Presbyopia (Aging Eyes) and Eye Exercises
by Dr. Merrill J. Allen, Dr. Steven M. Beresford, Dr. Francis A. Young.
PRESBYOPIA AND THE AGING PROCESS
The eye succumbs to the aging process just like the rest of the body and is one of the first things to decline. As the eye ages, it becomes ‘stiff’ and unhealthy. The inner lens loses its flexibility, the eye muscles lose their strength, natural focusing power declines, focusing becomes sluggish, and eye coordination deteriorates. This condition is known as presbyopia (aging eyes) and usually becomes apparent after the age of forty.
The most obvious symptom of presbyopia is loss of focusing power at close distances. People who previously had good vision must hold reading material farther away to see it clearly. People who already have visual problems such as myopia, hyperopia, or astigmatism also develop presbyopia as they grow older and often have to wear bifocals.
There’s more to presbyopia than is commonly realized. A major complication is that the circulation of blood and nutrients in and around the eyes also declines, which increases the risk of glaucoma, cataracts, and macular degeneration. For this reason, its important for presbyopes to exercise their eyes to improve the circulation and reduce the risk of these diseases.
Although we cannot avoid growing old, many people realize that aging is a ‘use it or lose it’ process and by staying active and eating healthy, they can grow old gracefully instead of becoming senile and decrepit. The good news is that just like physical exercises can improve the health and strength of the body, eye exercises can improve the health and strength of the eyes.
The traditional method of treating presbyopia is with corrective lenses, which modify the light before it enters the eye so that near objects can be seen clearly.
Surprisingly, no clinical or statistical studies have demonstrated the long-term safety or effectiveness of corrective lenses. All that is really known is that most people who wear them get worse and need stronger prescriptions every few years. It is also widely believed that corrective lenses cause dependency and make the eyes even weaker so they lose more of their natural focusing power.
Recent research suggests that corrective lenses may actually damage the eyes. In a series of important experiments, Dr. Earl Smith of the University of Houston College of Optometry fitted various types of corrective lenses on rhesus monkeys with normal healthy vision. What he found was that monkeys fitted with the type of corrective lenses used for hyperopia adapted to the lenses by developing hyperopia. The lenses used were identical to those used for presbyopia.
The implications of this research are of serious concern because the visual systems of monkeys and humans are almost identical. What it means is that in humans, corrective lenses may cause or aggravate the visual problems they are supposed to correct. In view of the fact that presbyopes are much more likely to develop glaucoma, or cataract, or macular degeneration, corrective lenses may be a risk factor for these diseases.
The National Eye Institute is the government agency that funds almost all eye research in the USA, mostly through research grants to colleges. A few years ago, the National Eye Institute issued a major report known as ‘Vision Research, A National Plan (1999 – 2003)’, which stated:
“Another major influence on visual sensitivity is perceptual learning. The past 5 years have yielded a flood of behavioral studies demonstrating that practice on specific perceptual tasks results in increased sensitivity to weak visual signals and increased capacity for discriminating among very similar signals, which can be sharply restricted to the region of space in which the important signal commonly occurs. Hence the adult visual system is not immutable but can change according to behavioral demands.”
The National Eye Institute thus confirms the position that the American Vision Institute has held since it was founded in 1979: the adult visual system can change, and the ability to see small details can be improved by learning and practice.
Although presbyopia must gradually get worse as we grow older, what often happens is that it rapidly gets worse when corrective lenses are worn. The reason is that corrective lenses do the focusing that the eyes should be doing. This creates dependency and makes the eyes lose even more of their natural focusing power so even stronger lenses are needed.
The result is a vicious cycle of weaker eyes → stronger lenses → weaker eyes → stronger lenses. The situation is even worse with bifocals, which rob the eyes of even more of their natural focusing power. The typical result is that by the time the person reaches 55, the ciliary muscle has lost most of its strength, the inner lens has lost most of its flexibility, and the eye’s natural focusing power may be seriously compromised.
We recommend eye exercises to strengthen your eyes, combined with weaker glasses. The most important thing is to reduce the rate of deterioration because presbyopes are at a much higher risk of diseases such as glaucoma, cataract, macular degeneration, and dry eye syndrome. Even if you don’t get all the way back to normal vision, simply reducing the rate of deterioration is a major accomplishment that may prevent serious loss of vision later in life.
A) Early (Low) Presbyopia. If you’re just starting to lose your focusing power, we suggest you avoid corrective lenses and concentrate on exercising your eyes instead. If you need glasses for reading, use the weakest pair you can manage with and use them as little as possible. Drugstore glasses are usually okay. Use even weaker glasses as your vision improves. If your vision is not too bad, you may be able to regain all or most of your natural focusing power quite easily and avoid or delay the need for corrective lenses.
B) Moderate Presbyopia. If you can’t read without glasses, we suggest you use the weakest pair you can manage with and exercise your eyes to regain as much of your natural focusing power as possible. Drugstore glasses or weaker glasses from previous years are usually okay. When you can see clearly through them, go back to even weaker glasses. In this way, you may eventually be able to see well without glasses most of the time.
C) Advanced Presbyopia. If you wear bifocals and can’t see well without them, we suggest you increase your natural focusing power with eye exercises and adapt to a series of weaker prescriptions, such as old glasses from previous years. Although you may never completely get rid of glasses, you may reach the point where you only need them for reading and the rest of the time you can do without them.