Presbyopia is age-related failing near vision that usually occurs around the age of 40. Even those that have never had a vision problem before can experience poor vision when reading or looking at objects close-up.

Causes of Presbyopia

While nearsightedness, farsightedness and astigmatism are caused by a misshape of the eye, presbyopia is a loss of flexibility of the lens inside the eye. The lens hardens and loses elasticity making it difficult to focus on near objects.

Signs and Symptoms

  • Blurred near vision
  • Clearer vision when holding objects further away
  • Headaches with near vision focusing
  • Eyestrain with near vision focusing

Treatment Options

Presbyopia can be corrected with bifocals, progressive addition lenses (PALs), reading glasses, multifocal contact lenses, conductive keratoplasty (CK) surgery and, for those with far or nearsightedness and/or astigmatism, Lasik surgery can help treat multiple conditions.

Presbyopia is a gradual and continuing condition and your presbyopia prescription will need to be increased as you age.


Bifocal lens provide two points of focus. The upper main portion of the lens contains a prescription for near or farsightedness and/or astigmatism and the lower portion has the stronger near vision prescription.

Progressive Addition Lenses (PAL)

PAL prescription eyeglasses have a gradual transition of multifocal lens powers for vision at various distances. PAL glasses do not have the visible line of the bifocal lens.

Reading Glasses

Both bifocals and progressive addition lenses are worn throughout the day while reading glasses are used just for close-up work for those with otherwise normal vision or those who wear contact lenses. Reading glasses can be prescription lenses or over-the-counter readers, which can be purchased at most retail stores.

Multifocal Contact Lenses

Multifocal contact lenses are lenses with more than one power of vision and are prescribed as either alternating vision or simultaneous vision.

  • Alternating lenses are designed similar to bifocal eyeglasses with the main portion correcting near or far vision and the lower portion correcting the presbyopia.
  • Simultaneous lenses combine both near and far correcting abilities throughout the lens. The eye adjusts to select the power for correcting multi-distances.

Multifocal lenses are available in gas permeable or soft lens materials.

Monovision Contact Lenses

With monovision lenses the prescription for one eye is for distance and the other prescription is for near vision. The brain learns to favor one eye or the other for either far or near vision.

Conductive Keratoplasty (CK)

If your vision is normal other than the presbyopia, conductive keratoplasty is a good alternative to corrective lenses. CK uses radio waves to adjust the contour of the cornea by shrinking the collagen. CK is a less invasive alternative to Lasik surgery.

LASIK Surgery

If you are also far or nearsighted and/or have astigmatism, Lasik surgery can be done to improve those conditions as well as your presbyopia. In a recent study at the Mercy Center for Corrective Eye Surgery in McHenry Illinois, presbyopia was corrected in 92 percent of patients that underwent the surgery and improvement lasted beyond two years.

Refractive Lens Exchange (RLE)  

In extreme cases, refractive lens exchange is a consideration. RLE is a relatively aggressive surgical procedure where the hardened lens is removed and replaced with an intraocular lens.  It is unusually not performed in persons younger than 55 years old.

If you are experiencing problems with near vision or have questions or concerns about your vision correction options, call our office at 425.822.8253 to schedule an appointment.