The Eye Condition 123 Million Americans Don’t Know They Have

This eye problem can contribute to headaches, interfere with concentration, and even cause you to fall—yet most people have never heard of it. This is what you need to know.

glasses doctorTero Vesalainen/Shutterstock

You probably accept that your joints will lose flexibility as you hit middle age, but you might not expect the same from your eyes. Unfortunately, it happens. The lenses in your eyes must bend to focus on print in an article like this, for example. Once you hit 40, those lenses stiffen, resisting the flex, and reading small print becomes more difficult. It’s called presbyopia, and it’s irreversible.

In a recent survey by Alcon, an eye-care company, eye doctors reported that 92 percent of their patients 40 and over didn’t know what presbyopia was, yet nearly all of them—99 percent—had symptoms of the condition. “A lot of people don’t understand what’s going on with their eyes and think something is wrong, even though it’s completely normal,” says Brenda Pagan, MD, clinical spokesperson for the American Academy of Ophthalmology. Through an evolutionary blunder of sorts, “we lose the accommodative ability of our eyes to focus up close.”

It’s no small thing. By 2020, some 123 million people in the United States will have trouble seeing up close. Not taking care of the issue is leading to nearly $25 billion in lost productivity, according to research published in the journal Opthalmology. The good news is that presbyopia is easy to recognize—and correct. Here’s what you need to know.

What is presbyopia?

The root of the word is Greek for “old eye.” Beginning in your 20s, says Dr. Pagan, your lenses start stiffening. But most people only start to notice the loss of close focus in their 40s as they lose the ability to perform tasks such as reading or needlework. The lens continues to harden until about age 65.

Even if you’ve never had a vision problem before—and here are some vision boosters that can improve your eyesight—you can’t escape presbyopia, though for some the onset is delayed or the symptoms are milder. If you find you’re holding menus further away or cocking your head back from your computer screen, it’s a sign that your lenses losing flexibility.

Does vanity interfere with treatment?

Most people delay seeking professional help until the focusing problems interfere with daily life. (No one likes the idea of reading glasses.) A common ophthalmologist’s joke is that their patients only seek help when their arms become “too short”—they’re unable to hold their phones far enough away to focus on the screen. “Reading glasses force people to admit they are getting older,” says Dr. Pagan.

Signs and symptoms 

These are the signs worth discussing with an eye-care professional:

  • Difficulty reading and doing close work
  • Eye strain
  • Squinting
  • Headaches

By the way, certain drugs such as antidepressants, antihistamines, and diuretics can accelerate presbyopia.

Prevention

Although nothing can stop or reverse presbyopia, these 39 easy tips can help protect your eyes, and possibly delay troubles. If you do a lot of knitting, reading, or spend hours staring at a computer screen, take a 10-minute break every few hours to relieve eye strain. To rest your eyes, allow them to focus on objects at a middle or long distance away.

What are the best ways to treat presbyopia?

“Presbyopia can be fixed in a number of ways,” says Dr. Pagan. The simplest is drugstore reading glasses, though you can also get special contacts or even opt for vision surgery. If you already wear glasses, bifocals, trifocals, or progressive lenses can correct presbyopia. Eye doctors can fit you for contact lenses to help in one of two ways: Monovision contacts in which one contact lens helps with distant sight, the other for closeup work; there are also multifocal contacts (similar to bifocal glasses).

If wearing glasses or lenses bothers you, you could ask about refractive surgery. In recent years, a new kind of surgery, called corneal inlay, has emerged as a faster, easier way to treat presbyopia than standard surgical procedures.

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Elizabeth is a Colorado-based journalist specializing in spirituality, sustainability, health and wellness. Her work has appeared on Reader’s Digest online, in Yoga Journal, Prevention, AARP, Backpacker, 5280 and in dozens of others publications. Elizabeth loves that her job requires non-stop learning. Her curiosity about the world is insatiable—and she has a knack for distilling complex concepts into understandable talking points.