Death. Taxes. Presbyopia. They’re coming for us all. If you’re not familiar with the third eventuality on that list, you must not have turned 40 yet.
But just wait, it’s happening.
From the Greek terms presby, meaning “old,” and ops, meaning “sight,” this obscure dirty word basically translates to “old vision.” (How cruel is that?). Physiologically, it refers to a gradual hardening of the eye’s internal crystalline lens. This change is irreversible and progressive through middle age and beyond, and it results in a gradual loss of the ability to focus on things up close.
The universal symbol that a person has succumbed to presbyopia is a pair of reading glasses on his or her person, which, when not actually being used, can often be found in a shirt pocket, on top of one’s head, on the tip of one’s nose, or clipped onto a shirt collar like a necktie. And although these “cheaters” are readily available, inexpensive and generally effective, they are often an undesirable accessory for the 40-and-up set.
Thankfully, there is an alternative to reading glasses that can work very well for many patients. Contact lenses are now available in more presbyopic designs than ever before. All of the major soft contact lens manufacturers offer multifocal lens designs, which can provide good vision at both distance and near while allowing one to avoid the dreaded reading glasses. These contact lens designs are now available in both monthly and daily disposable modalities, which can suit a variety of lifestyles and wear schedules, from only occasional wear to seven days a week.
Soft contact lens materials have never been more comfortable too, allowing people with dry eyes or ocular allergies to tolerate lens wear where they may not have previously. If you have astigmatism, there are even some multifocal contact lens designs that can work for you too. Where there’s a will, there’s a lens!
What if multifocal contact lenses just don’t work well for you? Fear not. There is another presbyopia-correcting contact lens approach that may be successful for you. Monovision is a technique that refers to intentionally fitting one eye’s contact lens to focus at distance and the other eye’s lens to focus at near. The two eyes then work together to achieve binocular focus at all distances, and reading glasses are not needed. Virtually every time I discuss this potential option with a patient, she is skeptical that it will work or that she will tolerate it. But it is amazing how frequently it works well; often its success simply depends on how it is presented. Just another example of how incredibly adaptive our human brains and visual systems are.
So if you (like me) have hit the dreaded Big-Four-Oh and have been feeling the effects of presbyopia on your near vision, consider giving a multifocal or monovision contact lens fitting a try. With some patience, motivation and the expertise of your optometrist, you may be able to shed those annoying “cheaters” after all. (The death and taxes part, you’re on your own.)