Presbyopia is the gradual loss of the ability to focus on near objects, typically in those over 40. This natural condition is caused by the stiffening of iritis for which age is a risk factor, and usually develops gradually over time. Other causes can be from eye surgery or a serious injury causing damage to the lens of one or both eyes. Presbyopia occurs in tandem with myopic astigmatism, so that people who have this condition are also more likely to have difficulty focusing on near objects and less likely to see clearly at distances.
Symptoms:
1. Reading difficulty: It is very difficult to focus clearly on a print or text with the naked eye.
2. Eye strain: Irritation or pain after spending a long time focusing on near objects.
3. Blurred vision: When looking at nearby objects, you may see double images, which can make it hard to notice when the car rears up in front of you while driving or when someone runs into your office.
4. Low vision: Presbyopia often makes it difficult to see far away and hard to read without close-up help, especially at night in dimmer light and when driving at night.
5. Double vision: Double vision or ghosting of images may be seen when looking at close objects and can create difficulty in seeing things clearly.
6. Causing stress: Presbyopia is a condition that generally makes it very stressful for a person, as he may often experience eye strain and a reduced ability to see clearly.
7. Goofy eyes: Presbyopia can give people the appearance of having "goofy eyes" as one eye appears closer to the object being viewed than the other eye.
When to see a doctor?
If you are experiencing difficulty focusing on near objects, blurry vision while trying to focus on nearby objects or if you notice a change in how far you can see clearly, you should visit an optometrist.
Causes:
1. Aging: Ageing is a primary factor in the development of presbyopia.
2. Eye injury: Although this is not common, it can be caused by an eye injury or eye surgery. Presbyopia may also occur if you have had an eye surgery using radial keratotomy, which is a surgical procedure used to correct mild or moderate myopia and some astigmatism.
3. Genetics: Genetics are not often the cause of presbyopia although there have been some cases reported where it runs in families as well as in twins who typically share the same genes.
4. Other factors: Other factors that may lead to presbyopia include cataract formation, retinal detachment and macular degeneration
5. Glasses or contact lenses: People who are near-sighted, who have astigmatism or who have undergone vision correction surgery can wear glasses or contact lenses to help them see things more clearly. However, even if you don't need corrective lens for distance, it doesn't hurt to have your eyes checked once a year.
6. Drugs: Presbyopia may be worsened by taking certain medications such as steroids or beta blockers and can cause changes in your vision as well as double-vision.
7. Smoking: Smoking has also been noted to increase the chances of developing presbyopia.
Diagnosis
1. Visual acuity test: To confirm whether you have presbyopia, a visual acuity test will be conducted whereby the eye doctor will look for possible signs of this condition.
2. Eye chart: The eye chart used during the visual acuity test will typically have letters and/or numbers that get smaller and smaller as you go down the page. This test will determine whether you are able to see these clearly at varying distances or if you have trouble focusing on nearby objects in particular.
3. Ocular pressure test: If there is no evidence of any disease or damage in your eyes, your optometrist may conduct an ocular pressure test to see if presbyopia has developed in both eyes or just one eye.
4. Pupil reaction test: This is a special eye test that determines how your pupils react when exposed to various light intensities. The results of this test will also show whether you have difficulty in seeing near objects or not.
5. Gonioscopy: This is an eye test used by the doctor to examine the inside of your eyes with a special lens called a goniolens.
6. Slit lamp examination: This ophthalmic examination is performed using a slit lamp which allows doctors to look at the cornea, iris and retinal layers in detail.
7. Ophthalmoscope: This is an examination with a special instrument called the ophthalmoscope, which allows you to view your entire retina, both inside and outside your eye.
8. Retinal photography: This is a test that helps doctors see the inside of your retina in great detail.
Treatment:
There are various treatment options available to help cope with presbyopia as well as slowing its progression. Some of these include:-
-Wearing glasses or contact lenses: If you have presbyopia and you cannot wear contacts at work or for most outdoor activities, then wearing glasses may be an option for you. Glasses have the advantage of being more affordable compared to contact lenses.
-Progressive lenses: These are specialty glasses that allow for clearer distance vision as well as near vision. For example, you may find it easier to tie your shoelaces while wearing such glasses whereas if you were to wear regular glasses, you would need another pair for close-up activities.
-Vision enhancement surgery: There are several types of surgery that can help treat presbyopia and improve your ability to see clearly both far away and near objects. Some of these surgeries include iris implants, corneal inlays and multifocal lens implants.
-Multifocal contact lenses: If you prefer contact lenses to glasses, you may find it a good idea to choose multifocal lenses, which have been specially designed to help you see both near and far objects clearly.
-Corneal inlays: The cornea is the clear covering of the eye that sits on top of your iris. A small section of this can be surgically removed using a laser in order to reduce image blurring.
-Iris implants: This is a special procedure that can be used to correct nearsightedness as well as astigmatism in both eyes. With this surgery, the cornea can be reshaped using laser technology to adjust for presbyopia.
Tips for living with presbyopia:-
1. You should see an eye doctor about once a year, just to make sure you don't have any signs of presbyopia developing in both eyes.
2. If you wear glasses all day long, it isn't uncommon to experience a change in distance vision if you wear contact lenses as well.
3. If you experience blurriness reading on a computer or other electronic device, you may wish to consider reducing the size of the text on your screen as well as wearing reading glasses while you do so.
4. Even though presbyopia is not a disease, wearing glasses all day long could be. Make sure to remove your glasses when you are outside or in other places that aren't very bright which can cause double vision.
5. To reduce double vision, make sure that you don't adjust your glasses for close-up objects such as books or food when using computers as it may increase twitching and blurring in your vision due to presbyopia.
6. If it gets too difficult for you to see clearly at the required distance, consider getting laser surgery or optometrical laser vision correction surgery.
