Presbyopia: Let Old Age Not Be The Reason For Your Weak Eyesight

  – Dr Mahipal Singh Sachdev –

About few years ago, Rita Malhotra (51) noticed that she was having trouble reading and helping her son with his homework. Malhotra

knew right away what her problem was. Until then, she wore her regular contact lenses to correct her myopia.

Like many people, when Malhotra first noticed she was having trouble reading she tried to compensate by using brighter light in her room and by her bedside. A few of them try holding reading material at arm’s length. But at some point, even the longest-armed person can no longer read the fine print on a menu. Also, when they perform near work, such as embroidery or handwriting, they may develop headaches, eye strain or feel fatigued. And that is when they look for some help or seek an appointment with their ophthalmologist.

What Causes Presbyopia

Everything seems to stiffen up as we age, and our eyes are no exception. But as the years go by, the lens of the eye becomes harder and losses it’s elasticity. The result is a gradual worsening of the ability to focus on objects up close called presbyopia.

And mind you, there’s no escaping it. Diet and exercise have no effect too. Presbyopia generally starts in the mid-40s, when people begin to notice that they have difficulty typing a number on their mobile phone or reading a book. Over the next 20 years or so, the eyes continue to lose their ability to zoom in on things; and by about 65 years of age their eye sight gets really weak and there could be need for cataract surgery too.

Presbyopia differs from astigmatism, nearsightedness and farsightedness, which are related to the shape of the eyeball and are caused by genetic and environmental factors.

The symptoms of hyperopia (farsightedness) and presbyopia are similar, however, they are caused by different things. Hyperopia is a refractive error that occurs when the eye is shorter than normal or has a cornea (clear front window of the eye) that is too flat. As a result, light rays focus beyond the retina instead of on it. Generally, this allows you to see distant objects clearly but near objects will appear blurred. While hyperopia is usually present from birth, presbyopia develops later — usually around age 40.

See an eye doctor if blurry close-up vision is keeping you from reading, doing close work or enjoying other normal activities.

Seek immediate medical care if you:

Have a sudden loss of vision in one eye

Experience sudden hazy or blurred vision

See flashes of light, black spots, or halos around lights

Diagnosis

Your eye doctor can diagnose presbyopia as part of a comprehensive eye examination. In addition to checking for other eye problems, he/she will determine your degree of presbyopia by using a standard vision test.

Your doctor will measure the amount of refractive error you have and helps determine the proper prescription to correct it. You will try out several corrective prescriptions to determine which one will offer the best presbyopia correction for you. He/she can also discuss presbyopia surgery as another method for treating your presbyopia symptoms.

Presbyopia Treatment:

There is no best method for correcting presbyopia. The most appropriate correction for you depends on your eyes and your lifestyle. You should discuss your lifestyle with your ophthalmologist to decide which correction may be most effective for you.

Eyeglasses

Eyeglasses with bifocal or progressive lenses are the most common correction for presbyopia. Bifocal means two points of focus: the main part of the spectacle lens contains a prescription for distance vision, while the lower portion of the lens holds the stronger near prescription for close work.

Progressive addition lenses are similar to bifocal lenses but they offer a more gradual visual transition between the two prescriptions, with no visible line between them. Reading glasses are another choice. Unlike bifocals and Progressive lenses which most people wear all day, reading glasses typically are worn just during close work.

If you wear contact lenses, your ophthalmologist can prescribe reading glasses that you wear while your contacts are in.

Contact Lenses

Presbyopes also can opt for Multifocal contact lenses or monovision,  in which one eye wears a distance prescription, and the other wears a prescription for near vision. The brain learns to favor one eye or the other for different tasks. But while some people find these lenses comfortable, others complain of reduced visual acuity and some loss of depth perception with monovision.

Because the human lens continues to change as you grow older, your presbyopic prescription will need to be increased over time as well. Therefore, it’s important to get your eyes examined regularly especially after you cross 50 years of age.

Surgery

Surgical options like keratoplasty are available to treat Presbyopia. Apart from this, LASIK can be used too to create monovision, in which one eye is corrected for near vision while the other eye is stronger for distance vision.

With the recent introduction of presbyopia-correcting intraocular lenses, some people undergoing cataract surgery may be able to achieve clear vision at all distances.

Also, an elective procedure known as refractive lens exchange may enable you to replace your eye’s clear but inflexible natural lens with an artificial presbyopia-correcting lens for multifocal vision. This is essentially cataract surgery, but it’s performed on people who don’t have cataracts for the purpose of providing all-distance vision.

Symptoms

Presbyopia develops gradually. You may first notice these signs and symptoms after age 40:

A tendency to hold reading material farther away to make the letters clearer

Blurred vision at normal reading distance

Eyestrain or headaches after reading or doing close work

You may notice these symptoms are worse if you are tired, drank alcohol or are in an area with dim lighting.