Reading glasses, drugstore readers, blue-light filters: what actually makes sense

Some time after your 40th birthday, your arms get too short. The menu moves further away and small print blurs. This is not a disease but age-related long-sightedness – presbyopia. Sooner or later it affects everyone. The good news: the fix is usually simple and cheap. The less good news: blue-light filters, eye drops and exercises come with promises the studies do not keep.

What happens in the eye

To focus up close, the lens of the eye has to become more curved – a process called accommodation. With age the lens stiffens and loses this ability. Most people notice the first symptoms at an average age of 42 to 44; between 50 and 55, near focusing is largely gone. Typical signs are blurred near vision, holding text further away, needing more light, and tired eyes or headaches.

As a rough guide to the reading power needed (the "near addition"), a review in the Community Eye Health Journal suggests: +1.0 dioptres at 35 to 45, +1.5 at 46 to 50, +2.0 at 51 to 55 and +2.5 or more over 55. Most people need between +1.0 and +3.0. The right power also depends on your usual reading distance.

Can presbyopia be trained away?

Eye exercises and the "Bates method" promise to make reading glasses unnecessary. But no training makes a stiffened lens elastic again. The American Academy of Ophthalmology (AAO) states that there is no way to stop or reverse the normal ageing process that causes presbyopia.

Perceptual learning is a different idea: over several weeks you practise spotting very faint patterns on a screen. In a study by Polat and colleagues (Scientific Reports, 2012) of 30 people around 50, reading small print improved after about 37 half-hour sessions. Accommodation, pupil size and depth of focus did not change – the brain apparently learned to process blurred images better. The study was small and not randomised, the control group had three people, and the lead author had ties to the company that part-funded the work. Commercial training apps are based on this principle. There is no evidence that they spare you reading glasses in the long run.

Drugstore readers: when they are enough

Ready-made readers have the same power in both lenses and a fixed distance between the lens centres – cheap, but limited. They cannot do harm: glasses that are too strong or wrong can cause headaches and fatigue but have no permanent effect on vision, as an ophthalmologist explains in the AAO's expert forum.

When the German consumer organisation Stiftung Warentest tested ready-made readers, the lens powers were all correct – yet the glasses suited only two of ten testers, mainly because their eyes differed in strength. Ready-made readers have their own standard (ISO 16034); according to Warentest, the European standard requires labels such as "for near vision and reading only". Readers are made for reading distance: for a monitor they are often too strong, for the road unsuitable.

Beyond reading glasses

• Varifocals (progressives): the power increases gradually from top to bottom – for people who already wear distance glasses.
• Computer or office glasses: optimised for screen and desk distance. Under Germany's occupational health ordinance (ArbMedVV), employers must offer people who work at screens an eye examination and provide special glasses if that check shows they are needed and normal glasses are unsuitable.
• Contact lenses: with monovision, one eye is corrected for distance and one for near – this can impair judgement of distance. Multifocal lenses may give slightly less sharp vision.
• Surgery: laser correction on the monovision principle, or lens exchange with multifocal implants. Eye surgeons recommend lens exchange from around the mid-50s; done too early, it risks retinal detachment and other serious complications.
• Eye drops: the US Food and Drug Administration (FDA) approved pilocarpine 1.25% in 2021; by narrowing the pupil it increases depth of focus. In the approval trials, after 30 days 31% and 26% of treated people read at least three more lines in dim light, versus 8% and 11% with placebo drops. The effect lasts up to six hours. Headache and red eyes are commonest; the label warns of rare retinal detachment and of night driving. In the EU, no product for this use had been approved by the end of September 2026; applications are pending with the European Medicines Agency, and in Germany only off-label use is possible.

Who pays in Germany?

For adults, statutory health insurance (GKV) pays for lenses only in severe visual impairment or very high values – more than 6 dioptres of short- or long-sightedness or more than 4 dioptres of astigmatism (§ 33 of Social Code Book V). It never pays for frames. Simple reading glasses are therefore almost always a private expense.

Blue-light glasses: the fact check

A Cochrane review by Singh and colleagues (2023) analysed 17 randomised trials with 619 participants in six countries. Its conclusion: blue-light filtering lenses may not reduce symptoms of eye strain with computer use in the short term (low-certainty evidence). Whether they improve sleep is unknown (very low-certainty evidence). Not one study looked at protection of the central retina (macula). The AAO does not recommend special blue-light-blocking eyewear for computer use and notes that blue light exposure from screens is much less than from the sun.

What helps tired eyes at the screen

We blink less at screens, which dries the eyes. Conscious blinking, lubricating eye drops and the 20-20-20 rule help: every 20 minutes, look at something about 6 metres (20 feet) away for 20 seconds. The evidence is modest: in a study without a control group of 29 screen users, symptoms eased during two weeks of break reminders – one week after they stopped, the effect was gone. Measurable tear-film changes did not occur.

And sleep? In a laboratory study, reading on a light-emitting e-reader in the evening lengthened the time to fall asleep, suppressed the sleep hormone melatonin and shifted the body clock. A phone's "night mode" did not help in a randomised study of 167 young adults; putting the phone away partly did. What we do on screen seems to matter more than its light colour. More: Sleep and cardiovascular risk.

What this means for you

• Have your eyes examined the first time – this shows whether ready-made glasses will do and rules out other causes. Cataract, for instance, can show up as blurred vision, glare and needing more light to read.
• Eye-pressure measurement for glaucoma screening is a self-pay service in Germany (IGeL, usually €20–40). The independent IGeL-Monitor rates it "tending negative": only about one in ten people with raised pressure has glaucoma, and one to two in four glaucoma patients have normal pressure. If glaucoma is suspected or risk factors are present, insurance pays.
• Eye vitamins: AREDS formulations reduce progression by about 25% only in intermediate age-related macular degeneration or advanced disease in one eye – they offer no benefit without or with early macular degeneration (see Supplements).

This article is general information and not individual medical advice. Decisions about tests and treatment belong in a conversation with your own physician.