Interview transcription

What are presbyopia symptoms?

In an interview, Robert Morris discusses the symptoms of presbyopia. 

Robert Morris: Presbyopia symptoms occur very gradually. What happens in presbyopia is that the lens becomes less flexible as we age.

The lens of the eye, which is what gives the eye its focusing power, is a protein, and that protein when we’re young is very flexible. So we see babies; they can look at their fingers inches from their face, and that’s because their lens is super flexible.

As we get older, that protein, just as the protein in egg white changes and goes hard, the lens becomes harder and can no longer focus as well. So even in our 20s, we can no longer hold our fingers this close, but as we hit middle age, typically mid-40s, maybe early 50s; we begin to notice that we can’t see print as clearly.

Initial onset of presbyopia

Initial onset of presbyopia is something that we notice when the light is dim, the print is very small, and we start holding print further and further away. Because if we increase the distance at which we’re looking at print, then the lens doesn’t need to change shape as much.

Gradual onset of presbyopia

The gradual onset of presbyopia is initially not seeing quite so well in the dark, not seeing the very small print clearly and then noticing that we can’t see the print at all so that we have to hold it further away. And then finally, the requirement for reading glasses. What we find is people who’ve never worn glasses find reading glasses incredibly frustrating. They have a pair, and they put them down, and they can’t find them, and then they need to read something. Then they have several pairs, and they’re all over the house, and they can’t find them. They can’t cook without their reading glasses, and that’s one of the things that people find very ageing; when they need to put glasses on to see their food, that really drives people mad. And of course people don’t want to wear glasses with a chain around their neck, typically, so when people reach that point, they start seeking surgical solutions for their presbyopia.

Last stage of presbyopia

The next stage of presbyopia is essential that your distance vision starts going as well. So not only do you need reading glasses and glasses at an intermediate vision, such as the computer, but also distance glasses for driving. But it’s a very gradual, insidious process. And particularly people who’ve not worn glasses before find it increasingly frustrating.

Available solutions to presbyopia

The good news is that there are solutions for this now. 40 or 50 years ago, people in their 50s and 60s were a lot less active than they are now. People in their 50s and 60s now are super active; they swim, they play golf, they travel, they use computers all the time, they use tablets all the time, and they don’t want to be wearing glasses. Luckily for them, there are solutions. That solution may be cornea laser refractive surgery, in other words, presbyopic laser surgery such as Laser Blended Vision or PRESBYOND, or it may be refractive lens surgery.

People often ask me when I’m out chatting to them or when they hear that I’m a refractive surgeon, “should I have laser eye surgery or refractive lens surgery?” And the answer is, I don’t know. The only way to find out is for me to see you and asses you, to examine your eyes, check your prescription, get my optometrist to do that in detail and then put you through a series of diagnostic tests. Only when I know what your visual requirements are, when I know what your spectacle prescription is and I’ve performed the diagnostic tests, will I be in a position to inform you what the best solution for you is.

About the Author

Mr Robert Morris

BSc(Hons), MB BS (Hons), MRCP, FRCS, FRCOphth
Consultant Ophthalmic Surgeon

Robert Morris trained at St Bartholomew’s Hospital, part of the University of London, and graduated with Honours in his final examinations. Robert completed his post-graduate ophthalmic training at the renowned units in Oxford Eye Hospital and London’s Moorfields Eye Hospital. Within the NHS, he has performed over 12,000 cataract procedures. He has an interest in squint surgery and is a national expert in this field. In addition to his NHS work, Robert manages a successful independent private practice. He continually updates his training to keep abreast with the latest technology and techniques in refractive surgery.