Why do people need reading glasses as they get older?
Clear lens exchange San Diego
Almost everyone notices that their vision changes as they get older. The most common change is needing reading glasses. People begin to hold items farther from their face to try to read them. Eventually, virtually everyone starts needing to wear glasses in order to see clearly enough to read.
Why does this happen? And is there anything that you can do to stop it?
How does the lens work to focus light in the eye?
The changes in vision as you get older are medically known as presbyopia, and they’re caused by changes in the lens of your eye.
The lens is a transparent structure located just behind the pupil. It acts to focus light onto the retina, which is the light-sensing tissue at the back of the eye. Light that comes into the eye through the pupil then passes through the lens, which bends the light rays slightly in order to focus them. This is what allows you to see clearly.
In order to change what the eye is focusing on, the lens needs to change shape. Muscles around the lens, which are known as the ciliary muscles, pull on the lens in order to accomplish this. As the lens becomes rounder or flatter, this changes the point you’re focusing on.
When you’re young, the lens is very flexible, and this shape change happens easily. That’s why you’re able to switch from distance vision to near vision quickly and seamlessly. Most of the time, you’re not even aware of this process, because it’s so fluid.
Vision changes result from stiffening of the lens of the eye
The structure of the lens is made up of proteins. As we get older, these proteins start to break down and clump together in ways that make the lens stiffer, and the capsule around the lens thickens. These changes make it harder for the lens to change shape, which in turn makes it more difficult for the eye to change its focal distance.
At rest, the lens naturally has distance vision. To change to closer vision, the ciliary muscles pull on the lens and change its shape. That’s why it’s near vision that’s affected first, while distance vision is generally preserved. Your eye’s ability to detect light isn’t changing, but it loses the ability to focus on close objects.
The changes in the lens are a normal part of the aging process, and they happen to everyone. There really isn’t anything that you can do to prevent this. By their early 40s, virtually everyone starts to notice difficulty in focusing on close objects. By the late 40s, most people find it very difficult to read without glasses.
What can you do about presbyopia?
While you can’t stop the aging process, that doesn’t mean that there’s nothing you can do about presbyopia. If you prefer not to be dependent on reading glasses, you could consider a procedure known as clear lens exchange (CLE). During this procedure, the damaged natural lens of the eye is removed and is replaced with an artificial one known as an intraocular lens, or IOL. This type of procedure is commonly used to treat cataracts (which usually don’t develop until a much later age), but it can also be performed before cataracts form, in order to address presbyopia.
It’s important to recognize that an IOL is not exactly the same as your eye’s natural lens. A standard IOL actually can’t change focal distance at all. That’s why people who receive standard IOLs during cataract surgery will generally need to use reading glasses afterwards. Because of this, standard IOLs are not suitable for treating presbyopia.
However, advances in technology have led to the development of newer types of IOLs. Some options include:
- Accommodating IOLs. These are are able to change shape, much like the natural lens can.
- Multifocal IOLs. These can’t change shape, but they have multiple different focal points, which can allow your eye to have clear vision at both far and near distances.
- Monovision. This involves using a different IOL in each eye. One IOL is set for distance vision, while the other one is set for near vision. After an adjustment period, the brain learns to shift which eye it pays attention to, allowing you to shift between the different focal distances.
Clear lens exchange San Diego
The various IOL options each have pros and cons. In order to decide whether clear lens exchange might be a good option for you, and to choose the right IOL for you, you’ll need to consult an eye surgeon. If in the San Diego area and want to know more about the options available to you, please schedule a consultation with one of our expert eye surgeons. Simply contact our front desk to book your appointment.
