There are countless myths about presbyopia. That’s not surprising: so many people experience this change in their eyes during their lifetime and often end up relying on glasses or other visual aids. The problem with these myths, however, is that some of them foster prejudice, unfounded fears, false hopes, and, more generally, uncertainty.

This post dispels nine common myths and explains what really causes presbyopia.

Myth 1: Presbyopia is a disease

Many people believe that presbyopia is a disease that needs to be diagnosed and treated. It is true that diagnosis and treatment are not only possible but also important. Presbyopia is not a disease but a natural consequence of the aging process.

From around the age of 40, the eye’s lens loses elasticity, making it less able to adjust for near vision. The eye’s ability to accommodate decreases. This makes reading or focusing on near objects increasingly difficult.

Presbyopia is therefore not a disease, but an age-related change in the eye that, sooner or later, affects almost everyone. However, it can be treated effectively, for example with visual aids or modern laser eye treatments.

Myth 2: Only older people are affected

To be fair, the name might suggest that presbyopia only affects people of advanced age. In fact, the first symptoms often appear as early as age 40 and worsen over time.

The start of this process actually occurs even earlier. Because we age throughout our lives, the eye’s lens begins losing elasticity continuously from youth. The difference is that from about the age of 40, a critical point may be reached at which this process can lead to clearly noticeable symptoms.

Myth 3: Only near vision is affected

Although near vision is most affected by this condition, other aspects of vision can also be impaired.
Many people experience headaches, fatigue, or a general feeling of eye strain because their eyes are constantly trying to adjust to different distances.

Constantly switching between near and far vision can tire the eyes and compromise overall vision.
Especially in situations where you frequently have to refocus between different distances – such as driving or playing sports – presbyopia can also impair distance vision.

Myth 4: You can prevent presbyopia through lifestyle

Many diseases — including eye conditions — can be influenced by a healthy lifestyle and, in some cases, even prevented. Unfortunately, presbyopia is an exception: the loss of lens elasticity is linked to aging itself, not to any particular diet. Even quitting smoking cannot directly prevent this age-related loss of vision. However, the emphasis here is on “direct”.

Lifestyle can influence how much the symptoms of presbyopia bother us. Other eye diseases, such as cataracts or age-related macular degeneration, are associated with smoking. A lack of nutrients such as vitamin A or omega-3 fatty acids can also contribute to certain vision problems which, together with presbyopia, can lead to significantly poorer overall vision.

It has also been found that diabetes, cardiovascular diseases, or high blood pressure can cause presbyopia to occur earlier. And these pre-existing conditions can, in many—but not all—cases, be influenced by lifestyle.¹

Myth 5: Only women are affected.

Some people believe that only women are affected by presbyopia. In fact, presbyopia affects men and women equally. The aging of the lens of the eye is a natural process that occurs in almost everyone, regardless of gender.

This misconception simply stems from the fact that women are more likely to visit an ophthalmologist and address declining vision as soon as they notice symptoms. While there may be gender differences in how presbyopia is managed and women often have a diagnostic head start, men and women are affected about equally overall.¹

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

Presbyopia explained

Myth 4: You can prevent presbyopia through lifestyle

It has also been found that diabetes, cardiovascular disease, or high blood pressure can cause presbyopia to develop earlier. In many — though not all — cases, these pre-existing conditions can be influenced by lifestyle.

Myth 5: Only women are affected.

The reason for this misconception is simply that women are more likely to visit an eye doctor and address declining vision as soon as they notice symptoms. So, while there may be gender differences in how presbyopia is managed and women often have a diagnostic advantage, men and women are affected about equally overall.

Myth 6: Presbyopia remains constant

While this myth isn’t entirely accurate, it contains a kernel of truth. Presbyopia is essentially a progressive condition that typically begins around age 40. From then on, near vision gradually worsens, so visual aids need to be checked and adjusted regularly.

However, this process usually ends around the age of 65. By this age, presbyopia has typically reached its maximum extent and there are no further significant changes – neither for the better nor for the worse.

Myth 7: Eye exercises can prevent presbyopia

There is a rumour that special eye exercises or eye training can prevent or reverse presbyopia. However, there are no reliable studies to support this, so I do not recommend such training to my patients. The decline in vision is caused by a loss of elasticity in the eye’s lens, and this process is not reversible.

Although eye exercises can be beneficial for other aspects of eye health, such as relaxing the eye muscles or during prolonged screen use, they do not offer a solution for presbyopia. The only way to restore sharp near vision is to use visual aids or to undergo targeted treatments such as laser eye surgery or the use of multifocal lenses.

Myth 8: If I never needed glasses before, I won’t develop presbyopia

Presbyopia also affects people who have gone through life without glasses or other visual aids and who have never had refractive errors. It affects almost everyone, as it results from the natural aging of the eye’s lens.

Even people who previously had normal vision can begin to experience reduced near vision from around the age of 40. People who are farsighted may notice symptoms somewhat earlier, while those with mild nearsightedness may notice age-related near-vision decline a little later.

Myth 9: Laser eye surgery does not work for presbyopia

Many people believe that laser eye treatments only work for nearsightedness or farsightedness, not for presbyopia. My patients are often surprised when I explain the options available at our practice.

However, modern laser procedures such as PRESBYOND® or Monovision offer an effective solution for presbyopia. These laser procedures make it possible to adjust the refractive power of the eye’s lens, allowing patients to see clearly again at different distances – without glasses or contact lenses.

Another treatment option is the PRK procedure. In this method, the eye’s natural lens is removed and replaced with an artificial lens. A positive side effect: any cataract that may be present is treated at the same time, so clear vision is still possible even at an older age.

Presbyopia — More information