Long sightedness (hyperopia) and presbyopia are both conditions that affect near vision, but they have different underlying causes. Long sightedness is a structural refractive error caused by the shape of the eye or cornea and can affect people of any age. Presbyopia is an age-related condition in which the natural lens of the eye gradually loses its flexibility, making it harder to focus on near objects — it typically develops from around the age of 42. If you are over 42 and finding that your near sight is gradually worsening, it is important to have an expert assessment to determine which condition — or combination of conditions — is responsible.