After 40, eyes naturally lose the ability to focus sharply on nearby objects, a condition called presbyopia. Presbyopia refers as the gradual decline of eye ability to accommodate for near vision as a part of the natural aging process. The eye's natural crystalline lens, which focuses light on the retina, loses flexibility with age. This stiffening blurs nearby objects like books or phone screens. Presbyopia often begins around age 40, gradually worsens until about 65, then levels off. Historically, presbyopia has been recognized for centuries, with early mentions dating back to ancient Greece. Presbyopia" derives from Greek "presbys" (old man) and "ops" (eye). Though unavoidable, symptoms ease with options like glasses, contacts, or surgery to sharpen close vision.

Signs and symptoms are:

• Difficulty focusing on close object
• Eye strain Headache
• Blurry vision
• Difficulty reading small print
• Needing to hold reading material father away
• Double vision
• Fatigue
  

Types of presbyopia

There are five types of presbyopia:

• Incipient presbyopia. It's the first sign when fine text starts feeling tricky or fuzzy .
• Functional presbyopia. This happens when near vision problems become more obvious.
• Absolute presbyopia. With this stage, close-up objects are completely out of focus for the eyes (due to farsightedness).
• Premature presbyopia. This describes premature presbyopia, when the condition hits before age 40.
• Nocturnal presbyopia. This stage makes focusing on nearby objects especially tough in dim light.
  

Presbyopia treatment

Glasses

• ​Presbyopia can be corrected by wearing bifocal, trifocal, multifocal or progressive glass for near work out.
• Bifocals are those lenses that consist of near and distance power.
• Trifocals are those lenses that consist of near intermediate and distance vision power.
• Progressive lenses gradually change their magnification from top to bottom. Also known as multifocal lenses.
  

Contact lenses

• ​For those who already wearing contact lenses, are often add reading glasses on top to handle presbyopia.
• Contact lens options are Monovision, Modified monovision, Bifocal or Multifocal and Non-refractive bifocal contact lens.
• Monovision contact lens to correct one for near and one eye for far with a method.
• Modified monovision contact lens is to correct for either near or far vision in one eye and other eye has a multifocal lens.
• Multifocal contact lens to correct vision for both near and far from one lens.

Surgery
Various surgical options now address presbyopia. Some rely on monovision, tuning one eye for near vision and the other for clear distance sight.

1. Kamra® corneal inlay

• The Kamra® corneal inlay was approved by the US FDA in 2015.
• It's a thin, dark implant with a tiny center hole. Surgeons slip it into the cornea over the pupil for a pinhole boost—like peeking through paper—that fixes near sight but keeps far vision clear. The inlay typically is implanted in the non-dominant eye.

2. Laser eye surgery

•  Monovision LASIK (Laser-Assisted In situ Keratomileusis) and PRK (Photo- Refractive Keratectomy) reshape the cornea by removing a bit of tissue to cut reading glasses need. They target just one eye.

3. Monovision conductive keratoplasty (CK)

• CK applies mild radiofrequency energy to tighten corneal edge fibers, steepening the curve for better near focus. Like monovision laser surgery, it corrects one eye for close vision and leaves the other for distance.

4. ​Refractive lens exchange (RLE)

• RLE removes and replaces the eye's natural lens with an artificial one, much like cataract surgery, often using a multifocal type though options vary. It reduces reading glasses need with clear distance vision, especially helpful for age-related long sight turning into cataracts.
  

Dealing With Presbyopia: As Presbyopia is The Part Indication of Growing Older

• Get a pair of reading glasses.
• Optimize workspace with better light and ergonomic setup to cut down eyestrain.
• Take a break from close work like reading, excessive phone used.
• Maintaining a healthy lifestyle with balanced diet, regular exercise and adequate hydration supports overall eye health.
• Eye checkup if any discomfort or change in vision is noticed.

Conclusion

Presbyopia is a widespread age-related issue that impairs the eye's focus on close objects, usually starting after 40 as a normal aging effect. It makes it difficult to see near objectives like reading

or near work activities. It can't be reversed, but corrective lenses, contact lens or surgery manage it well.

Reference
    1. Presbyopia | AOA
    2. Presbyopia - Wikipedia
    3. Presbyopia: How Aging Affects Your Vision
    4. Singh P, Zeppieri M, Tripathy K. Presbyopia. 2025 Jun 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32809403.
    5. Presbyopia: Understanding Symptoms and Treatment Options - The Kingsley Clinic​​

About the Author 

Roshna Bhuju completed her Bachelor of Optometry from Pokhara University in 2025. She is passionate about raising awareness about various ocular health issues and its possible solution.

Not long ago, the term mental health barely existed in people’s vocabulary. I remember mental health being whispered about and how people denied its importance altogether.

When someone felt overwhelmed, anxious, or low, society labeled it as weakness and dismissed it as "all in the head".

However, I am proud to see that today the narrative is shifting and people are slowly bringing the topic into the spotlight. The world of media encourages conversations about struggles, therapy, burnout and self‑care. By choosing relatable media such as memes, reels and digital content, the younger generation has turned mental health into an unavoidable conversation.. But the big question remains, “Is it enough?”

According to the World Health Organization (WHO), “Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.” However, people often fail to realize that the absence of a disorder does not guarantee mental wellness.

I believe that mental health goes beyond the presence or absence of illness as it includes a person’s psychological and social well‑being, which affects how we think, feel and interact with the world.

In a developing country like Nepal, where the load of non-communicable and communicable illnesses is already heavy, the mental health of people often stays on the sidelines. But within a short span, people have started to see mental health as a real part of overall health, which I consider a partial success. But recognizing and acting on mental health are not the same. Not all households are same, and homes still exist where talking about well-being brings looks and frowns worry and young people try to open up to the families are met with: "Samaj le ke sochla?" – what will the society think?

The truth is that the world moves forward whether society approves or not. Mental health has come a long way, from being a word continuously stigmatized by society to being talked about openly, it’s evident that the walls built by generations are cracking slowly.

The movement has begun and voices are growing louder. Gen-Z has started the conversation, and now it’s up to all of us to keep it going as believe it or not, breaking a taboo doesn’t happen in one day, it happens one honest conversation at a time.’

About the author

Sankalpa Gautam is a 2nd year MBBS student currently studying at Kathmandu University School of Medical Sciences. He has interests in topics regarding mental health and through this article, he hopes to share his perspective and contribute meaningfully to ongoing discussions around mental well-being.​