Why we all need glasses as we age

Changes in your eyesight can creep up on you. One day everything might be fine – perhaps your phone screen seems to be getting smaller, and your arms might be getting shorter – but nothing to worry about.

And then, you might be enjoying an evening in a dimly lit restaurant with a group of friends and suddenly the menu seems incredibly hard to read. And it’s not just you. Take a look around the table and realise that everyone is squinting at the menu and/or holding it at arms’ length.

Yes, it happens to all of us, usually sometime in our 40s, as our eyesight seems to deteriorate. Indeed, there is nothing more satisfying than watching the Academy Awards and seeing your favourite movie star resort to their glasses while reading the teleprompter. It seems not all parts of ageing can be solved with cosmetic surgery.

This condition, called presbyopia, is a gradual, age-related loss of the eyes’ ability to focus actively on nearby objects. Simply put, your lens inside your eye is not as flexible as it once was. Colloquially, it’s when your arms seem to get shorter.

Optometry Australia’s resident optometrist, Luke Arundel says that presbyopia is extremely common – “because pretty much everyone over 40 has it”.

“It’s a misunderstood, very prevalent and very important condition,” he says. It’s also why prescription glasses are a big business for the over 40s.

Presbyopia is a Greek word meaning ‘old eye’ and is a progressive condition. “To some extent, presbyopia starts the day we are born,” says Arundel. “We are slowly getting changes in the lens, inside our eyes. It’s just around that 40 to 45 window when it’s actually starting to become noticeable or having a functional effect on us.”

And, while it seems that there can be a variation in ages at which the condition becomes noticeable, Arundel says that’s more to do with your lifestyle.

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Do you tend to squint to try and read labels?

“Sometimes it is a bit related to what you are doing with your eyes,” he says. “If you are in an occupation where you are very much near-based, looking at things up close all day, you will notice it earlier than if you are a gardener, or something that is more distance-based.

“The condition is changing at the same rate, it’s just that it’s more noticeable for you, depending on what visual tasks you are doing day to day.”

Arundel also says that he notices that men often ignore the condition for longer than women. “I think they just hope it goes away,” he says, laughing.

Other factors also can play a part in the early onset of presbyopia, including if you have spent more time outdoors or been (or are) a smoker.

Arundel agrees that the almost ubiquitous use of smartphones by people of all ages has added to the awareness of presbyopia. Trying to read a small screen is a particular challenge for the over 40s (even if you have changed the settings to the largest-sized font). In previous decades, you might have got away with the condition for longer.

“For us from a technical point of view, or from the vision science point of view, it comes down to working distance… how close you hold something,” he says. “And the reality is we hold our phones at about 30cm. The closer you hold it, the more you need help.

“With the onset of presbyopia, the more people hold things further away because they are unable to focus on things up close and that lens is unable to change its shape to let them change focus on things up close and that’s where it does become harder with the mobile phones.

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Using reading glasses is a simple solution to presbyopia

The most common solution to the condition is what are commonly called ‘reading’ glasses and Arundel is quick to point out that glasses will not hurt your eyes. It is not possible to treat presbyopia by surgery.

“One of the really common misconceptions is that if you get glasses, it will make your eyes worse,” says Arundel. “The reality is that your eyes change regardless and getting glasses is not going to make your eyes better, it’s not going to make them worse; it’s just going to make you see clearly.”

Glasses should have a prescription calculated for the distance at which you do your close tasks. This generally makes near objects clear but distant objects blurry. Sadly, this also means that if you have a pair of spectacles just for reading, you will not be able to watch television while wearing them.

You can also get bifocals, which are special lenses that have a prescription for distance vision in the top half of the lens and the prescription for near vision (reading) in the lower half. Another form of glasses is 'look-overs' (half-glasses). Other options include the use of trifocals, progressive lenses and some special contact lens prescriptions.

Optometry Australia recommends having your eyes examined every two to three years to review your prescription and your general eye health. If you experience vision problems within two or three years of your previous examination, you should make a review appointment with your optometrist.

Have you had to start wearing reading glasses? Tell us your story.

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