Presbyopia is a state where the eyes are not able to focus on the nearby objects. It occurs gradually and gets noticeable at the mid-40s and worsens around the age of 65. When the person is not able to read books at arm's length and hold it close to the eyes, it must be taken as a sign of presbyopia. One can opt for different ways of presbyopia treatment, including contact lenses or eyeglasses and even surgery.
Symptoms
One can notice the signs after the age of 40. Apart from that, one can notice the following symptoms as well:
- Habit of reading by keeping books away from the eyes to make the words look clearer
- Usual headache while reading or doing some work by keeping it close to the eyes
- Blurred vision even at normal reading distance
Presbyopia Causes
To form an image, your eye relies on the cornea and the lens to focus the light reflected from objects. The closer the object, the more the lens flexes.
In order to form an image, eyes rely on the cornea and the lens help in focusing the light reflected from the objects. Closer the object, more is the lens flex. Unlike cornea, the lens is somehow flexible and can take the help of a circular muscle around it to change the shape. When a person tries to see the objects at a distance, the circular muscle relaxes. On the other hand, when someone wants to see something near, the muscle gets narrower. Consequently, helping the lens to curve and change the focus power.
In the case of presbyopia, the eye lens gets hard and that in direct relation with the age factor. Due to the inflexibility of the lens, changing lens shape to focus on the closeup images is not possible. Eventually, the images come out to be out of focus.
Diagnosis
One of the ways to diagnose the condition of presbyopia is undergoing an eye exam. Generally, the eye exam consists of a refraction assessment and a test to check eye health. In the refractive test, the doctor asks you to look through different lenses to analyze the distance and the close-up vision conditions of the eye.
In eye health exam, a doctor put drops in the eyes and dilate the pupils. Thus, the eyes get more sensitive to light even after a few hours of the test. Doctors do dilate the eyes to have a clear view of the patient's eyes. Doctors advice frequent exams to ensure the condition and proper health of the eyes.
Presbyopia Treatment
Presbyopia treatment is about correct the vision condition. One can opt from eyeglasses, contact lenses, lens implant, and refractive surgery to treat the problem.
1) Eyeglasses
This is one of the safest ways to deal with the condition. Doctors help the patients to get the perfect eyeglasses by asking them to try different Vision-powered glasses. There are different types of eyeglasses one can choose from:
Prescription glasses for reading:
One can choose reading glasses for reading purposes. However, one must remove them when not reading.
Bifocals:
Bifocal eyeglasses have two prescriptions in one glass. The primary part of the glass is to deal with nearsightedness or farsightedness, while the other one, usually, lower one, is there to help to see the objects nearby.
Trifocals:
Trifocals help in dealing with conditions related to close-up work, average to middle distance work, like computer screens, and even distance vision. These eyeglasses have two visible horizontal lines.
Other Types:
Other than these types, there are progressive multifocal and office multifocal eyeglasses. In progressive multifocal eyeglasses, there is no visible line, however, it helps in seeing objects that are close, far or at medium distant. On the other hand, office multifocals help in dealing with the condition while using computers, driving, reading and walking around.
Contact lenses
People who do not want to wear eyeglasses can go for presbyopia treatment by opting for contact lenses. There are different types of contact lenses one can use to deal with presbyopia.
Bifocal contact lenses
Bifocal contact lenses help in dealing with distance and close-up vision problems. Latest versions of bifocal contact lenses come with the correction to one type through the periphery of each lens and the correction of other types through the center of the lens.
Monovision contact lenses
In monovision contacts, one can wear a lens for distance vision in the dominant eye and another one for close-up vision in the second eye.
P.S. To check the dominant eye, one should look at a triangle. First, one should close the left eye and see if the right eye is able to see the triangle at its original position. If this happens, then the right eye is dominant. However, if not, then one should close the right eye and do the same.
Modified monovision.
In modified monovision contacts, the bifocal or multifocal lens is worn in one eye and a contact lens for distance in the dominant eye. Thus, one eye is for reading and both for distance.
Refractive surgery
Refractive surgery is done to modify the shape of the cornea. In presbyopia, the modification is done to improve the closeup vision of the non-dominating eye. However, even after the surgery, one needs to wear eyeglasses to do closeup work. One might need to try monovision contact lenses for some time prior to the surgery.
Types of refractive surgery:
Conductive keratoplasty
Conductive keratoplasty involves the use of radiofrequency energy. It helps in applying heat to the tiny spots present around the cornea. Inclusion of heat helps in contracting the edge of the cornea, further helping in increasing the curve to increase the focus ability. The results of Conductive keratoplasty may not last long.
Laser-assisted in situ keratomileuses (LASIK)
In this type, an eye surgeon makes a thin, hinged flap deep into the cornea. Subsequently, the surgeon uses the laser to remove inner layers of the cornea to steepen the domed shape.
Laser-assisted subepithelial keratectomy (LASEK)
In LASEK, the eye surgeon makes an ultra-thin flap in the cornea's epithelium (outer protective cover). The surgeon uses a laser to reshape the cornea's outer layers and steepens the curve, eventually replaces the epithelium.
Photorefractive keratectomy (PRK)
Photorefractive keratectomy (PRK) is quite similar to that of LASEK. However, the surgeon removes the epithelium and then uses the laser to modify the cornea. Epithelium grows back naturally and adjusts to cornea's new shape.
Bibliography
https://my.clevelandclinic.org/health/diseases/8577-presbyopia/management-and-treatment
https://www.mayoclinic.org/diseases-conditions/presbyopia/symptoms-causes/syc-20363328
https://www.mayoclinic.org/diseases-conditions/presbyopia/diagnosis-treatment/drc-20363329
https://www.mayoclinic.org/diseases-conditions/presbyopia/diagnosis-treatment/drc-20363329
Jun 04, 2019
May 30, 2018