Do people become nearsighted or farsighted with age? Dr. med. Bányai explains

To put it simply, people become farsighted as they age. However, it’s not quite that straightforward. While presbyopia does cause symptoms that typically resemble those of farsightedness, it is not the same as classic farsightedness (hyperopia).

Unlike short-sightedness or long-sightedness, which are caused by an incorrect eye shape, in presbyopia the eye’s lens loses its elasticity, making it increasingly difficult to focus on near objects.

But how does presbyopia differ from classic farsightedness, and what solutions exist? In this article, we explain the differences and present modern treatment options.

Short-sighted or long-sighted – how the refractive errors differ

Nearsightedness (myopia) and farsightedness (hyperopia) are two common refractive errors that are often confused. In myopia, people have difficulty seeing distant objects clearly because light is focused in front of the retina. However, people with myopia can see near objects clearly.

Long-sightedness, on the other hand, occurs when light is focused behind the retina. People with long-sightedness can often see distant objects clearly but have difficulty seeing up close, such as when reading or using a computer. In this respect, long-sightedness is also similar to presbyopia.

However, both short-sightedness and long-sightedness often have genetic causes and can result from an abnormal eye shape (an eyeball that is too long or too short). Unlike presbyopia, which develops with age, short-sightedness and long-sightedness can be diagnosed at a young age.

Presbyopia: a special case — how vision can change with age

Presbyopia is not a typical refractive error like nearsightedness or farsightedness; it is a natural age-related condition that affects many people from around the age of 40. Therefore, presbyopia is not considered an eye disease.

As we age, the eye may lose its ability to focus on nearby objects. Patients often tell me they can only read text, price tags, or the text on their phones by holding them at arm’s length.

Unlike farsightedness, which is genetic and often appears early in life, presbyopia is caused by the normal aging of the lens. People usually first notice it when reading or doing close-up work. Even with good distance vision, people with presbyopia often need reading glasses to compensate for the loss of near vision.

Why people appear to become farsighted as they age

The main reason people develop symptoms resembling farsightedness as they age is the eye’s natural aging process. Over the years, the eye’s lens gradually loses elasticity. This flexibility is essential for focusing on objects at different distances, especially up close.

In addition, the ciliary muscle, which curves the lens to focus, weakens with age. This leads to reduced accommodation, causing near vision to become blurry.

Unlike refractive errors such as nearsightedness or farsightedness, which are caused by an altered shape of the eyeball, presbyopia results from the lens’s diminishing ability to focus on nearby objects. This forces people to hold objects farther away to see them clearly, which is often found to be bothersome — especially during everyday activities such as reading or working.

As already mentioned, presbyopia typically begins around age 40 and progresses over time. This process is generally complete by about age 65: at that point, the near point (the shortest distance at which objects can still be seen clearly) is approximately 2 meters. ¹

¹ Apotheken-Umschau: Presbyopia. https://www.gesundheitsinformation.de/alterssichtigkeit-presbyopie.html.

Diagnosis and treatment of presbyopia – from visual aids to laser eye surgery

Presbyopia is diagnosed by an ophthalmologist using vision tests to determine its severity. Presbyopia is difficult to distinguish from classic farsightedness based on symptoms alone, since the symptoms are very similar.

In addition to classic reading glasses, which are specifically designed for near vision, there are also more modern options to correct the refractive error. For example, progressive lenses provide seamless vision correction across different distances. For people who do not want to wear glasses, multifocal contact lenses are an alternative.

Refractive surgery also offers options for treating presbyopia. At Bányai Neue Augen, for example, various laser treatments are available for the permanent correction of presbyopia. Among the most advanced procedures is PRESBYOND®, which uses Laser Blended Vision to extend the depth of field by optimizing one eye for distance vision, the other for near vision, and both eyes for intermediate distances.

From these varied visual inputs, the brain constructs a sharp image, thereby compensating for presbyopia.
Monovision has also produced very good results; it is based on a similar principle to the PRESBYOND® procedure and is also considered particularly gentle. In addition, Bányai Neue Augen offers refractive lens exchange (RLE), in which the natural lens is replaced by a multifocal artificial lens.

These modern treatments offer a long-term solution and allow many patients to remain independent and glasses-free even into old age.

Laser eye surgery in Baden-Württemberg

If you suffer from presbyopia and want a long-term improvement in your vision, professional laser eye surgery in Karlsruhe or Stuttgart can be an ideal solution. Experienced specialists such as Dr. med. Bányai use modern laser technologies to achieve lasting improvements in your vision and reduce your dependence on reading glasses or contact lenses. Take the opportunity to consult with professionals near you. Schedule an appointment for laser eye surgery in Karlsruhe or Stuttgart today.