Age-related Hyperopia - What To Do After 40 Years? Treatment Methods

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Age-related Hyperopia - What To Do After 40 Years? Treatment Methods
Age-related Hyperopia - What To Do After 40 Years? Treatment Methods

Age-related farsightedness - what to do?


Clear vision is a guarantee of an objective and complete perception of the surrounding world, with all its beauty and uniqueness. This is why deteriorating eye health is always such a major concern. With age, almost all people inevitably face the problem of blurred visualization of objects located at close range, even if their eyes worked flawlessly throughout their lives. This is due to the natural process of aging and wear and tear of our body, of which the visual apparatus is an integral part.

Presbyopia, or senile hyperopia, is a violation of near visual acuity combined with the preservation of the ability to see distant objects well. This is what makes the pathology different from true hyperopia, at high degrees of which people see poorly at any distance. The reason is that light rays passing through the optical media of the eye are not refracted enough, so their focus is located behind the retina of the eye, and not exactly on it, as in healthy vision. A special adaptive mechanism helps to correct this situation - accommodation, that is, a change in the curvature of the lens. But the older a person is, the less his accommodative resource.


  • What is Presbyopia?
  • Treatment of age-related hyperopia
  • Farsightedness after 40 years is inevitable?
  • How to stop hyperopia: prevention

Age-related hyperopia develops the earlier, the more actively the near vision is exploited, and the more it was initially impaired. But usually, even perfectly healthy people at the age of 40-45 begin to notice that it is difficult for them to focus their gaze on nearby objects for a long time, to read texts written in small print, and to perform painstaking precise work. Many questions arise: is presbyopia inevitable, how to stop the progressive deterioration of vision, is it possible to cure age-related hyperopia or at least slow down its development? We will tell you about all this today.

What is Presbyopia?

The "senile eye" (presbyopia) is characterized by a loss of near vision acuity, already at a distance of 25-30 centimeters from the face, while more distant objects are seen quite clearly. This encourages older people to move books and newspapers away from themselves when reading, to step back from too small inscriptions and notices on the walls in order to be able to see them from a comfortable distance of 50-60 cm.

According to ophthalmological statistics, most people aged 40-50 need "plus" glasses with one diopter, 50-60 years old - with two, and after 60 years - with three. Further development of senile farsightedness does not occur, because by this time the process of sclerosis is completed in the lens of the eye.

What is Presbyopia
What is Presbyopia

The reasons

This visual impairment occurs, first of all, due to the loss of its elasticity by the lens. Essential for focal length adjustment, our organic biconvex lens is refreshed over a lifetime. A healthy lens is filled with special transparent fibers and easily changes its curvature using the efforts of the ciliary muscle. This ensures the ability to clearly see objects both near (expansion) and in the distance (flattening). But with age, the fibers inside the lens knock into a dense nucleus, which gradually scleroses, which prevents the lens from being flexible. Another cause of the problem is the simultaneous wear of the ciliary muscle and the ciliary girdle - the lens controls.

Already by the age of 30, the ability of the human eyes to accommodate is reduced by half, by the age of 40 - by two-thirds, and by the age of 60 it is completely lost. It is impossible to avoid this process; all that remains is to protect your eyesight in order to push back presbyopia as late as possible.

The reasons for the early, accelerated development of age-related hyperopia are the following negative factors:

  • Pre-existing hyperopia, especially moderate (from +3 to +5) or high (more than +5) degrees. With such a pathology, throughout life, the eye muscles are constantly tense, the accommodation resource is mercilessly exploited, and therefore depleted faster;

  • Eye trauma (burns, bruises, wounds) and inflammatory diseases (conjunctivitis, blepharitis, keratitis);

  • Professional predisposition - work as a programmer, photographer, jeweler, welder, and in general any types of activities associated with harmful effects on the eyes (bright flashes, dust, temperature changes, radiation exposure);

  • Concomitant chronic diseases - hypertension, osteochondrosis and hernia of the cervical spine, neurological pathologies, diabetes mellitus, dysfunction of the thyroid gland and pituitary gland, alcoholism.



The characteristic signs of age-related farsightedness include the following factors:

  • Slowly progressive deterioration in near visual acuity;
  • Increased need for good lighting in the workplace;
  • Merging and / or doubling of letters after 20-30 minutes of continuous reading;
  • Blurring the contours when quickly moving the gaze from a near object to a distant one;
  • Burning, stinging, itching, lacrimation, photophobia, feeling of sand poured into the eyes as a result of prolonged eye strain. Dizziness and headaches are also possible, bursting sensations in the eyebrows, bridge of the nose and eyeballs.


To confirm the presence of age-related farsightedness in a patient, assess its degree and develop a therapeutic tactics, an ophthalmologist may need the following procedures:

  • Visometry is a simple test in which the patient needs to make out from a distance the letters of different sizes shown in rows on the poster. Usually, the study is carried out using trial "plus" lenses;

  • Refractometry - measurement of indicators of clinical refraction of the eyes using a special electronic device - a refractometer;

  • Ophthalmoscopy - examination of the fundus using an ophthalmoscope or fundus lens to assess the condition of the retina, optic nerve, vascular network and other important components of the visual apparatus;

  • Tonometry is the measurement of intraocular pressure. Its persistent increase signals the risk of developing glaucoma;

  • Biomicroscopy - examination of the internal structure of the eyes using a special slit lamp;

  • Study of accommodation is a group of tests, which include the determination of its relative and absolute volumes, as well as proximetry, ergography and accommodation.

Video with Elena Malysheva about age-related hyperopia, lenses and vision correction

Treatment of age-related hyperopia

Treatment of age-related hyperopia
Treatment of age-related hyperopia

When, after 40 years, vision begins to noticeably deteriorate, many panic: what to do, how to stop hyperopia, can it be cured, do I need to wear glasses? In an attempt to get answers to all questions at once, people start looking for information on the Internet, most of which is either incompetent or outright advertising. The last point fully applies to pharmacy pharmacists who are ready to recommend an effective (albeit expensive) drug or eye drops for "quick and complete restoration of vision." However, miracles do not happen - all such drugs can only have an auxiliary or preventive effect, and then only if they are selected by a qualified doctor for a particular patient based on the results of a thorough diagnosis.

Important: if your age-related farsightedness is progressing, the treatment should be complex and strictly individual. You shouldn't spend money on medications and eye trainers without even finding out if they are right for you - this can damage your eyesight even more!

Treatment methods for presbyopia can be roughly divided into conservative and surgical. Let us consider in detail all the methods of dealing with age-related farsightedness available in the arsenal of modern ophthalmology.

Optical vision correction

The most effective, simple and reliable way to regain the ability to see well at close range after 40 years and slow down further deterioration of vision is to start wearing glasses or contact lenses with positive diopters. You can use the optics constantly or only in those moments when it is especially needed: during work, while reading.

Optical vision correction
Optical vision correction

Glasses. The best option for older people with farsightedness is bifocals. Their lenses at the top give the focus needed for clear distance vision, and at the bottom for good visualization of close objects. Wearing such glasses, a person can do manual work or read, lowering his eyes downward, and at the same time retain the ability to consider a distant object, simply by looking up. The most advanced type of bifocal lenses are progressive lenses; they lack a clear boundary between zones, which makes them even more comfortable in everyday use.

Contact lenses. Modern optical products of this type have many advantages: they are invisible, gas-permeable, and do not irritate the mucous membrane of the eyes. By analogy with bifocal glasses, multifocal contact lenses have been developed, the central and peripheral parts of which are responsible for the visual acuity of far and near objects. There is also an interesting way to treat age-related hyperopia with two different contact lenses, one of which is scattering and the other is collecting. The technique is called "monovision" and consists in wearing both lenses, while the brain itself understands which eye is convenient for him to see in the distance, and which - close. But not all patients can get used to this method of correcting presbyopia.

Optical vision correction
Optical vision correction

Do you need glasses for hyperopia? This is a strange, at first glance, question that torments many people after 40 years, who are faced with visual impairment. There is an opinion that if you start wearing glasses or contact lenses, then soon you will not be able to do without them at all. Like, the eyes will stop training, and then blindness is not far off. This is fundamentally wrong when it comes to presbyopia.

Important: optical correction of age-related hyperopia relieves eye strain and protects the remnants of the accommodative resource. Thanks to the plus lenses, the process of reducing the clarity of near vision due to wear and tear of the visual apparatus is inhibited, so wearing glasses for presbyopia is a must!

We should also mention the inadmissibility of using other people's glasses. It often happens that only one of the elderly spouses finds the time and desire to visit an ophthalmologist, be examined and get a prescription for an optician. Usually this is the one who sees very badly. The second spouse sometimes "borrows" the glasses acquired by the first - although it is not very clearly visible in them, it is still better than without glasses at all. You cannot do this, it aggravates the course of presbyopia, forcing your eyes to additionally adapt to "other people's diopters". See a doctor and get a prescription for your own perfectly fitting glasses!

Another important point: regarding the correction of age-related farsightedness, you need to contact the clinic or a private medical center, and not immediately to the optics salon. There they will quickly measure your visual acuity and sell the first available glasses. More precisely, not so - the most expensive of those that are. And if they undertake to make a product to order, they will campaign for the installation of the most prestigious lenses and frames for them. Of course, the cost and quality of such materials are directly related, but it is better to get additional qualified advice from the attending physician before spending the entire pension for glasses alone.

Video about presbyopia - is it a disease or an age norm? Do I need to wear glasses after 40?

Laser correction and eye microsurgery

Laser correction and eye microsurgery
Laser correction and eye microsurgery

Let's move on to radical methods of restoring visual acuity after 40 years:

  • Thermokeratoplasty - the operation consists in applying point burns with a hot needle along the periphery of the cornea. Because of this, after a while the cornea contracts at the sites of cauterization, respectively, it becomes more convex, and its refractive power increases. The focus returns to the retina, the manifestations of age-related hyperopia disappear. For the same purpose, a more modern laser technology is used, where a narrowly directed beam acts instead of a needle;

  • Photorefractive keratectomy (PRK) and laser keratomyeliasis (LASIK, LASEK, Epi LASIK, Super LASIK, etc.) are different types of procedure for "evaporation" of the middle layers of the cornea in the right places using an excimer laser. When these methods are used to treat age-related hyperopia up to +5 diopters, the upper layer is removed from the cornea and folded to the side in the form of a "cap", the middle layers are ablated along the periphery, and then the "cap" is returned to its place. The effect of the operation is the same as described in the previous paragraph, but rehabilitation takes less time, the risk of complications is much lower;

  • Implantation of phakic intraocular lenses (PIOL). This method of surgical treatment of hyperopia is relevant for patients with a thinned cornea, which is a direct contraindication to laser vision correction. Lenses are installed in the anterior or posterior chamber of the eye through micro-incisions. It is advisable to do this only if the lens is still working and retains the ability to accommodate;

  • The replacement of the lens with an artificial analogue is carried out with a high degree of age-related farsightedness, after 40 years, when the above methods are already powerless, and the lens has exhausted all resources. It is removed using ultrasound, a procedure called “phacoemulsification,” and an artificial multifocal lens is implanted in this place, which will perform the necessary optical functions.

It can be said about all the listed interventions that they take a minimum of time (5-30 minutes), usually do not require either preliminary or postoperative hospitalization, are carried out under local anesthesia and are not accompanied by painful sensations. Rehabilitation lasts from 24 hours to several months, the effectiveness is also different - for someone it helps to fully restore visual acuity, for someone - only partially, and some people complain of further aggravation of the disease or even the appearance of new problems.

Hardware and physiotherapy methods

These include:

  • Vacuum massage;
  • Wearing special glasses for training and relaxing the eyes;
  • Laser, magnetic, ultrasonic, color pulse and electrical stimulation.

To achieve good results, it is necessary to carefully visit the treatment room with regular repetitions of the courses, since none of these methods has a radical effect. But with perseverance and combination with other treatments, you can count on improving near vision.

Gymnastics for the eyes

Performing such exercises at home or at work, in between cases, you will bring yourself great benefit and can, if not stop the age-related hyperopia, then at least delay its arrival as much as possible:

  • Close your eyes with force, and then open your eyes wide for 3 minutes;

  • Blink frequently for 30 seconds in a row, then keep your eyes relaxed and closed for the same amount of time. Repeat the exercise 3 times;
  • Rotate the eyeballs clockwise for a few minutes, then counterclockwise the same amount;
  • Place your index finger on your nose and focus on it. Slowly move your finger away from you, without taking your eyes, and then bring it back to your nose. Now use the finger of your outstretched hand to draw a figure of eight in a horizontal plane, following its tip. You can also draw imaginary eights in the air with your eyes. Alternate these exercises for a few minutes;
  • Sitting on a stool with your back straight and hands at the seams, lean back, take a deep breath and close your eyes. Then bend forward, exhale and open your eyes. In this position, mow your gaze alternately towards the right elbow, then towards the left. Do this exercise for 3-5 minutes;

  • At the end of the gymnastics, do "palming". Rub your hands to warm them up. Close your eyes, shape your palms into cups and cover the top of your face in a crisscross pattern. Wait until the darkness before your eyes turns black - at first you will see a gray background. Open your eyes and fix your gaze on a distant object, then immediately on a near object, and so on several times.

Here are some more effective eye exercises:

several effective eye exercises
several effective eye exercises

Farsightedness after 40 years is inevitable?

Hyperopia after 40
Hyperopia after 40

Presbyopia is the same manifestation of natural aging as hair thinning, wrinkles on the skin and other signs of wear and tear of our body, depletion of the resources of its cellular regeneration. It would be strange to expect that the lenses and muscles of your eyes are unique and will not lose elasticity with age. But each person can take certain measures to maintain visual acuity, and his efforts will certainly be rewarded.

All people can be roughly divided into three groups, depending on the initial status of their visual apparatus:

  • Emmetropia is a healthy refraction, in which the focus of refraction of light rays is located exactly on the surface of the retina, in the area of ​​the "macula" (macula);

  • Myopia - myopia, when the focus shifts to a conditional plane in front of the retina;
  • Hyperopia - farsightedness, when the focus "leaves" behind the retina.

Each of these categories of people inevitably develops presbyopia with age, that is, "senile vision", but when exactly this will happen, and what the clinical manifestations of pathology will be, depends on the initial state of the eyes. Of course, it also depends on how they were exploited throughout their lives, what diseases and injuries affected them.

So, among emmetropes, people with one hundred percent vision, age-related hyperopia manifests at about 40 years old, which is why this age appears in almost all thematic medical publications. This visual impairment is characterized by difficulties when considering nearby objects, but rather clear vision in the distance.

In nearsighted elderly people, presbyopia develops later - at 45-50 years old, because their ciliary muscle did not strain so much, and the lens did not stretch to the sides, trying to "drag" focus to the retina in an accommodative way. But when age-related hyperopia nevertheless arises, and this will certainly happen after the hardening of the lens, at a maximum of 65 years, they will not see much at any distance.

With people who are farsighted from birth, the situation is the worst - in them presbyopia manifests itself already after 30-35 years. Moreover, they very soon begin to see poorly both near and far: as the accommodation resource is exhausted, the point of extreme clarity of near vision will merge with a similar point of distant vision, and the contours of any objects will become blurred to one degree or another. This is why hyperopics should consider keeping their eyes healthy as early as possible.

How to stop hyperopia: prevention

How to stop hyperopia
How to stop hyperopia

To slow the age-related deterioration of near vision, it is not at all necessary to give up all the benefits of modern civilization, such as television and the Internet. But limiting the time of communication with appropriate electronic devices and learning how to take breaks every 30-60 minutes is the very first thing to do to prevent presbyopia.

Here are some more helpful tips:

  • Provide quality lighting in your work area - not too bright, but not dim. The optimal indicator of the power of a table lamp is in the range from 60 to 100 watts;
  • The longer the period of use of the near vision, the longer the break it requires. We spent an hour at the computer - walk for at least 5 minutes, warm up, be distracted by other activities. Worked for three hours in a row - give yourself a rest for at least 15 minutes, it is best to do a set of eye exercises;
  • If you suspect you have a rapidly progressive age-related farsightedness, do not be lazy and go to see your doctor. Only timely diagnosis and quality treatment can save you from a critical drop in visual acuity, and sometimes from serious complications of presbyopia, such as cataract or glaucoma;
  • Eat a balanced diet, give up bad habits, exercise, take vitamin and mineral complexes in the cold season to maintain the health of the visual apparatus (if your doctor recommends them);
  • Treat ophthalmic infections in a timely manner, protect your eyes from injuries, if possible, eliminate factors that negatively affect vision from your everyday life. Remember that many somatic illnesses directly or indirectly affect the health of the eyes and require prompt treatment, including for this reason.

And most importantly - do not despair, because age-related farsightedness is not a sentence, given the possibilities of modern medicine in the treatment and correction of visual impairments. Take care of your eyes, and be healthy!


The author of the article: Degtyareva Marina Vitalievna, ophthalmologist, ophthalmologist

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