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Ophthalmology & Optometry/Near vision worsens as the day goes on


Dear Dr. Axelrod,

I am 58yo, nearsighted, and have worn glasses since 8th grade, ~ 1970.  I was told then not to wear them all the time, so since my near vision was always good, I generally only wear them for watching television and driving.  Though I've been aware for a while that my near vision was changing, it has still been good enough that I didn't need to get bifocals.

I am a big reader, finishing several books weekly.  Mostly I sit at the table or my computer desk, with the book resting on the surface about 8" away from my face.  This has always been a good distance, even for the print in paperbacks.  However, within the last year or so, I've had to hold the book further and further away as the day goes on, until by evening I'm holding the book at arms length to see the print clearly.

Can you explain what is happening to my near vision?  Is this an age thing or do I not have "near" vision any more?

I really don't think I'd do well with bifocals.  I'm going to get new glasses within a month or two, and am considering 2 pair, one for near, and one for distance.  Before when I told my optometrist that I'd tried some OTC "reading" glasses in different strengths and none of them worked, I was told that my correction would be so small that you couldn't buy that strength over the counter.  This fairly recent change - my near vision getting worse over the day - doesn't seem to support that opinion any more, but the OTC readers still aren't working for me!

In case it matters, I'm a 58yo woman, married since 1980 with two grown children.  I have never smoked, and maybe have 3 drinks a year.  I'm through menopause, am slightly overweight, and have high blood pressure successfully treated with medication.  I've been treated for GERD since 1982, and have some assorted sensitivities and allergies to certain foods, nickel, adhesive, a few medications...  Otherwise I'm in pretty good shape.

Thanks for your time, and for sharing your expertise on this website.  It is greatly appreciated!


Hi Linda, assuming your naked eyes' distance vision is stable, since you didn't mention any changes in your distance vision, you are just noticing the final changes related to your presbyopia.  it is normal, unavoidable, and frustrating.  I included a couple of links to help explain, but you just don't have as much or as easy focusing ability for up close.  You've had a good run as it usually happens around 43 if your far vision is good; because your nearsighted, you have relied on that component, not so much the auto-focusing system.  But you did use the focusing system, called accommodation, somewhat and since it is waning you notice the difference.  If you think your distance vision unaided has improved, you should see your general doctor to make sure you don't have any blood sugar problem. Otherwise, you'll have to start using glasses for more comfortable near vision.
Welcome to adulthood, finally!

Mitch Axelrod,OD

Ophthalmology & Optometry

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Mitchell Axelrod


I'm happy to answer questions about eye exam findings and procedures, glasses and contact lens types/prescriptions/problems. I can also answer questions about general eye conditions/diseases. I do not answer questions concerning surgical techniques/procedures. Please state your age or within a small range when asking questions, as it is often important.


Optometrist 19 yrs.

Doctor of Optometry, cum laude; Residency in Ocular Disease

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