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Presbyopia

Presbyopie

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Not a disease but the lens focusing less with the years — it happens to everyone.

Also known as: presbyopia · age-related farsightedness · reading glasses

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This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.

From around the mid-40s the eye’s near focus declines: the lens becomes less elastic and the ciliary muscle tires sooner, making close reading harder. A natural ageing process affecting almost everyone. Reading or progressive glasses are common; alongside, people use vision training, relaxation and eye-related nutrients.

Levers & pathways

studiedLight and distance first

More light directly on the page and a slightly greater reading distance often bring more than the next dioptre. Near focus needs contrast, and contrast comes from light.

traditionalThe break for the eyes

Every twenty minutes look into the distance for twenty seconds. The tired feeling in the evening comes from the ciliary muscle, not from the lens — and it recovers in seconds.

studiedOne pair fits only one distance

Book, screen and workbench lie at different distances. Measuring the distance and stating it before the fitting gives glasses that suit one’s own day.

studiedHave the eye pressure measured at the same time

The appointment for reading glasses falls at exactly the age when glaucoma begins and nothing hurts. Two extra minutes at the same appointment.

studiedIf it gets worse suddenly

Long sight of age comes over years. A change in vision within days or weeks is something else — a derailed blood sugar is one of the most common reasons for it.

infoNumbers and timeframes

The lens loses its flexibility across the whole of life; from about forty to forty-five it no longer suffices for near vision. The near point moves from about ten centimetres at twenty to around twenty-five at forty and beyond a metre at sixty. The strength of reading glasses rises by about half a dioptre every three to five years and stops around sixty, because the lens then loses no more. It is not a sign of illness but the course itself.

infoWhat the medicine does — and what it does not

Eye drops with pilocarpine narrow the pupil and so create more depth of focus — they work for about six hours, worsen vision in the dark and can cause headaches; the lens does not become flexible again. Eye training does not restore the flexibility, because it is the lens itself that hardens and not the muscle that weakens. What helps is optical: reading glasses, varifocals, multifocal lenses or a lens in the eye.

Possible complaints

studiedThe arm gets too short

The menu moves further away, the phone is held at arm’s length, and with more distance it really does get better. That is the identifying sign above all.

studiedHarder in the restaurant than by the window

In low light the pupil widens and the depth of focus drops. So the same small print is readable in daylight and not by candlelight.

studiedTired eyes and headache in the evening

A pressure above the eyes and at the temples after longer reading or handwork comes from the ciliary muscle constantly readjusting. It is a muscle like any other, and it tires.

associatedShort-sighted people notice it later

Short-sighted people simply take their glasses off and read on — that shifts the moment by years. Long-sighted people, by contrast, notice it earlier than others.

Blood values

studiedFasting glucose

If sharpness changes within days to weeks, swinging blood sugar can be behind it — the lens swells and refraction shifts.

studiedHbA1c (long-term sugar)

Shows whether sugar was raised over weeks.

Nutrients

studiedLutein & zeaxanthin

Macular carotenoids from leafy greens and egg yolk.

studiedOmega-3 (EPA/DHA)

For tear film and retina.

studiedVitamin A

Building block of the visual pigment (rhodopsin).

associatedZinc

Cofactor in retinal metabolism.

traditionalAnthocyanins (bilberry)

Berry pigments; traditionally for circulation and twilight vision.

Supplements

associatedAstaxanthin

Used for eye fatigue and accommodation.

traditionalGinkgo

To support microcirculation.

traditionalBilberry extract

Concentrated anthocyanins.

infoOmega-3 (EPA/DHA)

Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.

Hormones

studiedInsulin

With diabetes the focusing power shifts with the sugar value — the lens swells and shrinks. This is why some weeks are allowed to pass after a new treatment setting before reading glasses are prescribed.

associatedGH (somatropin)

The lens goes on growing lifelong and becomes stiffer in the process — that is the actual reason for long-sightedness with age. It is not wear and not a muscle problem, but simply growth that never stops.

Food

studiedLeafy greens & egg yolk

Rich in lutein/zeaxanthin.

studiedOily sea fish & algae oil

EPA/DHA sources.

traditionalBilberries & dark berries

Anthocyanin-rich.

Alternative approaches — what people use

no studiesPalming & eye yoga

Promoted against age-related long-sightedness. The lens loses its flexibility over the years — a mechanical process no training reverses. The exercises relax, nothing more.

studiedScreen breaks (20-20-20 rule)

Every 20 minutes look at something about 6 metres away for 20 seconds. This eases fatigue during close work — it does not change the long-sightedness itself.

Frequencies — what is on file

traditionalEye, nearsightedness and farsightedness

Listed values: 727 · 787 · 880 · 5000 · 10000 Hz