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The Reading Glasses Thing

Very often I have the following conversation with patients:

ME: So tell me about those glasses you have. What do you use them for?

PATIENT: Oh these are just drug store reading glasses. I use them for tiny print but I try not to use them too much.

ME: Why's that?

PATIENT: I don't want to get dependent on these. I want to make my eyes do the reading sometimes. You know, so they don't get lazy.

I've said this before and I'll say it again: That's not a thing.

But I can see why you would think that. After all, if I stopped using my left arm entirely the muscles would atrophy and pretty soon I wouldn't be able to use my left arm. If I stop doing yoga, one day I'll wake up and be 55 and unable to touch my toes. Exercise your body, we've been told. Work your body regularly to keep everything functioning to its full potential. But this logic does not apply to presbyopia, or that near vision blur we get when hit our 40's, 50's, and so on.

A better analogy is this: When I was 15 I used to listen to my headphones loudly. Like really loudly. And my dad said, "Ali, turn that down you are going to ruin your ears." To which I'd (freshly) reply, "No, Dad, I'm making my ears work harder so they can be strong." Flawed logic. Same goes for your resistance to reading glasses.

Presbyopia occurs due to changes in the crystalline lens inside our eyes as we age. A young person is able to physically change the shape of the lens inside the eye. When the lens shape changes, it acts like a different power- almost like "dialing-in" the reading glasses prescription internally. This ability is best around age 10, and gradually decreases until around age 70. So in theory, a 10 year old kid could hold something riiiight up to his face and with some effort make it look perfect. I, on the other hand, can only hold it about 6-8 inches away before it looks blurry (I'm 31). And as we age, this distance that things look clear becomes further and further away. Because that internal lens loses its ability to change shape. Becomes less flexible, or less elastic, so to speak. This happens at a rate that is very predictable and has been repeated in studies time and time again. There is no evidence that the rate is different in those who wear reading glasses compared to those that don't.

But wait, I know what you're thinking. You have a friend/parent/aunt/co-worker who is like 60 and STILL DOESN'T NEED READING GLASSES. She has not escaped presbyopia. There are a few reasons for this:

1. She is in denial.

2. She is, in fact, blurry up close but doesn't mind.

3. She is naturally nearsighted. Nearsighted people see blurry far away but are naturally in focus up close (hence the word near-sighted). So a nearsighted person a lot of times can remove her glasses and see perfectly for reading.

4. She wears multifocal contact lenses. I can hook you up.

My advice is this: Embrace the reading glasses. Be reassured that your vision may continue to change whether you wear the glasses or don't wear the glasses. So instead of suffering through blurry vision, tired eyes, headaches, pushing things back as far as your arms go, and pulling out your flashlight at restaurants because you're afraid your glasses are doing you harm- don't. Don't struggle unnecessarily. Don't make things harder for yourself.

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