Successful Aging and Your Vision

Written by Roger Mummert

Is it just me or do I need to extend my arm to rad the time? If reading has become a blur for you too, take comfort in that it happens to all of us.

For Donna Sinetar of Woodbury, NY, the signs of maturity came in threes.  First, was her 29th high-school reunion, then her 40th birthday.  The third sign was most unexpected.  Whe she read to her first-grade twins, she found the words getting fuzzier and fuzzier. 

Signs of presbyopia include headaches when reading, fuzzy letters and difficulty reading in low-light situations.
Nearly two-thirds of all eyewear prescriptions are written for presbyopia.
By 50 or 52, most everyone is affected.
Bifocals or reading glasses are the least expensive solution.
Progressive lenses offer the most natural vision solution.

Sinetar was experiencing presbyopia, the loss of ability to focus on close objects.

For most people, presbyopia is a discovery, accompanied by the lament, "I think I need bifocals." Presbyopia usually occurs in the early 40s and claims virtually everyone by age 50.

In the past, the options for correction were limited to reading glasses, bifocals and trifocals. Today, you can choose trifocals or progressive lenses, a technology that provides clear vision at every distance range. Another high-tech option, bifocal contact lenses, also offers full-range vision.

In the case of Sinetar, who had never worn glasses or contacts, the solution was simple: stylish, teal, half-eye glasses that she says make an "amazing" difference in her bedtime recounting of Charlotte's Web.

Why is That Menu Blurry?
Some people become frightened when their vision seems to change so dramatically over-night. But presbyopia is a progressive condition that begins the moment we are born. The changes are so subtle that we don't usually become aware of them until middle age.

To understand presbyopia, it is helpful to know exactly how the eye focuses. Without our awareness, our eyes automatically make the necessary adjustment to focus on objects at different distances. This process, called accommodation, is involuntary and occurs in a fraction of a second.

Think of a camera, says David Higgins, an optometrist in Kittery, Maine. When the focus mechanism is not activated, the camera is naturally focused for great distance. But to take a picture of something up close, you have to change the lens' focal length by moving it.

"The brain triggers the same kind of mechanical change in the eye when we change our focus from far to near," says Higgins. "It sends a neurological command to a ring of muscle (ciliary muscle) behind the iris. This muscle is connected to the lens by tiny ligaments. When it receives the brain's message, the muscle contracts, which in turn loosens the ligaments' tension on the lens. This frees the lens, which is elastic, to bulge out and become thicker. This adds power to the eye and enables us to focus on a near object."

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Scientists agree that with age the lens of the eye naturally gets larger, thicker and less elastic. But they don't see eye-to-eye on what happens to our accommodation reflex, our ability to focus on images at varying distances.

Some say it diminishes because the lens is less flexible and cannot change its shape as easily. Others believe the ciliary muscle weakens and loses its tone. Or it may be a combination of these factors.

One thing is certain: Everyone will become presbyopic. It's not always an easy adjustment.

"We're a very youth-oriented society, and anything that suggests that time is catching up is a little discouraging," says Dr. Melvin Freeman, an ophthalmologist in Seattle.

Because we live in the Information Age and rely heavily on computers, television and printed materials, we're intensely concerned about our mid-life visual deficiencies. "But these are exciting times for presbyopes because so many options are available," says Freeman.

There are at least 75 alternatives for correcting the problem, so your best bet is an eye-care professional who is knowledgeable about all the various solutions.

Off-the-rack glasses are not always a bargain. Most people need a different prescription for each eye, but both lenses are the same in store-bought glasses. Their optical center may not correspond to the distance between your eyes. And they don't correct for astigmatism, a common vision problem.

According to the American Optometric Association, blurred vision cannot always be traced to presbyopia; it could signal a more serious eye-health problem. So it's best to get an examination to rule out other causes.

Presbyopia is progressive and your prescription will likely change over time, so eye doctors recommend a checkup every year or two after 40.

There is something to look forward to: At about age 65 the process levels off and your vision probably won't change much after that.

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