Can You Have Both Presbyopia and Astigmatism

In the world of eye health, there are a multitude of conditions you should be aware of. Among them are presbyopia and astigmatism. These conditions, often misunderstood, are more common than one might think. This guide introduces you to these conditions individually and explores their interrelationship.

What is Presbyopia?

Presbyopia is an age-related eye condition that primarily affects your ability to see objects up close. It’s characterized by a decrease in the flexibility of the eye’s lens, which hinders near vision.

Causes of Presbyopia

The root cause of presbyopia lies in the natural aging process. As we age, the proteins in our eyes’ lenses begin to harden, resulting in less elastic lenses. These less flexible lenses can’t change shape as efficiently to focus on close-up images, leading to the symptoms of presbyopia. Apart from age, several other factors can contribute to the development of presbyopia:

  • Genetics: Family history can play a role in when you might experience presbyopia.
  • Eye Health: An underlying eye condition can hasten the onset of presbyopia.
  • External Factors: Prolonged close-up work or exposure to ultraviolet light can also contribute to the development of presbyopia.

Symptoms of Presbyopia

Presbyopia develops gradually and typically becomes noticeable in the early to mid-40s. The primary symptom is a slowly growing difficulty reading small print or performing close-up tasks, such as threading a needle. Other signs include:

  • There is a need to hold reading materials farther away to focus properly.
  • Headaches or fatigue from doing close-up work.
  • Difficulty seeing in low lighting or at the end of the day.
  • Eye strain or discomfort when reading for long periods.

Upon the first signs of these symptoms, it’s essential to schedule an eye examination. Early detection can prevent further complications and provide the necessary treatment to improve your quality of life.

What is Astigmatism?

Astigmatism is a common vision condition due to an imperfection in the curvature of your eye’s cornea or lens. Instead of being a perfect sphere, like a basketball, the cornea or lens may curve more like a rugby ball, with one meridian significantly more curved. This irregular shape prevents light from focusing correctly on the retina, leading to blurred or distorted vision.

Causes of Astigmatism

Astigmatism can be caused by a variety of factors including:

  • Genetics: It’s often present from birth and may run in families.
  • Eye Surgery: Certain types of eye surgery can cause astigmatism.
  • Eye Conditions: Certain conditions like keratoconus, which involve thinning and shaping of the cornea, can result in astigmatism.
  • Injury: Sometimes, an injury to the eye can result in astigmatism.

Symptoms of Astigmatism

The symptoms of astigmatism can vary from person to person. Some common signs include:

  • Blurred or distorted vision at any distance.
  • Eye discomfort and headaches due to strain.
  • Difficulty with night vision.
  • Need for squinting to see clearly.


A common misconception about astigmatism is that it’s a disease or due to reading in poor light, but it’s a refractive error, just like nearsightedness and farsightedness. Another myth is that only adults have astigmatism. In reality, infants and children can also have astigmatism, highlighting the need for regular eye exams for children. It’s important to understand that astigmatism is a common and treatable condition rather than an unusual, rare, or severe problem.

Can You Have Both Presbyopia and Astigmatism?

Yes, it’s possible and even common for someone to have both presbyopia and astigmatism simultaneously. These conditions affect different aspects of your vision and can occur independently of each other, but they also can, and often do, occur together, particularly as we age.

When we look at the population of older adults, the occurrence of both conditions becomes more prevalent. The natural aging process leads to an increased likelihood of presbyopia, usually beginning in the early to mid-40s. At the same time, astigmatism can occur from birth or develop over time due to factors like eye strain, injury, or surgery.

Combining these two conditions in the same person isn’t rare but rather a common scenario. It’s important to note that having one condition doesn’t affect the development of the other, and each should be treated as its distinct issue, even though they may occur together.

Presbyopia and astigmatism in a person might require a more comprehensive treatment approach, considering both conditions’ symptoms and effects on vision quality. This further underscores the importance of regular eye examinations, particularly for adults over 40, to detect and address these vision issues as soon as possible.

Diagnosis Procedures

Diagnosing presbyopia and astigmatism is integral to managing these common eye conditions. It involves an all-inclusive eye examination, typically carried out by an optometrist or ophthalmologist, to evaluate your vision and the overall health of your eyes. Here’s a breakdown of the key tests involved in the assessment process:

  • Visual Acuity Test: This test uses an eye chart to assess how well you see at various distances. It’s a fundamental part of eye exams and helps identify vision issues.
  • Refraction Test: In this part of the examination, an instrument known as a phoropter is used. You’ll look through a series of lenses and provide feedback on which lenses make your vision clearer. This helps determine your prescription for glasses or contact lenses if required.
  • Keratometry Test: This test measures the curvature of your cornea, which is crucial for diagnosing conditions like astigmatism and fitting contact lenses correctly.

These tests are crucial for the early detection and treatment of many common eye conditions, including presbyopia and astigmatism. Regular eye exams are a key part of maintaining good eye health.

Treatment Options

Treating presbyopia and astigmatism has become more diverse and effective due to strides in medical technology. Several options are available to address these vision conditions, tailored to the individual’s visual needs and lifestyle preferences.

  1. Eyeglasses: The most common and straightforward solution can correct presbyopia and astigmatism. For those with both conditions, bifocal or multifocal lenses may be prescribed.
  2. Contact Lenses: Contact lenses offer a more natural appearance and uninterrupted field of view. Specific types, like toric lenses, are designed to correct astigmatism. For presbyopia, there are multifocal contact lenses or a method called monovision (one eye is corrected for distance and the other for near vision).
  3. Refractive Surgery: Advances in surgical techniques have made refractive surgery a viable option for some. Procedures like LASIK or PRK reshape the cornea to correct refractive errors, while lens implants can be used for presbyopia.

Modern developments have also given birth to specialized lenses, like multifocal toric contact lenses, which simultaneously correct presbyopia and astigmatism.

Remember, the best treatment option depends on multiple factors, including your condition’s severity, lifestyle, and personal preferences. Consultation with an eye care professional is essential to determine the most suitable treatment for you.

Managing Presbyopia and Astigmatism

Understanding presbyopia and astigmatism has shown us that these conditions, while common, are manageable with the proper knowledge and professional support. These conditions can and often do occur concurrently, especially as we age.

We can better navigate these vision health challenges by becoming familiar with the symptoms, causes, and treatment options for presbyopia and astigmatism. It’s important to remember that regular eye exams are key in diagnosing these conditions early and managing them effectively.

Seeking professional support is crucial in maintaining optimal vision health. At Garibaldi Eye Care, we stand ready to offer our expertise, cutting-edge technology, and experience. If you’re experiencing symptoms of presbyopia, astigmatism, or both, we invite you to reach out to us. Together, we can ensure that you continue to experience the world around you in clear, vibrant detail.