Presbyopia and myopia are refractive errors. Presbyopia affects near vision, myopia affects distance vision. Other differences include prevalence, age of onset, and anatomical abnormality.
Do you recall when you first felt the urge to hold your book at arm's length to read its contents? If you're around the age of 40 or older, you're in good company. This is a common experience related to a condition called presbyopia. But wait! What's this got to do with myopia, or nearsightedness, you might ask? Stick around, as we delve into presbyopia and myopia, two vision conditions that might be affecting your life more than you realize.
Presbyopia and myopia
Presbyopia and myopia are both refractive errors; in layman's terms, refractive errors simply refer to vision problems that occur when your eye doesn't allow light to focus correctly on the retina.
There are four common types of refractive errors:1
- Myopia, or nearsightedness, makes far-away objects look blurry
- Hyperopia, or farsightedness, makes nearby objects look blurry
- Astigmatism, which can blur or distort both distant and nearby objects
- Presbyopia, age-related farsightedness, makes nearby objects look blurry and can happen with myopia at the same time.
These errors can occur due to various factors, such as the length of your eyeball, the shape of your cornea, or the loss of flexibility in the lens of your eye due to aging.
Myopia typically occurs when the eyeball is too long or when the cornea is excessively curved. This causes light to focus in front of the retina, resulting in blurred distance vision. On the other hand, anatomical changes that lead to light focusing at the back of the retina, which is the opposite of myopia, is hyperopia.
Individuals with myopia require vision correction with a prescription that has a minus power. On the other hand, hyperopia is characterized by a need for vision correction with a prescription that has a positive power. A zero power means no vision correction.
Hyperopia is often present from birth, and the body usually self-corrects to achieve normal vision in childhood. However, in the case of myopia, the self-correction process can overshoot into the minus power.
Presbyopia, on the other hand, is an age-related condition that occurs when the lens of the eye becomes stiff and loses its flexibility. This makes it challenging to adjust focus when transitioning from near to distance vision.
Presbyopia typically develops in individuals in their 40s and can occur even if they have other refractive errors, including myopia. Similar to hyperopia, presbyopia is corrected with a prescription that has a positive power.
(Learn more about how to read a vision prescription)
Presbyopia vs Myopia
So, how exactly are presbyopia and myopia different? Let's take a look at three aspects: Prevalence and age of onset, eye structure, and the effect on vision.
- Prevalence and age: Myopia often begins in school-aged children, with 42% of adults in the US reported to have myopia.2 Presbyopia, on the other hand, is a part of the aging process and almost everyone experiences them starting after 40.3
- Eye structure: In presbyopia, the lens in your eye becomes harder and less flexible with age, causing difficulty focusing on nearby objects. In contrast, myopia is primarily caused by an elongation of the eyeball or when the cornea is excessively curved, causing light to focus in front of the retina instead of on it.1
- Vision: When it comes to vision, presbyopia affects your ability to see things up close, like reading a text message or a label on a medicine bottle. Myopia, however, makes distant objects appear blurry, so you may struggle to read road signs while driving or see the blackboard in class.1
Presbyopia and myopia treatment
The main goal of presbyopia and myopia treatment in adults is to help you see clearly.1 For presbyopia, common options include wearing corrective eyeglasses or contact lenses, refractive surgery, or even an intraocular lens implant, usually offered when also treating cataracts. Furthermore, there's an eye drop called Vuity that can help improve near vision in people with presbyopia.
For myopia in adults, the solutions are somewhat similar: eyeglasses, contact lenses, refractive surgery, and again, an intraocular lens implant for those also treating cataracts.
However, myopia in children has an additional goal of preventing progression through myopia control.1 This involves slowing down the elongation of the eyeball with specially designed glasses or contact lenses, atropine eye drops, or an emerging treatment known as repeated low-level red-light therapy (RLRL). Do remember that surgical treatments are not suitable for children until they reach early adulthood and their myopia stabilizes.
Interestingly, some people with myopia, especially those with low myopia (-3.00 D or less), may find they can 'self-treat' presbyopia by simply removing their glasses. As the prescription for correcting presbyopia is usually between +1.00 to +3.00 D, it could be a simple and workable solution for people with low myopia.
Summary
And there you have it! A glimpse into the similarity and differences between presbyopia and myopia. So, if you ever catch yourself squinting at your smartphone or stretching your arm out to read a book, remember - it's all part of the journey. We're all just growing wiser, with our vision keeping pace with our wisdom!
Related articles:
1. Can you have both farsightedness and nearsightedness at the same time?
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- Jacobs, Deborah S et al. “Refractive Errors Preferred Practice Pattern®.” Ophthalmology vol. 130,3 (2023): P1-P60. doi:10.1016/j.ophtha.2022.10.031
- Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–42.
- Patel I, West SK. Presbyopia: prevalence, impact, and interventions. Community Eye Health. 2007;20(63):40-41.
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