It starts with the pullback.

A book, a menu, or a phone held at arm’s length.

Add a squint and some eye fatigue.

Then come enlarged fonts. 

It’s official…

You can no longer see things up close, and presbyopia is to blame.

From the Greek meaning ‘old man’, presbyopia takes your crystal clear vision and smears a veil of vaseline on it. 

 
The gradual loss of focus of things up close is universal, and typically starts when you’re 40ish. It happened to Monica and it will happen to you.

Here’s why.

Behind your cornea and pupil is the lens of your eye. As light rays enter, the lens which is loose and flexy focuses the rays on the retina which lines the back of the eye. 

As the lens changes shape, it allows you to see things at various distances. Over time the lens gradually stiffens like a dry sponge, and has a hard time changing shape.

That’s when pictures start to look like old blurry polaroids, and by age 65, nearly all lens flexibility is lost. (Presbyopia is different from farsightedness which is when light rays focus incorrectly due to a misshapen eyeball, cornea or lens.)

Presbyopia is not a disease and has no cure, but there are lots of tools to improve close vision. Reading glasses are the obvious choice. 

I assumed reading glasses worked by magnifying your subject, and that the power numbers, +1, +1.5, +2.5, etc. referred to the amount of magnification. But the number doesn’t actually reflect magnification, it’s a unit of measurement called a diopter. 

Magnification is a measure of enlargement. Diopter is the strength of a lens measured at the length of a meter (about 39”). 

+1 power reading glasses translates into clear vision at a meter distance. As lenses get stronger, the number translates to the inverse of the focal length. So 2+ power is clear vision at ½ a meter, not 2 meters. 3+ power is clear vision at ⅓ a meter. 

Presbyopia crept up on me around age 50 when threading a needle became as impossible as putting toothpaste back into its tube.

After a couple of weeks putting my cute Eyebob readers on and off, and on and off, and on and off to read, and toying with humungo fonts on my phone like Monica, I wanted to find a non-eyeglass option for reading. My optometrist suggested I try monovision.

Monovision or blended vision is a simple concept: one eye is corrected for distance vision, and the other eye for nearsighted vision, allowing you to see at any distance. It can be done with contact lenses but it’s also possible with surgery.

There are also bi-focal and multifocal contact lenses that have 2 or more lens strengths to correct focus at different distances. If you can wear contacts comfortably they can replace bifocal and progressive glasses.

If you want to go the no glasses, no lenses, no surgery route, you may be able to train your eyes to delay the onset or improve presbyopia. There are lots of apps to strengthen eye muscles, and decrease strain and relaxation, including GlassesOff which is backed by science. This New York Times reporter wrote about his positive experience with GlassesOff. 

Eye health is not to be tinkered with so I’m not suggesting you run out and get mismatched contacts, but monovision works for me and I love not pulling out glasses to look at prices, menus and most of all my phone. 

I’m sold on monovision until eye drops that temporarily remedy presbyopia symptoms become available. It exists! The medicated drops make the pupils smaller, which increases depth of focus. Allergen Eye Care submitted the drops for FDA approval which may happen by the end of 2021. 👀