Presbyopia Diagnosis and Treatment

If you are approaching age forty or you are any age above that and you start noticing changes in your vision, this could very well be a natural process taking place, known as presbyopia, which comes with great optical correction options.

Have you noticed that you need to hold your book further away when you read? Are you concerned about needing reading glasses? Presbyopia is a term that describes a natural part of the aging process pertaining to the eyes. When people reach the age of forty or older, the lens inside the eye has more difficulty bending as flexibly as it used to, which is necessary to focus on nearby objects. Thus, people around this age start having a challenging time reading and doing various functions up close as their vision for nearby tasks becomes less clear. If you are around this age, give or take, and you notice changes in your vision, especially up close, please schedule an appointment with your eye doctor. Presbyopia can be diagnosed during a routine eye exam and your eye doctor will discuss with you effective ways to be able to see up close.

Amplify EyeCare Manhattan

Diagnosis

Presbyopia is detected during a routine eye exam. The eye doctor will start by asking you for your medical history and if you have been experiencing any eye symptoms or changes in your vision lately. Your visual acuity will be checked, followed by a full refractive eye exam. During refraction, your vision is checked and the eye doctor determines your optical prescription. The eye doctor might use various instruments and lenses, while asking you if you feel your vision is improving or getting worse with the different options. 

It is common for eye drops to be used which will dilate your eyes for a few hours. This causes light sensitivity and it is recommended that you arrange for someone else to drive you home while your pupils are dilated. The eye doctor gains more access to observe the inside of your eyes when your pupils are dilated and the health of your eyes will also be assessed. Your eye doctor will tell you if you have presbyopia and will discuss treatment methods with you.

Treatment

Treatment

Presbyopia cannot be prevented as it is a biological part of the aging process, but there are wonderful ways to assist people who are experiencing blurry vision at near distances. The possible treatment methods are glasses, contact lenses, refractive surgery, or lens implants. Each option will be discussed more in depth below. Please schedule an eye exam with our eye doctor in New York by calling (212) 752-6930 to figure out what is the best approach for you and your lifestyle.

Treatment

Over-the-Counter Glasses

If you have just been diagnosed with presbyopia and this is the first time that you require glasses then you might have a very basic prescription for reading glasses which you can buy over-the-counter at a pharmacy. Most pharmacies have ready-made reading glasses with prescriptions that range from +1 to +3 diopters, which is the measurement used for power in the glasses. These glasses are low prescription and can be used if you don’t have any other vision problems such as nearsightedness or farsightedness. You can ask your eye doctor if this option is suitable for you and which power glasses will fit your needs. You can also try on the reading glasses in the pharmacy and test which power best suits your visual needs as you practise reading while wearing the glasses. Using trial and error and experimenting with the most comfortable reading distance for you, you can find the best suited reading glasses for you in the store.

Prescription Reading Glasses

If you have other vision issues such as nearsightedness, farsightedness or astigmatism then your eye doctor can prescribe glasses specific for your vision needs that you will only use for reading or at close distances. When you are driving or doing anything that requires vision at an intermediate or far distance then you will take off these glasses as the prescription is only for close up.

Prescription Glasses/ Contact Lenses for Both Near and Far Distances

There are a variety of glasses and contact lenses available which allow for an optical correction at both near and far distances within the same lenses. There are bifocals which have a prescription for distance vision on the top of the lens and then there’s a line that separates that from the bottom of the lens which has a prescription for near vision. 

There are multifocals, also known as progressive lenses, which allow for distance vision when looking through the top of the lens and then there’s no visible separation, but rather a smooth transition to the bottom of the lens which provides clear vision for up close distances. You can’t tell if a person is wearing multifocals as it has the same appearance as a regular lens. Please speak to your eye doctor to find out which option is best for you and your needs.

Monovision

This is a unique approach used with contact lenses in which one eye has a lens that allows for clear vision at a distance, while the other eye has a lens that allows for clear vision up close. This can be a helpful option for some people, but this method isn’t suitable for everyone so please consult with your eye doctor to figure out what is best for you.

Treatment

Refractive Surgery

This method is non-reversible and the patient must be warned prior to surgery that they may still need to use glasses even after going through the procedure. Some people with presbyopia get refractive surgery to achieve monovision. This means that they will undergo surgery to reshape the cornea of one eye in order to see clearly at near distances using this eye while the other eye can see clearly at far distances. There are various refractive surgery options and each comes with its own advantages and disadvantages. Please consult with your eye doctor to find out if you are a qualified candidate for refractive surgery and to figure out the best option for you.

Lens Implants

There is a procedure available in which the biological lens inside the eye can be removed and replaced with an artificial lens called an intraocular lens. There are various types of implants and each come with their own pros and cons. Your eye doctor can figure out with you which intraocular lens best suits your needs and lifestyle. Lens implants can decrease the quality of your near vision so people who go through this procedure may still need to wear reading glasses. Keep in mind, any eye surgery comes with risk of side effects or complications. Depending on the health of your eyes and your overall health, your eye doctor will decide if you qualify for this procedure and will discuss the benefits and risks with you.

Common Questions

Presbyopia is a natural age-related process. Over time, the biological lens inside of the eye loses flexibility and begins to thicken. These changes take place inside the proteins of the lens which make it harder and less elastic. In addition, the changes also take place in the muscle fibres around the lens. When the lens is flexible, it is able to bend in different ways to allow us to be able to see at various distances. When a person experiences presbyopia, it becomes more difficult for the eye to focus up close due to the lack of flexibility in the lens.
There are effective options which help a person with presbyopia be able to read and function when viewing objects up close. There are various types of glasses including simple reading glasses, some prescribed by your eye doctor or low prescriptions could be purchased over-the-counter at the pharmacy. In addition, there are different types of glasses and contact lenses such as bifocals or multifocals which provide an optical prescription for both far and near distances within the same lenses. There are also surgical options such as laser eye surgery or lens implants which are used to correct presbyopia. Please speak to your eye doctor to find the option that best suits your needs.
Myopia occurs when light does not focus on the retina correctly. Myopia is caused by light focusing in front of the retina. The condition of presbyopia, however, is completely different from myopia. The physical change in the eye's lens causes presbyopia, not the way light focuses inside the eye. Presbyopia is the only refractive error that is mostly caused by aging, with most people over 40 reporting some degree of it. Myopia and presbyopia can coexist, even though they are totally separate issues.
Presbyopia Diagnosis and Treatment
Dr. Wernick cartoon

Summary

If you notice any decrease in the quality of vision when viewing nearby objects, especially if you’re around the age of forty or older, please schedule an eye exam by calling (212) 752-6930. Your eye doctor will check for the cause of this change in vision which could likely be due to presbyopia. Presbyopia is a natural age-related condition when the lens inside of the eye becomes less flexible making it harder to focus on objects closeby. Your eye doctor will discuss the best treatment plan for you to help you perform visual functions at a near distance. Patients searching for advanced treatment for presbyopia and alternatives to reading glasses visit our clinic from all over New York, and we are proud to be a leading provider of medical eye care services for patients from New York, Queens, Brooklyn, and Long Island. 

Testimonials


At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.


Cynthia Norton

Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.


Steve Fay

Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


Mary K.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Peter G.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Kinkie F.

I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.


Allen B.
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