A diopter table can illustrate the average progression of presbyopia, since its course typically follows a predictable pattern. Beginning at around age 40, presbyopia increases by about 0.5 dpt every five years, until the process is complete around age 65.

Accordingly, in this article you will find not only information about the typical progression of presbyopia, but also a table showing the expected dioptres by age.

Progression of presbyopia – when does it start and when does it stop being relevant?

Presbyopia typically begins at around age 40 and progresses with increasing age. The cause of presbyopia is the natural aging of the eye’s lens and the ciliary muscle, which are responsible for changing the lens to enable near vision.
This impairs accommodation – the eye’s ability to focus at different distances. This also explains the main symptom of presbyopia:

Near visual acuity declines, while distance vision often remains unaffected. This process is completely natural, so it is not counted among the most common eye diseases in old age – because it is not a disease. Nevertheless, it causes inconveniences that increase over time, by about +0.75 dpt every five years.

This process, which will affect almost all people at some point, is completed around the age of 65. At that point, presbyopia has reached its maximum degree and stabilizes at about +3 dioptres.

”Most of our patients who are interested in laser treatment for presbyopia do so for two reasons. On the one hand, they feel uncomfortable wearing glasses; but even more importantly, they want to be able to see again, as they did in their younger years.” – Bányai Neue Augen

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Table: Diopters for presbyopia

The table below showing diopter values indicates how pronounced presbyopia typically is at different ages:¹

Age	Diopter values (dpt)
45 – 50	+0.75 dpt
50 – 55	+1.5 dpt
55 – 60	+2.25 dpt
60–65(+)	+2.75 to 3 dpt

¹ Apotheken.de: Presbyopia. https://www.apotheken.de/krankheiten/4141-alterssichtigkeit.

These values serve as a rough guide and may vary individually. They do, however, make clear that the near vision can decline significantly over time. It is recommended that this process be monitored by ophthalmological examinations. In particular, if changes occur rapidly, you should act quickly and consult an ophthalmologist.

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Assess the severity of presbyopia

An ophthalmologist can determine how severe presbyopia is and record the result in an eyeglass prescription. For this purpose, the ophthalmologist or optician performs vision tests to determine the refraction of light in the eye.

Existing refractive errors such as myopia or corneal astigmatism are taken into account. Especially when presbyopia and myopia occur together, a targeted approach is important to achieve clear vision both at distance and up close. Multifocal lenses and progressive lenses are often used for this purpose.

Calculate dioptres for presbyopia

As mentioned, your ophthalmologist or optician will determine the exact diopter values you need for clear vision. Positive values (+) indicate farsightedness or presbyopia; negative values (-) indicate nearsightedness.

The reciprocal of the focal length (in meters) gives the refractive power in diopters: D = 1/f. This unit indicates how much a spectacle or contact lens must refract light to correct a visual defect or visual impairment.

Counteracting the increasing diopters of presbyopia

There are several ways to counteract presbyopia. Reading glasses are the simplest visual aid for clear near vision. Progressive and bifocal glasses provide clear vision both at distance and up close and are particularly popular with people who are also nearsighted. Contact lenses for presbyopia are also a popular way to compensate for its symptoms.

Ophthalmology also offers long-term methods to treat declining vision: modern procedures such as laser eye surgery in Karlsruhe and Stuttgart offer a permanent correction of the eye’s refractive power. At Bányai Neue Augen, we offer, among other things, the PRESBYOND® procedure and the monovision technique, in which one eye is optimized for distance and the other for near vision so the brain can form a sharp image.

In refractive lens replacement, on the other hand, we replace the eye’s rigid natural lenses with multifocal intraocular lenses to help our patients achieve improved visual acuity at different distances.

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