Presbyopia is not farsightedness!

I know not many people are going to really care what it’s called. I had a patient yesterday tell me that if anyone wants to know what the problem is with his eyes they should just call me. He said that’s what he pays me for. I get it.  No matter how much I try to find the right analogy to help explain something, I think most of the time the patient just wants to know if it’s normal or if it’s a problem and how it will be fixed.

But I’m going to try explaining this anyway (it’s all over the internet already….the explanation…..but not on my site).

We need to start with a person that does not have a prescription and is 28 yo (just a random young age I picked, could be 10 or 38 too). That person reads the smallest letters on my distance eye chart so I call that 20/20. That person reads the little letters on the little up close chart too that I stick in front of their face about 40 cm (16 inches). I call that 20/20 at near. There’s a word that describes the result of this situation and it’s called emmetropia (can’t sell them glasses darn it).

But that same person comes back to see me 20 years later and is now 48 years old. You know what they’re going to complain of right? They are having some problems reading up close but still see fine at distance. I’m sorry to tell the patient but they have reached that time in life where the good ‘ol drugstore reading glasses will solve their problems (probably). At least the presbyopia problem. Presbyopia is Greek and means old eyes. It sucks! But this person is NOT farsighted. Read on.

But lemme go back to the 28 yo person and change something about them. Let’s say they read the distance eye chart fine and they read the up close chart fine. Nothing different about that so far. But perhaps they have told me their eyes might tire quicker than they used to and go in and out of focus when they read. Ah hah! I already know what’s going on. Well, don’t tell me that patient has presbyopia….they aren’t old enough. I do my thing and spin my little lenses on my machine and find out the patient actually has a prescription for distance! And you might wonder, how could they read perfectly and have that? It’s a dirty little secret, that’s why. And it’s call farsightedness. They are farsighted.

Maybe we just should just get rid of that word. It doesn’t really make sense if a person can see far AND near and be called farsighted. Those eyes can deal with having to do some work all the time when we’re younger. But maybe not for a long time when reading. And eventually their distance, sometime years later, will also not be as clear. And eventually they will be 48 and develop presbyopia too. Yep, they’ll have both conditions.

Let me tell you about a real patient I had a few years ago. She was 35 (I think). She had a pair of drugstore glasses and used them for reading. She wasn’t 48 (or even in her early 40’s when presbyopia can rear it’s ugly head). She was using +2.50 power reading glasses! I did a little testing and found out her distance prescription was, guess what? +2.50! I asked her to put those reading glasses on, the ones she uses to read her books, and asked her to look at my distance chart. She read 20/20 with the glasses on and she also read 20/20 with them off. It’s that dirty little thing…..farsightedness. I think she was slightly confused and I didn’t help much trying to explain this occurrence that her reading glasses worked even when she looked far away. Oh my. I think she thought her glasses were just evil little instruments that people like me sold to unsuspecting shoppers in drugstores.

So why did I write this post? I sure would like to just give this to every patient that is farsighted and/or is just getting presbyopia and let them read this. Maybe they will get a sense of what I’ve said here so that when I try explaining it….however I do in the exam room, that they will somehow magically understand what they have.

Now I know what’s going to happen here. You are going to be thinking that you’re particular situation doesn’t quite match up to what I’ve said here. Well, ok. There’s a lot more that could factor in to all this. But I’m not going there. Let’s leave the 28 yo old patient happy that I just saw and you can come in and we’ll figure out exactly how your situation differs if this isn’t cuttin’ it for ya!

Are reading glasses ok to buy? Listen, if your mom (or whoever) says no, then come see me and I’ll clear that up. And if they work for you, then you probably found a solution to your problem….I hope. But buy multiple pairs, trust me on that.

Oh, farsightedness does have a real name in doctor speak….hyperopia. Does that word make sense either? Not to me. But, thems words for ya.

Here’s my favorite ophthalmologist talking about his reading glasses product line….