Presbyopia

As many as 24.5 million people in the U.S are estimated to be suffering from Presbyopia, or farsightedness. Read and learn all about the causes, symptoms, treatment and more about this eye disease.

Presbyopia Definition

It is an ocular disorder characterized by the lack of ability of the eye lens to focus actively on objects that are closer in distance. The condition deteriorates with progressing age. It is a natural but very annoying part of the ageing process. Generally, the disease starts becoming apparent when an individual in his or her mid-40s and continues to deteriorate until they are around 65 years of age.

Sometimes, the condition is also referred to as “Short Arm Syndrome.” This name alludes to the fact that patients are often compelled to bring reading material in small print to an arm’s length to be able to see it.

Types of Presbyopia

The condition is generally classified into five types:

Picture 1 – Presbyopia

Incipient

It is the earliest stage of the condition. Sufferers find it a little more difficult to read letters in small print.

Functional

It is the stage where patients begin to have more problems in noticing objects at closer range.

Absolute

It is the form where your eyes completely lack the ability to focus on closer objects.

Premature

It occurs before an individual turns 40 years old.

Nocturnal

Sufferers of this form find it difficult to focus on closer objects in dim-lit environment.

Presbyopia Symptoms

The condition is typically marked by problems like:

• Strain on the eyes
• Headaches
• Double vision
• Reduces ability to focus on near objects
• Blurred viewing of letters, even when reading material is held at close distance
• Urge to hold reading material away from the eyes to see the letters clearer
• Difficulties in understanding contrast between small letters
• Headaches or strain in the eyes after reading, or working at a desk or sitting at a computer for prolonged hours or even after short periods
• Need for greater light to read or perform close activities such as sewing

The problems can worsen in dim-lit environment. The symptoms may also deteriorate if you are tired, working in dim-lit surroundings or are under the effects of alcohol.

Presbyopia Causes

The disorder arises due to a hardening of the eye-lens, which typically occurs due to ageing. With increasing age, the lens of the eye tends to lose its flexibility. It is no longer able to change shape and focus on images that are closer. Due to this reason, images of closer objects tend to become out-of-focus.

What Occurs in Presbyopia?

In any healthy individual, the cornea and the lens of the eye focus on the light reflected from an object to create an image of it. Both the cornea and the eye-lens refract (bend) the reflected light to focus the image over the retina. The retina is situated on the inner side of the posterior (back) wall of the eyes.

Unlike the cornea, the eye-lens is somewhat flexible. It can change shape with the aid of a circular muscle that enwraps it. This muscle relaxes when you look at a distant object. It constricts or squeezes as soon as you look at a nearer object. This act of constriction makes the lens curve sharply and changes its power of focus.

In Presbyopia, the ocular lens becomes hard and is unable to change shape and concentrate on closer objects. Due to this, the images tend to be out-of-focus.

Presbyopia Diagnosis

The disease is generally detected by a basic physical examination of the eye. This type of test is generally performed by an experienced optometrist or ophthalmologist. A complete ocular examination includes a series of tests, such as:

• Refraction test
• Muscle-integrity test
• Visual acuity examination
• Slit-lamp test

Each test lets a doctor determine a different aspect of the vision of sufferers. In an attempt to artificially dilate the pupils, a doctor is likely to put a few drops into your eyes which can make it more light-sensitive for several hours after the test. Dilating the pupils helps a physician assess the inside of your eyes more easily.

During diagnosis, an eye-doctor may use different instruments. Your eyes may be put under bright light. You may have to look through various types of lenses to help doctors test your close-up vision and distance. You will be asked to read aloud materials kept at normal reading distance while the doctor places various lenses before your eyes. This particular exam helps assess the extent of the condition that you are having.

Presbyopia Treatment

As of now, there is no treatment for this ocular disease. On an average, the eyes lose most of their power of elasticity by the time an individual turns about 65 years old. Treatment, when used, aims at controlling the condition and not curing it. It helps compensate for the inability to focus on closer objects. Curative options involve:

Corrective lenses

The condition can be kept in check with the aid of contact lenses or spectacles. Nonprescription, over-the-counter reading glasses are recommended for individuals having good vision before the onset of the disease. If you intend to use these, consult your doctor to know whether they are right for you. In some individuals, use of bifocal to existing lenses can be enough to cure the disorder. But the bifocal prescription should be changed if the condition takes a turn for the worse.

Refractive surgery

This type of operation alters the shape of the cornea, the transparent dome-like anterior part of the outer eye covering that protects the pupil and the iris. As per a recommendation by The American Academy of Ophthalmology, individuals affected with this disorder should try monovision contacts to assess whether they can adjust to this type of correction before undergoing this operation.

Lens implants

This is another corrective process employed by certain ophthalmologists. The process involves removing the clear natural lens of patients and replacing them with a synthetic lens within the eye (intraocular lens implant). Certain latest lens implants are designed to let the eye see objects that are near and far. These special lens implants, however, have not been completely satisfactory. This is because the advantages of these lenses are marred by the fact that they can give rise to visual side effects like blurring and glare.

Laser Surgery

This is an effective treatment for the disease, albeit expensive for patients with low income. Laser-aided operative techniques, such as Lasik surgery, create a monovision effect for patients. Sufferers considering this surgery are recommended to use monovision lenses before actually undergoing the operation.

Presbyopia Risk Factors

The risk factors for farsightedness include:

Age

Advancing age is the greatest risk factor for this disease. Most sufferers of this condition are found to be over 40 years of age. However, some individuals may also develop the disorder even before this age. In such cases, the condition is termed as “Premature Presbyopia”.

Family history

Those with family members suffering from an early onset of this condition may also be at higher risk of developing this disease.

However, any person regardless of race, gender and other demographic factors can fall prey to this condition.

Presbyopia Complications

If not cured in time, farsightedness can deteriorate over time and give rise to difficulties during work, driving and other daily activities.

Presbyopia Management

The management of this condition can be done by following certain measures like:

Picture 2 – Presbyopia Image

Using proper glasses

Use of appropriate glasses can help optimize the vision of sufferers.

Preventing injuries to the eye

Wearing specialized or protective eyewear while painting or indulging in sports activities can help you avoid injuries and toxic fumes that may cause damage to the eyes and cause this condition. It is recommended that you buy lenses that measure up to the ANSI Z87.1 standard of effectiveness.

Protecting eyes from sunlight

Take adequate protection for the eyes while going out in the sun. Sunlight contains UV rays, prolonged damage to which may cause damage to the eyes. Wearing sunglasses that are capable of obstructing UV radiation can help you work or move about for long hours under the sun without fearing a possible ocular damage.

Checking eyes regularly

It is recommended that you check your eyes at regular intervals to ensure a constant clear vision. This is irrespective of how well you are able to see.

Working in a well-lit environment

If you feel the place where you work or stay is not well-lit enough, add more light to the place. A brighter environment not only refreshes the mind but also makes it easier for the eyes to work.

Presbyopia Home Remedies

Although home remedies are unable to prevent occurrence of this disorder, they are effective enough to make the condition develop at a later stage. Such remedies include:

Eating healthy foods

A healthy diet for a good vision should include plenty of green vegetables and fruits. Such foods contain high amounts of Vitamin A, antioxidants and beta carotene, which are essential for maintaining a healthy vision.

Controlling chronic disorders

Unmonitored high blood pressure or diabetes can affect your eyesight. If you are suffering from such disorders, it is important for you to keep them in check to prevent vision problems.

Many herbalists also recommend intake of Lutein, a supplement that is said to be effective in preventing the occurrence of this ocular disease. Lutein is contained in rich doses in egg yolks and green vegetables.

Presbyopia Eye Exercises

Various exercises for the eye are said to be somewhat effective in delaying the onset of the disorder. These include:

Crossing eyes

It involves crossing the eyes and concentrating on the tip of the nose, followed by looking at a distant object and focusing on it. This technique should be repeated and performed in sync with the timing of your breathing. In other words, you should look at your nose while inhaling and focus on a far-off object at the time of exhaling.

Running the gaze around

This involves holding any reading material upside-down and about 3 inches apart from the face. You should try to “run your gaze around” every letter contained within a word.

20-20-20

If you spend a lot of time reading or doing close work, perform this exercise to decrease eye fatigue. After 20 minutes of working and observing a close object, look away to rest your eyes on an object that is located approximately 20 feet away from you. Return to your work after gazing for 20 seconds in this way.

Some optometrists hold that exercising the eye can enhance visual acuity or sharpness of vision and eliminate or reduce Presbyopia. Although there is anecdotal evidence to confirm the effectiveness of their claim, there is no scientific evidence as yet to support the effectuality of ocular workouts in warding off this disorder.

Presbyopia Prognosis

The problems occurring due to this disease can be controlled by use of contact lenses or glasses.

Presbyopia Prevention

No way of preventing this disorder is known as yet. It is supposed to be an inevitable part of the ageing process. However, seeking medical attention at the earliest signs of the disease can help avoid its deterioration over time and with increasing age. Presently, however, there are no guidelines to delay an onset of this condition or prevent its occurrence.

If you have been lately suffering from vision problems symptomatic of Presbyopia, get in touch with an eye specialist as soon as you can. Visual problems can hamper your daily activities, seriously affect your health and take the joy out of your life. Naturally, it is important for you to seek medical attention for such conditions as early as possible.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002021/

http://www.mayoclinic.com/health/presbyopia/DS00589

http://www.webmd.com/eye-health/eye-health-presbyopia-eyes

http://www.umm.edu/ency/article/001026.htm