What is presbyopia and how is it treated?

Posted on 2016/02/16 at 12:02 pm by LASIK MD

As people age, their eyesight naturally changes. While some individuals will only notice a minor difference in their vision, others will develop age-related issues, like presbyopia.

What is presbyopia? 
According to Doctors of Optometry Canada, presbyopia is an ocular condition that typically occurs in people aged 40 and over. While every patient is different, most notice initial symptoms in their early 40s. This often progresses over the course of 10 to 15 years, causing people’s vision to decline into their late 50s and early 60s.

When people have presbyopia, it means that the lenses of their eye’s lenses have lost their flexibility. As lenses stiffen, they don’t focus as easily, which prevents people from seeing things clearly – especially for near objects. It starts by affecting short distances, which is why many people first notice something is wrong when they’re trying to read or write at a close range. Other common signs of presbyopia are headaches and fatigue.

Notably, presbyopia is completely different from problems like astigmatism, farsightedness and nearsightedness, according to All About Vision. Those conditions are connected to eyeball shape, while presbyopia affects the lens.

The source noted that people who have never needed glasses or contacts are often taken aback when presbyopia appears, as the initial symptoms emerge quite suddenly. Because the greatest cause of presbyopia is aging, however, it often affects individuals who have never needed to worry about their eyesight before.

While presbyopia can’t be prevented, there are a few ways it can be treated.

Eyewear for presbyopia
Many people discover their presbyopia when they read a book, scan a menu or write a check. What once was a simple task now becomes a challenging feat, as their eyes refuse to focus on what’s right in front of their faces. When this happens, most people turn to glasses to help them see clearly.

CNIB  explained that there are a few different eyeglass options for those experiencing symptoms of presbyopia. Reading glasses are common choices, especially for people who have never needed visual assistance before. They only have one prescription and are intended to help with reading, writing and other activities that require you to focus on things close to your eyes. If you already deal with other ocular problems, reading glasses will likely be too weak to effectively manage your sight.

People who regularly wore glasses prior to their presbyopia diagnoses are often prescribed bifocal lenses, or glasses that are created with two prescriptions. The top lens is intended to help people see things at a distance, while the bottom lens allows them to focus on what’s close by. Those who also have difficulty focusing on items that are about an arm’s length away are typically fitted for trifocals, which contain an intermediate prescription as well.

While glasses certainly help treat presbyopia, they don’t correct it. To better eliminate the symptoms of this ocular issue, consider opting for a surgical procedure instead.

PRELEX for presbyopia 
PRELEX, or presbyopic lens exchange surgery, is a procedure that can be performed on patients over the age of 45. It’s a popular option among people who find they rely heavily on reading glasses in everyday life. The treatment employs the same techniques that are used in cataract removal, but instead of clarifying a cloudy lens, they restore flexibility to this area of the eye.

Before your procedure, you’ll need to undergo a consultation with your eye care specialist to determine if you’re a good candidate for this type of surgery. If you decide you to undergo the procedure, the process will begin with a doctor administering eye drops that will cause numbness. An incision will be made on your cornea that measures no larger than 3 mm. Your surgeon will then employ ultrasound technology, in addition to a tool known as a phacoemulsifier, to remove your rigid lens.

A folded artificial lens is then placed inside your eye through the small opening. Once it has been inserted, it will unfold on its own. The incision starts to heal naturally once the procedure is finished and doesn’t require stitches. Overall, the entire PRELEX process only takes about 10-15 minutes.

After your surgery, you’ll need to wear sunglasses and schedule a post-operative checkup for the next day. Many people heal quickly, and oftentimes patients are able to resume their daily routines just 24 hours after they undergo their procedures.

Monovision for presbyopia 
Another common surgical option for presbyopia is monovision. During this process, one eye receives total distance correction, while the other eye is not treated completely. The eye that is undercorrected is left with mild myopia, or nearsightedness. This procedure isn’t a total eradication of presbyopia, but it can greatly improve symptoms. The balance of the different treatment allows patients to see more clearly up close, though far distances usually remain somewhat blurry.

After undergoing a monovision treatment, people usually find that they don’t need reading glasses to do things like read labels or apply makeup in a mirror. However, very detailed tasks or extremely small print may still require patients to pull out their reading glasses. While many people find monovision extremely helpful, others don’t adapt as smoothly to having different vision in each eye. Before you select this treatment, your doctor will have you simulate monovision with the help of contact lenses.

Some of the side effects of monovision include needing glasses to drive long distances at night and having decreased depth perception. The latter effect can become especially prominent when you’re playing sports.

Because everyone’s presbyopia is different, you’ll need to consult with a physician before deciding which treatment option is best for you. If you’re over the age of 40 and notice that your vision is starting to change, be sure to address the issue with your doctor so that he can provide you with advice on which route to take. Even if you’ve never needed glasses before, you may require some type of corrective measure to deal with your eyes’ natural aging.

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