Presbyopia

1 What is Presbyopia?

The gradual loss of your eye’s ability to focus on nearby objects is called presbyopia and this condition is a natural and mostly annoying part of aging.

Mostly you will notice this in your early mid-40s up until it became worst when you reach 65 years old.

An eye exam can confirm if you have presbyopia and you will experience that you are starting to hold newspapers and books at arm’s length so you can read them.

Eyeglasses, contact lenses or even surgery can correct this condition.

2 Symptoms

The signs and symptoms of presbyopia that you may encounter at age 40 include:

  • when reading, you will move it farther away so you can read the letters clearly;
  • headaches or eyestrains after reading or ding close work;
  • blurred vision at normal reading distance.

These symptoms will become worse when you drank alcohol, in an area with dim lighting and if you are tired.

Consult your doctor if:

  • blurry close up vision is keeping your from reading or doing close work;
  • experience sudden hazy or blurred vision;
  • have a sudden loss of vision in one eye;
  • see flashes of light, halos around light or black spots.
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3 Causes

Your eye relies on the cornea and the lens to focus the light reflected form objects to form an image.

Presbyopia is caused by a hardening of the lens of your eye, which occurs with aging.

The lens is a clear structure about the size and shape of an M&M’s candy while the cornea is the clear, dome shaped front surface of your eye.

These two refract the light that is entering your eye to focus the image on your retina.

The lens is flexible and can change shape with the help of the circular muscle unlike the cornea.

When you look at something nearby the muscle constricts but when you look at a distance, it relaxes.

4 Making a Diagnosis

Presbyopia is diagnosed by a basic eye exam.

Consult your optometrist or ophthalmologist if you are having difficulty in your vision.

Make a list of all the symptoms that you are experiencing as well as the medications, supplements and vitamins that you are taking. Ask a family member or a close friend to accompany you during the visit.

Some of the questions that you can ask your doctor include:

  • What is causing my symptoms?
  • What are the other possible causes?
  • What tests do I need?
  • What treatments are available?
  • What are the possible side effects of these treatments?
  • How often will I need eye exam?
  • Are drug stores reading glasses safe to use?
  • What websites do you recommend visiting?

Your doctor will also ask you questions such as:

  • When did you first experience the symptoms?
  • Are they occasional or continuous?
  • How severe are they?
  • Do you do a lot of reading or close work?

Eye exam involves a series of tests.

First your doctor will put drops in your eyes to dilate your pupils that will make your eyes more sensitive to lights after a few hours of the exam.

Your doctor may ask you look through several lenses to test your distance and close-up visions and may also use various instruments.

The American Academy of Ophthalmology recommends that adults have a complete eye exam every:

  • five to ten years under the age 40;
  • two to four years between ages 40 and 54;
  • one to three years between ages 55 and 64;
  • one to two years beginning at age 65.

5 Treatment

Treatments for presbyopia are wearing corrective lenses, undergoing refractive surgery and getting lens implants.

For eyeglasses

This is use to correct vision problems and you can use over the counter or nonprescription reading glasses but ask your doctor first.

Most of these reading glasses range in power from +1.00 diopter (D) to +3.00 D. When selecting reading glasses, test each pair on any reading material and try different powers until you find the right one that will allow you to read comfortably. If you are not able to find the right nonprescription glasses, your doctor may recommend prescription lenses.

These are also for farsightedness, nearsightedness and astigmatism. It includes: prescription reading glasses – if you have no other vision problems;

  • trifocals – these are for close work, middle distance vision (computer screens) and distance vision;
  • bifocals – the lenses correct your distance vision when you look through progressive bifocals at eye level and these glasses come in two styles:
    • those with visible horizontal line;
    • those without a line.

This is a good solution for most people who have presbyopia. You can ask your doctor if you want to use contact lenses instead of eye glasses.

This option is for people who have certain conditions related to your tear ducts, eyelids or surfaces of your eyes.

The contact lenses

Bifocal contact lens

This provides close up correction and distance on each contact, the reading portion of the lens is weighted to keep the lens correctly positioned in your eye. There are newer types of bifocal contact lenses that offer distance correction through the center of each lens and near the correction in the periphery;

  • monovision contact lenses – your one eye wears a contact lens for close-up vision while the other eye wears contact lens for distance vision;
  • modified monovision – you use one eye for reading and both eyes for distance. You wear a contact lens for distance in one eye while you wear a multifocal or bifocal lens on the other eye.

In refractive surgery, they will change the shape of your cornea and this is to improve close-up vision in your non-dominant eye. This procedure is not reversible so talk to your doctor about the possible side effects.

The procedures include:

  • conductive keratoplasty – this uses radiofrequency energy to apply heat to tiny spots around the cornea, the heat causes the edge of the cornea to shrink slightly, increasing its curve (steepness) and focusing ability;
  • laser-assisted in-situ keratomileusis (LASIK) – your doctor will use a laser to remove inner layers of your cornea to steepen its domed shape;
  • laser-assisted subepithelial keratectomy (LASEK) – your surgeon will create a flap only in the cornea’s epithelium and then will use a laser to reshape the cornea’s outer layers;
  • photorefractive keratectomy – your surgeon will remove the epithelium.

Some surgeons will use a procedure called intraocular lens implant in which the lens in each eye will be removed and replace it with a synthetic lens. There are many types that are available for correcting presbyopia that have accommodative lenses but possible side effects are blurring and glare or risk for inflammation, glaucoma, bleeding and infection.

There is also the corneal inlay procedure in which your doctor will insert a small plastic ring at the edge of each cornea to change its curve.

6 Prevention

Because there is no known way to prevent presbyopia, it affects almost everyone, even if you’ve never had vision problems. Presbyopia occurs naturally as you age.

Some of these ways are to help your vision and eyes:

  • having your vision checked regularly,
  • wearing sunglasses to block ultraviolet rays when going outside,
  • close monitoring of your eye’s health,
  • wearing protective eyewear to avoid trauma,
  • eating healthier by getting of plenty of antioxidants and vitamins,
  • and recognizing symptoms such as blurred vision, headache and eye strain.

7 Alternative and Homeopathic Remedies

Consult with your doctor before starting any alternative and homeopathic remedies for presbyopia.

There are herbal remedies for presbyopia such as:

  • bilberry – to reduce strain in the eyes,
  • black currant – to improve distance vision,
  • celandine – for tired eyes and ocular inflammation,
  • horsetail – to reduce eye strain and to prevent vision deterioration,
  • nettle,
  • chamomile,
  • carrot – rich in vitamin A that protects eye health.

8 Lifestyle and Coping

You can follow some of these lifestyle tips:

  • have your eyes checked regularly,
  • control chronic health conditions such as high blood pressure and diabetes,
  • protect your eyes from the sun by wearing sunglasses to block the UV radiation when you are going outside,
  • prevent eye injuries by wearing protective eyewear when doing things such as painting or playing sports,
  • eat healthy foods that are rich in vitamin A, beta carotene and have high levels of antioxidants such as fruits and vegetables,
  • use the right glasses to optimize your vision,
  • use good lighting,
  • recognize symptoms so that you can consult your doctor immediately.

9 Risks and Complications

The risk factors of having presbyopia include:

  • age – most common after you reach 40,
  • drugs – such as antidepressants, diuretics and antihistamines,
  • other medical conditions – such as diabetes,
  • cardiovascular diseases or multiple sclerosis in people younger than 40.
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