• Early Loss: ages 42-46

• Adds +0.75 to +1.25D
• The patient usually needs help with near in low light like restaurants
• There are few problems at intermediate, even if they wear a distance Rx. This is because they have enough reserve of accommodation to see clearly at intermediate.
• Many bypass this stage and never get a near Rx or buy over the counter readers

• Transition and Adaptation: ages 47 - 52

• Adds +1.75 to +2.00D
• Here’s where the patient becomes dependent on a near Rx
• Many may prefer full-time wear for convenience

• Total Loss of Accommodation: ages 53 and above

• Adds +2.25D and above, the Near Rx essential
• Also, intermediate for most patients is gone and may be very important for their job or hobbies
• Those wearing flat tops notice it, those in progressives may describe that the lenses no longer provide really useful vision at mid-range