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Cameron Oglesby

Having trouble reading?


If you’re having trouble reading type this size, you’re not alone. Thanks to presbyopia (AKA farsightedness), so does everyone else at a certain age. Some people see their near vision start blurring in their 40s, others have a hard time with smaller fonts in their 50s, and just about everyone deals with it after reaching 60. “Your odds are 100 percent,” says ophthalmologist Peter McDonnell, director of John Hopkins University’s Wilmer Eye Institute.


When you’re young, your eyes’ lenses are incredibly flexible, able to change their shape to switch your focus. But as you age, they v-e-r-y g-r-a-d-u-a-l-l-y lose their elasticity. This starts in young adulthood, but thanks to what McDonnell calls “accommodative reserve,” it’s generally not noticeable until middle age.


That’s the bad news. The good news is that once presbyopia kicks in, there are lots of good ways to deal with it, besides having long arms or wearing out the command-plus keys on your computer keyboard.


The simplest is that if you’re nearsighted, just take off your glasses when you’re reading.


If not, a solution may be putting on a pair of glasses for reading. Drugstores have a whole array of low-cost reading glasses for sale, in different frames and different degrees of magnification, from +1 to +3.5 diopter strength. Try reading a magazine, a paperback, or your phone with different strengths, and pick the lowest number that works for you.


Another thing that helps is reading in brighter light. Bright light makes your pupil contract, creating a pinhole effect that brings the straightest and most focused light rays to your retinas.


Reading distance can matter. You might need glasses for reading a book but not for text on you computer monitor, which is farther away.


If you already wear prescription glasses or contacts, you might consider bifocals or progressive lenses, which have distance correction at the top, reading correction at the bottom, and no line in the middle. Many Medicare Advantage Plans cover all or most of the cost of progressive-lens glasses.


A new alternative is a prescription eye drop called Vuity, which the FDA approved for use last year. When taken once a day, the main active ingredient, pilocarpine, contracts the pupil to create the pinhole effect I described above. Studies showed that the drops improved near vision without affecting far vision for about six hours. After a month of daily use, 30% of participants were able to read three additional lines on a near-vision eye chart, while 70% showed less improvement or none at all. (Some study participants reported headaches as a side effect.)


Another eye drop treatment, to restore the lenses’ flexibility by softening them, is currently under investigation.


If all else fails, there are surgical procedures such as corneal inlays, LASIK, photoreactive keratectomy, and lens implants. If you’re having cataracts removed (and virtually everyone 60 or older has cataracts), you can get your vision corrected at the same time.


Even though Original Medicare doesn’t cover routine eye exams (Advantage Plans do), it’s a good idea to get them – especially if you notice changes in your vision.


Just as there are many approaches to dealing with presbyopia, there are many different approaches to senior care in general.


One approach is to specialize in only one or two services. That’s okay if you need those specific services; otherwise it can be like the proverbial man with a hammer who sees everything as a nail.


Another approach offers more services, menu-style. But if you need something that’s not on the menu, you’re out of luck.


Yet another is one-size-fits-all, where you can get (and end up paying for) more services, or a higher level of services, than you need. This wastes money and can undermine independence.


At Senior Insights, we take a different, individualized approach to senior care management. It’s one which recognizes that all seniors are uniquely different. And that each has his or her own set of values, priorities, definitions of independence, and health conditions to live with.



The difference that approach makes is very easy to see, so please contact us to learn more.


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