by Maria LaPiana
Oct 31, 2012
07:29 AM
Well, Now

Vision Quest


A while back, my husband and I went out for drinks with friends, a couple younger than us by a few years. The waiter appeared with menus and my husband and I, then both in our mid-40s, instinctively pulled out our reading glasses. Our friends looked surprised, then they smirked a little, and we all laughed about how it had come to this.

“Just you wait,” I thought to myself.

Sure enough, last winter we saw them at a party and took note of the wife’s latest fashion accessory: eyeglasses hanging on a beaded chain around her neck. I said nothing, but I smirked. Just a little.

I knew it was a matter of time. The fact is that presbyopia, the gradual worsening of our ability to see nearby objects clearly—things like menus, books and text messages on our iPhones—afflicts up to 95 percent of people over 45.

While not really considered an eye disease, presbyopia occurs when the eye’s crystalline lens becomes less flexible and elastic, diminishing our ability to adjust for distance. So close-up objects appear blurry. Commonly developing after age 40, the condition usually worsens steadily for some 10 to 20 years before stabilizing.

“Presbyopia has a more profound effect on people than turning 40 does,” says Raymond P. Dennis, coordinator of the Ophthalmic Design and Dispensing program at Middlesex Community College in Middletown. “For many, it’s the first time their body has let them down.” Some remain in denial for years. “They start holding things out farther and farther away to read them. They become convinced they’ve always read with their arms fully extended,” he says. “And when they can’t reach out any more, they finally bite the bullet and get glasses.”

Although presbyopia can occur without regard to any other eye conditions, its onset should be the impetus for a comprehensive eye exam, says Kristina Green, a licensed optician and spokesperson for The Vision Council, a trade association. “It’s always a good idea to get a baseline exam,” says Green. “More and more people in our aging population are on medications, and many of them have an effect on the eye. You want to be sure to rule out any other conditions or diseases.”

If, like me, you already wear glasses when presbyopia hits, your optometrist may prescribe bifocals. You can have these made with Granny’s telltale (but relatively inexpensive) line in the middle, or without lines (the pricier progressive lenses). Bifocal and multifocal contact lenses are also available; monovision (in which one contact corrects for near vision and one for far) is another option.

The solution is simple for those whose only concern is being able to read the fine print on an aspirin bottle. Thanks to an increasing demand, magnifiers or “readers” can be found everywhere—from dollar stores and chic boutiques to statewide vision centers like OptiCare, or online, where virtual retail outlets like and offer the latest in frame styles.

Readers are available in several powers or strengths. Early on, you may only need magnification in the .75 to 1.50 range, says Green. Most moderate conditions require strengths between 1.75 and 2.25. An advanced case of presbyopia can be corrected with 2.50 lenses or higher. But anything higher than 3 usually means there is something else going on, she warns.

Whatever their power, says Dennis, “readers” cannot technically be called eyeglasses according to Connecticut state law, and they don’t have to conform to optical industry standards. In other words, lenses may be distorted or made from inferior plastics, and frames may be held together by pins or glue, instead of screws.

The bigger issue is fit.

Over-the-counter readers are simply not designed to custom-correct your vision the way prescription lenses do. They don’t take into account the proper center of lenses based on your facial measurements, says Dennis.

And while both of our eyes are seldom created equal, “premade glasses are always the same strength in both eyes,” says Margharet Hollander, owner of The Optical Shop in Westport. “Nor do they correct for astigmatism [often caused by the irregular shape of a cornea].” Another serious problem with over-the-counter readers is the fact that too strong a lens could, over time, weaken your vision instead of improve it, says Hollander.

An experienced professional should do more than examine your eyes: He or she should ask about your lifestyle, your vocational, avocational and recreational vision needs, says Dennis.

If, for example, your job requires you to look at a computer monitor for much of the day, but also to look down at notes, and to look up at people who may be 10 to 20 feet away, no single lens will do the trick. These people need occupational, multifocal progressive lenses. Call them your “work” glasses.

But don’t confuse them with progressive “driving” glasses, which should correct for near vision (required for changing the radio station, or looking at the map on your Garmin) and for the longer-distance vision necessary for driving.

This makes me wonder if I probably need “at home” glasses as well—ones that will allow me to cook, fold laundry, help with homework, check email on my laptop and watch “Jeopardy” at the same time.

Eye-opening, isn’t it?

Vision Quest

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Want to feel good, get better, be your best?  In “Well, Now,” Maria LaPiana reports on the latest in health and wellness—from fitness tips and new findings in medicine to ideas and resources for enhancing mind, body and soul—both here in Connecticut and beyond.

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