Presbyopia in the Eyes of an Optometrist
For the record, I am not yet presbyopic, but I can’t help myself sharing the first-hand experience of my optometrist friend who recently turned 40. (With her permission of course. You know who you are.) She finds it quite “cute” that what we have been teaching our patients regarding their poor vision at near is actually happening to her. She says, “So… this is presbyopia”, and she now has the license to tell her presbyopic patients that she “deeply understands” because the struggle is real.
Presbyopia is a condition that starts when a person reaches 40 years old. This is what we call the “Oops, not too close” syndrome. The muscles that control how our natural lens focuses become “arthritic”, if it is appropriate to say that, or not as agile as before, and so the ability of our natural camera to zoom-in is altered. A presbyope would need to move the reading material away to be able to read it clearly — — the farther it is, the clearer it gets. For Asians, because we have shorter arms, presbyopia may be felt earlier, as compared to Caucasians who have longer arms. One may just wake up in the morning noticing that vision at near is not as clear as before. For those without existing prescription for far, you would notice that the prints became smaller and clumped together; and for those who are nearsighted, you will notice that when you remove your glasses, you can actually see better. A presbyope may enter 3 phases. First phase is wondering stage which is “I do not know what is happening to me”, or “My eyes feel weird when someone shows me things to read too close”. Second phase is the denial stage, which is, “No, I do not need to read those small prints”, or “I can just move my arm farther and I can still read”, or “I just need enough light”. The last phase is the surrender phase. This phase is where the patient would come in and shyly says, “I may need reading glasses already”.
Anyway, back to my friend’s story. She now experiences the doubling of her text messages. She thought she can get rid of the double images by closing one eye, but then, the doubling got worse. One of her most dreaded ordeal is when she has to ride a light rail transit (LRT). When someone texts her, she could not stretch her arm long enough as the train would often be filled with people and so she does not have the space to stretch. When asked why not just make the text size of her mobile phone bigger, well, she would not like everyone beside her to be able to read her messages. Then when dinner time comes and the food in front of her is fish? Oh…oh, what does fish have? Yes, hairline-thin, transparent, small, prickly fish bones. She sees them alright, however, she simply can’t pick them up. It seems like her 3D vision is affected — — so near, yet so difficult to remove. Contrast seems to be affected too, the words that were once dark seemed to be very light that she had the impulse to make them as bold as she can make it.
Yup, optometrists can experience presbyopia too, good thing that eyeglasses, contact lenses and some refractive procedures are available to manage presbyopia. Optically, the most straightforward options are reading glasses and bifocal lenses, however, when one has a more versatile lifestyle, progressive addition lenses (PAL) may be a better choice. PAL provides clear vision for all distances and come in a variety of designs. We also have several options for contact lenses. One can wear contact lenses to correct one’s distance vision and then put on readers only when one needs to read. Monovision contact lens system is also popular, wherein one eye wears a contact lens with the distance prescription and the other eye would be wearing a contact lens with the near prescription. Many are happy with the monovision set up, however, only multifocal contact lenses provide better vision when changing focus. Multifocal contact lenses provide good 3D vision as both eyes are being used to view distance and near. To be successful with these different management options, one has to be open and willing to learn how to use them. To know what suits you, you can visit your friendly optometrist.
At the end of our conversation, I couldn’t let my optometrist friend go without saying this… “for heaven’s sake, look for your missing glasses”. And so, when my turn comes to experience presbyopia, I just have to practice what I preach.
