Every day I hear patients say their up-close vision is starting to get worse. They tell me they need more light to read or need to hold things farther away to focus. Many of these patients have never had vision problems that required glasses or contact lenses, so this can seem very troubling.
This is a natural thing called presbyopia, and happens to almost every single person in their 40’s. The reason is simple, although aggravating, and easy to take care of with corrective lenses. The cause of this inability to focus is due to the maturing of the crystalline lens inside the eye.
Normally, we are born with a clear crystalline lens that tends to harden and thicken over time. This crystalline lens is the part of the eye that becomes a cataract later in life that often needs surgical correction. This lens is attached to an involuntary ciliary muscle in the eye by thousands of tiny elastic bands called zonules. Whenever we look at something up close, the ciliary muscle goes into action to change the tension on the elastic zonules, thus changing shape of the crystalline lens allowing us to automatically focus on the close target.
Over time, usually in the 40’s, the ciliary muscle gradually becomes unable to change the shape of the crystalline lens due to its natural hardening and thickening, and this is when patients report needing longer arms to read. Reading glasses, bifocals and/or progressive no-lines can easily fix this problem. Contact lenses can work in some cases but usually not as well as glasses.
If you are starting to notice problems with reading, be sure to tell your optometrist.