Treatment Options for Presbyopia (Age-Related Farsightedness)

After the age of 40, it’s normal for your eyes to lose their ability to see up close. This makes it harder to focus on things that are right in front of you, like a newspaper or your phone.

Presbyopia is the name for this condition, and it occurs because of natural changes that take place inside your eyes as you get older. Over-the-counter reading glasses are a safe and effective way to get around this problem, but they can be a hassle. Keep reading to learn more about the choices you have when it comes to dealing with presbyopia. 

Can presbyopia be fully corrected?

Presbyopia occurs because your eyes change over time. Your lenses are clear, cushion-shaped discs inside your eyes that start out flexible when you’re young. As you get older, these lenses get stiffer. This makes it more difficult to focus on objects that are up close.

Currently, there’s no way to keep your lenses soft as you age. That said, there are several ways to sharpen your up-close vision. 

Which glasses work best for presbyopia?

There are several types of glasses that can be used for presbyopia. Each type has its own pros and cons.

Reading glasses

Reading glasses are the most straightforward fix for presbyopia. If you can see distant objects well (including with your contacts), but find that small print is becoming harder to read, then over-the-counter reading glasses will probably work well for you. 

Reading glasses are designed to be put on when you want to see up close, and removed when you need to see far away. Some people find changing their glasses all the time to be inconvenient. 

Reading glasses are available over the counter in a range of different strengths. You’ll want to try several pairs to decide which ones are right for you. 

Prescription glasses

Prescription glasses are helpful if your vision is blurry at a distance and up close. If you wore glasses as a younger person, your prescription will probably change as presbyopia starts to affect you. 

When presbyopia kicks in, nearsighted people sometimes begin to use their regular prescription glasses for distance vision only, because their up-close vision is better with no glasses at all.

Bifocal or progressive (“no-line” bifocal) glasses are made with two or more prescriptions in each lens. Both farsighted and nearsighted people often end up needing this type of glasses as their presbyopia gets worse. Bifocals are convenient, because you can wear the same pair of glasses all the time.  

The different types of prescription glasses all require a visit to an optometrist or another eye specialist for measurements. 

Are there other options if I prefer not to wear glasses?

If you want to avoid glasses, contact lenses and surgery are your other options. Medications to slow down or reverse presbyopia could be available in the future.

Contact lenses 

Contact lenses always require a prescription. There are a number of different types to help with both up-close and distance vision for people with presbyopia. 

If you wore regular (single-vision) contact lenses as a younger person and you want to stick with them, one easy solution is to add reading glasses on top.

Bifocal or multifocal contact lenses include two or more prescriptions in each lens. These are more expensive than regular contacts, but they can help you avoid reading glasses.

Monovision is a different way to use regular contact lenses for presbyopia. For monovision, you’ll get an “up-close” contact for one eye and a “distance” contact for the other eye. Although this setup can help you avoid reading glasses, it can be difficult for some people to get used to.

If you think you’d like to try contact lenses, talk to an eye care professional and explore your options. Keep in mind that contact lenses tend to cost more than reading glasses. You’ll also need to be comfortable putting them in and taking them out, but your provider can teach you how to safely do this.

Surgery 

There is no cure for presbyopia, but certain surgeries can help improve your up-close focusing power. 

Refractive or clear lens exchange

Refractive lens exchange (RLE) is similar to cataract surgery. It involves removing your natural lens entirely and replacing it with an artificial one. A variety of different intraocular (implantable) lenses are available, including some premium lenses that include two or more prescriptions in each lens. 

LASIK laser surgery 

LASIK adjusts the cornea on the front of your eye so it’s a better match for the strength of your lens. This works well for improving distance vision in young, nearsighted people, but it can be a tricky choice for presbyopia. For one thing, LASIK is always a bit more complicated when you’re farsighted. Plus, as your presbyopia advances, your lenses will continue to change and stiffen over time. That said, it’s still a popular approach.

Corneal inlays 

Corneal inlays are tiny devices that can be implanted in the front of one of your eyes to improve your up-close vision in that eye. 

The most common corneal inlay works by turning your pupil into a pinhole, which improves its up-close focus. Newer corneal inlays, which aren’t available yet, promise to work like multifocal lenses to improve both up-close and distance vision. A corneal inlay might not be a good fit for you if you have other problems with your eyes, like dry eyes or cataracts. 

Eye drops

Eye drops to correct or treat presbyopia are currently being studied. One type works by turning one pupil into a pinhole, which brings up-close objects into focus. Another type of eyedrop works on the lens itself, causing it to soften and become more flexible. Neither type is available yet in the U.S.

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Written by:

Heidi I. Becker, MD

Heidi has almost two decades of experience practicing ophthalmology in academic, private, government, and HMO settings. She earned her undergraduate degree in history from Reed College and her medical degree from the Geisel School of Medicine (formerly Dartmouth Medical School).

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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