short" to read the menu in a restaurant is often the first sign of presbyopia.
Presbyopia, myopia, hyperopia
Presbyopia adds to other vision defects. Long-sighted (hyperopic) people often notice it earlier. Short-sighted (myopic) people notice it later, because they can read by taking off their glasses. Presbyopia does not cancel myopia: the two can coexist and be corrected together. See Presbyopia and myopia: correcting both at once?
How can it be corrected?
Glasses (reading or progressive) and contact lenses compensate for it. For some people, surgery can reduce dependence on reading glasses: laser on the cornea (Presby-LASIK, Presby-PRK) or replacement of the crystalline lens with an implant. The options are detailed in step 3 of the guide.
Further reading
Frequently asked questions
Yes. Presbyopia is linked to the natural ageing of the crystalline lens and affects everyone, at a variable age and to a variable degree.
No, no exercise or diet prevents it. It can, however, be corrected in several ways.
No. Presbyopia progresses with age whether or not you wear glasses. Not correcting it only causes eye strain and headaches.
No. Hyperopia is an optical defect of the eye present from birth. Presbyopia is related to age. The two can add up.
This general information does not replace a consultation: only an eye examination can establish a diagnosis and discuss a suitable treatment.