Early presbyopia: why some people notice it before the age of 40

Presbyopia usually starts to become noticeable at around the age of 40, when the eye gradually loses its ability to focus on nearby objects. However, some people notice symptoms earlier: they hold their mobile phone further away to read, need more light or experience eye strain when working with screens. This is known as early presbyopia or premature presbyopia.

What is early presbyopia?

Presbyopia is a natural change affecting near focus. It occurs because the crystalline lens, the internal lens of the eye, loses elasticity over time. As a result, it becomes more difficult for it to change shape in order to focus on nearby objects.

It can be compared to a camera whose autofocus gradually starts to become less responsive. At first, the near image becomes clear with some effort. Later on, the eye needs optical assistance to see comfortably.

We refer to early presbyopia when these symptoms appear before the age of 40. It does not always indicate an eye disease, but it should be assessed in order to rule out other associated factors.

Symptoms of presbyopia before the age of 40

Symptoms usually appear gradually. At first, many people attribute them to tiredness, excessive screen use or lack of sleep.

The most common signs are:

1. Difficulty reading at close range, particularly small text, labels or a mobile phone.
2. Needing to hold objects further away in order to see them more clearly.
3. Eye strain after reading, studying or working on a computer.
4. Headaches after prolonged near-vision tasks.
5. Needing more light to read comfortably.
6. A sensation of slow focusing, as though the eyes take time to adapt when looking from far away to near.

These symptoms should not simply be considered normal if they appear earlier than expected or interfere with everyday life. At Barraquer, we understand that an apparently small change in vision can have a significant impact on work, reading and day-to-day wellbeing.

Why some people notice presbyopia earlier

Age is the main risk factor for presbyopia, but it is not the only one. Certain conditions can cause symptoms to appear earlier or be perceived more intensely.

One common cause is uncorrected hyperopia. People with hyperopia already make an additional effort to focus. When the eye’s accommodative ability starts to decrease, even slightly, this effort becomes more noticeable.

Certain general health conditions, such as diabetes, multiple sclerosis or some cardiovascular diseases, may also play a role. In addition, some medicines, such as certain antidepressants, antihistamines or diuretics, have been associated with premature presbyopic symptoms.

Other factors that may make early presbyopia more noticeable include:

1. Intensive near work, particularly involving screens, reading or precision tasks.
2. Digital eye strain, which does not cause presbyopia but may reveal an emerging focusing difficulty.
3. Lack of appropriate optical correction, when hyperopia, astigmatism or another refractive error is present.
4. Unassessed visual changes, which may be confused with tiredness or stress.

Screens and early presbyopia: are they related?

Screens do not cause presbyopia in themselves. Presbyopia is mainly due to the gradual loss of elasticity of the crystalline lens. However, intensive use of mobile phones, computers and tablets requires many hours of near focusing.

For this reason, someone with emerging presbyopia may notice symptoms earlier if they spend all day working in front of a screen. The problem is not the screen as a direct cause, but the constant demand it places on the visual system.

In these cases, it is important not simply to buy reading glasses without first having an assessment. An ophthalmological examination can determine whether the problem is genuinely early presbyopia, uncorrected hyperopia, dry eye, eye strain or another cause.

When to see an ophthalmologist

It is advisable to have an ophthalmological assessment if difficulty seeing at close range appears before the age of 40, progresses quickly or is accompanied by other symptoms.

In particular, consultation is recommended in cases of:

1. Persistent blurred vision.
2. Eye pain or frequent headaches.
3. Sudden changes in prescription.
4. Difficulty working or reading normally.
5. A history of diabetes or other systemic diseases.
6. Double vision or loss of vision.

Diagnosis is made through a comprehensive ophthalmological examination, which allows the specialist to assess the prescription, focusing ability, the condition of the crystalline lens and overall eye health.

Treatment of early presbyopia

Treatment depends on the cause, the patient’s age, their previous prescription and their visual needs.

The most common options include:

1. Reading glasses, when the difficulty only affects reading or other near tasks.
2. Progressive lenses, if good intermediate or distance vision is also required.
3. Multifocal contact lenses, in selected patients.
4. Reviewing the existing prescription, particularly if hyperopia or astigmatism is present.
5. Surgical options, only when appropriate and following specialist assessment.

The key is to personalise the solution. Someone who works eight hours a day on a computer does not have the same needs as someone who drives frequently, reads very little or carries out precision manual tasks.

Detecting early presbyopia in good time makes it possible to correct vision appropriately, reduce eye strain and rule out other causes of blurred vision.

At Barraquer, we understand that seeing clearly at close range is essential for working, reading and enjoying everyday life. If you have started holding your mobile phone further away or are experiencing frequent eye strain, book an appointment for an initial ophthalmological assessment.

Dr Jose Lamarca, ophthalmologist at Barraquer Ophthalmology Centre