Need for Reading Glasses (Presbyopia)

Presbyopia is a universal focusing problem developing in most people around 45 years of age. When eyes are young, the gel inside the internal natural lens is soft so it can change shape to allow people to focus on things at various distances. But as the eye ages, the gel hardens and the lens enlarges and loses its ability to change shape to focus on near objects. People with natural 20/20 distance vision will likely need reading glasses when presbyopia develops.

Proven correction procedures are not currently available to correct presbyopia directly. Even if you achieve excellent vision through surgery, reading glasses are usually necessary beyond 45 years of age. However, new types of surgery to correct presbyopia are being investigated and may be available at our Centres in the future.

One surgical method that has been used to compensate for the effects of presbyopia is monovision. Monovision can be achieved through corrective lenses or through refractive surgery. If a person has less than two diopters of nearsightedness (vision of 20/100 or better), one eye can be surgically corrected to provide good distance vision, and the other eye can be left uncorrected for near vision. People with greater amounts of nearsightedness may have one eye corrected for distance vision, and the other eye undercorrected to provide better close vision. If this option seems desirable, people may wish to consider trying to achieve the similar effect with contact lenses prior to surgery, to determine its suitability for their individual needs and their ability to adapt to this situation.

The chief advantage of monovision is the freedom it provides from reading glasses. Monovision makes it possible to repeatedly change the range of focus, without having to constantly remove or add corrective lenses. This can be particularly useful for people who change their focus frequently—particularly teachers, public speakers, salespersons, and people involved in the performing arts.

As with any good thing, monovision comes with some drawbacks. People with monovision may have decreased depth perception without corrective lenses . They may also notice blurred vision in the "near" eye when glancing in the side mirror of their cars or when the vision in the "distance" eye is blocked by an object. Some people with monovision elect to wear corrective lenses for activities such as driving or prolonged reading so that both eyes are then in focus.