Presbyopia
Presbyopia is the natural decline in near vision that appears around 42–45, when the lens loses its flexibility. It affects everyone and can be corrected very well: glasses, contact lenses, laser or implants depending on your age and needs.
Presbyopia: the essentials in 30 seconds
- Natural change of the lens from age 40-45: focusing up close becomes difficult — no one escapes it.
- Optical solutions: progressive lenses, multifocal contact lenses, monovision.
- Surgical solutions: laser (PresbyLASIK) or multifocal implants (often combined with cataract surgery).
- The right choice depends on your distance vision, your age and your activities: personalised assessment at the practice.
What is presbyopia?
Presbyopia is the progressive loss of the ability to see clearly up close. It is not a disease but a natural phenomenon: with age, the lens — the lens located behind the pupil — loses its flexibility and the muscle that changes its shape to focus (accommodation) becomes less effective.
It appears in everyone, generally between 42 and 45, progresses until 60–65 and then stabilises. It adds to any other visual defects: someone who is short-sighted, long-sighted or has astigmatism becomes presbyopic too.
Recognising the symptoms
The first signs are subtle and often put down to tiredness:
Short-sighted people often read without glasses by taking them off; long-sighted people, on the other hand, become presbyopic earlier and are more troubled by it.
The assessment at the practice
The consultation includes a precise measurement of refraction for distance and near, to determine the « addition » needed, and a complete eye examination. The age of presbyopia is also when glaucoma, cataract and AMD begin: the first consultation for presbyopia is an opportunity for real screening (eye pressure, fundus examination, OCT if needed).
If a surgical solution is being considered, a further assessment is carried out on site: corneal topography and biometry (Anterion), lens measurement, eye dominance tests.
Optical solutions
Surgical solutions
Several techniques make it possible to reduce or eliminate dependence on glasses. They are offered after a complete assessment, depending on age, prescription and lifestyle.
Drs Chetrit and Srour, cataract and refractive surgeons, will guide you towards the appropriate technique — or explain why, in your case, glasses remain the best option.
Progression and follow-up
The addition increases in steps until 60–65: it is normal to change your prescription every 2 to 3 years. Regular check-ups allow the lenses to be adjusted and the health of the eye to be monitored. A sudden drop in vision, distortion of lines or a veil are not signs of presbyopia and require a prompt consultation.
Presbyopia in Noisy-le-Grand
The Grand Paris Ophtalmologie practice carries out the presbyopia assessment, prescribes glasses and contact lenses, and offers surgical solutions (laser, implants) to patients from Noisy-le-Grand and eastern Paris (93, 94, 77): Bry-sur-Marne, Villiers-sur-Marne, Champs-sur-Marne, Chelles, Torcy and Marne-la-Vallée, as well as Le Perreux-sur-Marne, Nogent-sur-Marne, Fontenay-sous-Bois, Vincennes, Saint-Maur-des-Fossés, Créteil and Montreuil. Assessment and follow-up by Dr Yaïr Chetrit or Dr Mayer Srour.
Presbyopia: questions and answers
Answers from Dr Yaïr Chetrit and Dr Mayer Srour, ophthalmologists in Noisy-le-Grand.
At what age do you become presbyopic?
Most often between 42 and 45. Long-sighted people become presbyopic a little earlier, short-sighted people a little later (they read without glasses for a long time… by taking them off). Presbyopia then progresses until 60–65 and stabilises.
Is presbyopia a disease?
No: it is a normal ageing of the lens, which loses its flexibility and can no longer focus up close. Everyone goes through it. However, a drop in near vision after 45 deserves a complete examination, because this is also the age at which glaucoma, cataract or AMD begin.
Are pharmacy reading glasses dangerous?
They are not dangerous, but they correct both eyes in the same way and do not take account of astigmatism or a difference between the eyes. They are a stopgap; an eye assessment remains essential for a suitable correction and to check the health of the eye.
Can presbyopia be operated on?
Yes, several techniques exist: laser (PresbyLASIK, monovision) in patients aged 45 to 55 without cataract, or replacement of the lens with a multifocal or extended depth of focus implant, in particular when a cataract is beginning. The choice depends on a complete assessment carried out at the practice.
Do you get used to progressive lenses?
In the vast majority of cases, yes, within one to two weeks, provided they are well centred and worn continuously at first. First progressive lenses, prescribed early and with a low addition, are the easiest to adopt.
Can you wear contact lenses when you are presbyopic?
Yes: multifocal contact lenses correct distance and near vision, and monovision (one eye corrected for distance, the other for near) suits some patients. A trial at the practice makes it possible to check tolerance.
Related reading
Do you hold your phone at arm’s length to read?
Presbyopia assessment, glasses, contact lenses or surgery: book an appointment at the practice in Noisy-le-Grand.
The Grand Paris Ophtalmologie practice in Noisy-le-Grand provides consultations, screening and surgery for patients from neighbouring towns: