Presbyopia is the diminution of accommodation of the lens of the eye, due to ageing.
Presentation
As previously stated, presbyopia doesn't occur suddenly, it develops over a period of time as a person ages. The initial signs of the condition usually are noticeable between the ages of 40 and 50. These noticeable signs can be [7]:
- Blurred vision at a normal reading distance
- Eyestrain or headaches following reading or working in close range
- Tendency to hold reading materials away from the face in order to better focus
Any of these symptoms can be made worse if the person is tired or if they’re in a room with poor lighting. Consuming alcohol can also affect a person with presbyopia as alcohol itself can cause a lack of focus.
Eyes
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Visual Impairment
Four hundred individuals with distance visual impairment were excluded from the analysis. Among the remaining 2448 individuals, 46% were male and 49.1% had no formal education. [ncbi.nlm.nih.gov]
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Miosis
We found significant differences in AAP among subjects with intense miosis ( 2,5 mm, x 51 D.E. 5.39 years) and without miosis (3 to 7 mm, x 47.47 D.E. 4.71 years) (p 0.02 t Student). [ncbi.nlm.nih.gov]
Presbyopia Eye Drop Targets Miosis and Accommodation. In: Refractive Surgery Outlook. 2016. . Accessed 15 Sept 2016. Google Scholar Copyright [eandv.biomedcentral.com]
“This means a mild and dynamic miosis, which changes with light intensity.” [reviewofoptometry.com]
Psychiatrical
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Suggestibility
Indirect data suggest also that it tends to superiority vs. ReZoom or Array refractive MFIOLs. Adverse events. No pooling was possible (heterogeneity of assessment and reporting). [ncbi.nlm.nih.gov]
Presbyopia, or age-related focus dysfunction, as the name suggests, is one of the side effects of the general aging of the body and progressing deterioration of functioning of all human organs. [bateseyeexercises.com]
Workup
An optometrist or ophthalmologist will use a basic eye examination in order to diagnose presbyopia in a patient [8]. He or she will perform a number of tests to evaluate how the person sees. During these tests they may use eye drops to dilate the patient’s pupils in order to better evaluate the eye.
The administered tests can involve shining bright lights at the eyes and having a patient look through different lenses in order to evaluate their distance and close-up range of sight. The findings from these tests can help the optometrist or ophthalmologist figure out if the person in questions has presbyopia and what treatment can be done to remedy the situation.
Treatment
Treatment usually is in the form of corrective lenses. If the presbyopia is considered to be severe enough, surgery might be necessary [9]. This surgery is known as a Presbyopic Lens Exchange (PRELEX). Here, the old lens will be replaced with an artificial lens. This is done under local anesthesia.
Bifocal or varifocal lenses may be prescribed for those who are already using corrective lenses since these will work differently than their normal eyewear. If a person prefers contact lenses, a professional may prescribe them two different lenses for either eye in order to help them better focus.
Prognosis
In all cases, presbyopia will continue to progress and get worse until it reaches a point of stabilisation. While the loss of clear vision can be seen as a slight inconvenience, there are no harmful effects that are associated with the disorder. There is no link between presbyopia and mortality. Corrective measures including eyeglasses and contact lenses can help with the loss of focus.
Etiology
The loss of clear vision is due to growth of the lens equator of the eye. This happens naturally with aging. The lens’s elasticity is what makes focusing on objects possible so this growth of the lens is directly related to the loss of focus [2].
People generally begin to notice this loss of focus around the age of 45. This usually occurs when they realize that they have a hard time reading materials that are at a normal reading distance. They are only able to focus on reading materials when they hold the text away from their eyes, usually at an arm’s length.
Epidemiology
Presbyopia is seen in about 98 percent of the general population that is over the age of 50 as it’s a normal part of the aging process [3]. Most reported cases come from developed countries as underdeveloped and developing countries have limited studies that are limited to distance vision and do not cover presbyopia [4]. With this lack of research, professionals use a general population-based estimation. This makes it harder to figure out the prevalence of the condition in these areas as it isn’t an exact number.
Pathophysiology
The growth of the lens equator is the main factor behind presbyopia [5]. This occurs due to the ectodermal origin of the crystalline lens.
The anterior subcapsular epithelial cells around the equator of the lens undergo mitosis which causes the creation of a new lens fibers resulting in a growth of the lens’s diameter. During this process, the circumlenticular space gets smaller due to the growth of the lens. At the same time, the maximum force of the anterior ciliary muscles also decreases. This occurs because the force of a muscles is in direct correlation with its length [6]. This whole process leads to presbyopia.
Prevention
There is no real way to prevent presbyopia from happening since it’s a natural part of the aging process. There are measures that a person can take to improve the health of their eye which can help them in the long run [10]:
- Eat a healthy diet rich with antioxidants, vitamin A, and beta carotene
- Follow regimens for chronic conditions that can contribute to a loss of vision (diabetes, high blood pressure)
- Read or work under proper lighting
- Schedule regular eye exams
- Use proper eyeglasses or contact lenses
- Wear protective eyewear during perilous activities
- Wear sunglasses on sunny days
Summary
Presbyopia is a common vision problem that affects nearly all people over the age of 50 [1]. It is characterized by the loss of clear vision within normal or working distance. This problem focusing on objects takes place even after corrective measure were taken by the person in question.
The first signs of the condition are commonly noticed between the ages of 40 and 50 and progress slowly over time instead of coming on suddenly.
Patient Information
Presbyopia is a naturally occurring loss of close-range focus that happens to close to 100 percent of the general population as they age. It is usually noticed between the ages of 40 and 50 and gets worse over time until it stabilises itself around the age of 65. The disorder has to do with the normal growth of the eyes’ equatorial lens which causes the lack of focus.
Usually, a person will notice the problem when they see that they have to hold reading materials away from their face (usually at an arm’s length) in order to better see it. If a person is already near-sighted, the person in question may find that they need to remove their glasses in order to read.
A visit to the optometrist or ophthalmologist will allow the doctor to diagnose presbyopia. During their evaluation a line of treatment will be formatted. This usually means that corrective lenses of some kind will be necessary. In more severe cases, a surgery known as a Presbyopic Lens Exchange may need to be done.