The Fine Print: Demystifying Presbyopia and Ageing Eyes

As I sit down to write this, I am reminded of an all-too-familiar scenario: a slightly older millennial yet still relatively young-looking, with a standard line that goes, “Woah, nowadays I usually just remove my glasses to read.”

Picture this: you’re sitting down with your favourite book or scrolling through your phone, and suddenly, the words on the page seem to blur, or you find yourself stretching your arms to create some distance between your eyes and the screen.

It was never like that – or was it? Over time, however, you just find it much easier to remove your glasses to read things. Sound familiar?

If you’ve experienced this, you’re not alone. Chances are, you might be encountering Presbyopia, a condition often referred to as Lao Hua Yan in Mandarin. But let’s clear up a common misconception right from the start: Presbyopia is not the same as being Long-sighted. It’s a distinct condition that affects many as we age. People may first start experiencing early symptoms, such as increased reading difficulty with smaller fonts in their late 30s, but most typically, in their 40s.

The author advising this father, Kai Hung, who has Presbyopia

So, what is Presbyopia?

According to SingHealth, Presbyopia occurs due to the natural ageing process, where the lens in our eyes loses its elasticity and capacity to adjust its shape. This lens functions akin to the “autofocusing” mechanism in a camera. In our youth, it’s flexible, seamlessly adapting to various distances by altering its shape. However, with age, this flexibility diminishes, impeding its ability to focus light precisely. Consequently, we encounter blurriness when attempting to view nearby objects.

What then exactly is Long-sightedness? While the symptoms of Long-sightedness and Presbyopia may appear similar, they stem from different causes. Long-sightedness is typically attributed to the eye’s structure, such as having a shorter eyeball, whereas Presbyopia is primarily age-related. Apart from struggling to see nearby objects clearly, individuals with Long-sightedness may also experience difficulty in focusing on distant objects. Unlike Presbyopia, which typically manifests around the age of 40, Long-sightedness can occur at any age.

How about short-sightedness (Myopia)? One question that often arises is whether one can have both myopia and Presbyopia simultaneously. The answer is yes. In fact, it’s not uncommon for individuals to experience a combination of refractive errors as they age, necessitating tailored solutions to address each condition effectively.

This holds particular significance for individuals residing in Singapore, where the median age has shown a consistent upward trend, reaching 42.4 years in 2023 as reported by Singapore’s Department of Statistics.

One more aspect of ageing we all have to worry about

The prevalence of Presbyopia is on the rise, with an increasing number of adults encountering this issue as they reach the significant milestone of 40. Alongside the complexities of parenting and career progression, individuals in this age group often find themselves having to contend with a range of health considerations, including those affecting their vision.

I have seen firsthand the importance of regular health screenings once we cross the 40-year mark, acknowledging the heightened risk of chronic diseases and cancers with age. However, one aspect often overlooked in these screenings is our eye health, despite Presbyopia being a natural part of ageing that affects nearly everyone over 40, and tends to worsen over the years until we reach around the age of 65.

A study conducted by the Singapore Eye Research Institute and Duke-NUS Medical School between 2017 and 2022 uncovered a concerning trend: a third of presbyopic adults in Singapore neglect to address their declining near vision. What’s more alarming is that this neglect is more pronounced among older individuals, with uncorrected rates of Presbyopia soaring to 38.2% in those aged 80 and above.

In a society where technology permeates every aspect of our lives, from the workplace to leisure activities, the implications of unaddressed Presbyopia are even more profound. Extended screen time, whether on our computers or mobile devices, only exacerbates the strain on our eyes, making early detection and intervention all the more critical.

No cure doesn’t mean no care

I emphasise the utmost importance of dispelling misconceptions surrounding Presbyopia. It’s not just about needing reading glasses; it’s about understanding the changes occurring within our eyes and addressing them appropriately before it becomes too late to do so.

Presbyopia may not be curable, but there is a wide range of corrective measures available, from reading or progressive lenses to both soft and rigid-type multifocal contact lenses. People often worry about having a demarcated “line” across their spectacle lenses, but I assure you, that is almost a thing of the past (we hardly prescribe those anymore), and the majority of the lenses that correct for Presbyopia cannot be differentiated from regular, clear spectacle lenses.

Above all, I stress the importance of proactive eye check-ups in detecting issues that may otherwise go unnoticed. Early detection not only allows for timely intervention but also empowers individuals to take control of their eye health at an opportune moment.

As we navigate the complexities of ageing in a modern society, let’s not overlook the importance of caring for our eyes. Whether it’s adjusting our screen habits, scheduling regular eye exams, or seeking professional guidance, let’s take proactive steps to ensure that we continue to see the world with clarity and confidence, well into our golden years.


Contributed by Lee Feng Yuan, Senior Optometrist, KJ Optometrists

Images: KJ Optometrists

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