What is Presbyopia?

By | 30 April 2021


Eye tissues, like every tissue in the body, are tissues that age over time, and some problems may occur due to this aging. One of these problems is presbyopia. Presbyopia is the occurrence of near vision impairment associated with advancing age. This problem usually starts at the age of 35-40 and can progress up to the age of 60.

What is Presbyopia?

Presbyopia is a near vision disorder that begins to appear with aging as a result of the loss of flexibility of the lens in the eye, and the severity of it may increase to a certain degree as the lens progresses.

The lens changes shape so that objects at different distances from the eye can be seen easily. This straining process is called accommodation. The lenses start to harden gradually from the age of about 14 years. For this reason, their ability to change shape decreases, and problems are experienced in vision. The lenses continue to harden until about 65 years of age and now become completely rigid. It is not known exactly what causes lenses to lose their flexibility due to age, it is considered a natural part of aging. It occurs in many people and generally, everyone is affected by this disease.

It is beneficial for people to have regular eye checks from the early 40s. An eye check should be done every 2 years. Thus, in case of such a problem, it can be detected early and a path can be followed accordingly.

The problem with presbyopia is actually the same as in hyperopia. The focal point of the rays coming into the eye from objects close to the eye remains at the back of the retina, thus making it difficult to see the rays that are out of focus. Although the problems experienced in hyperopia and presbyopia are the same, the reason for this problem to occur is actually different. While the eyeball is shorter than it should be in hypermetropia causes problems, in presbyopia, problems begin to appear as a result of the hardening and loss of flexibility of the lens associated with old age.

What are the symptoms of presbyopia?

This disease may not show symptoms in some elderly people, but even in this way, the disease can be diagnosed, because, with this disease, other vision problems often occur in the person. These problems may hide the symptoms that point to the actual presbyopia.

  • Feeling the desire to zoom out while reading something or looking at an object, and the blurred vision of objects closer than 50 cm to the eye becomes more blurred in the future,
  • With the progression of the disease, pain begins to be seen in the forehead and temples caused by a long-term inability to see clearly,
  • The person needs a bright light while reading something such as a book or newspaper.
  • Difficulty seeing some distant objects clearly after focusing on a nearby object or after reading because the eye focusing on the near object also tries to develop harmony to see the distant object clearly.

What are the causes of presbyopia?

The cause of Presbyopia disease has not been found fully yet, but some opinions have emerged as a result of the studies. Presbyopia, which is generally seen in the age range of 38-45, occurs as a result of the hardening of the structure called the lens in the eye over time, the loss of flexibility due to hardening, the deformation of the capsule in the structure of the lens, and the deformation of the fibers in the eye that help the lens to move. The lens in the eye is transparent, flexible, and structurally surrounded by an external capsule and works in harmony with the different structures in the eye. Some eye cells do not have the ability to constantly renew themselves. People who have eye problems in this way should therefore not wait for their eyes to heal spontaneously, they should definitely consult a doctor and start an appropriate treatment under the supervision of a doctor as soon as possible.

How is Presbyopia diagnosed?

If the patient experiences symptoms, he or she consults a doctor, and the doctor performs an eye examination and vision test at the first stage. People with presbyopia on eye examination usually have difficulty seeing objects closer than 50 cm.

The next step in diagnosis is to perform an eye test. This test is called the Snellen vision test. Most people are familiar with this test. In this test, there is a table at a predetermined distance and the patient is expected to read the letters on this table. It is very easy to diagnose as a result of this test applied by the doctor.

How is presbyopia treated?

There are many different methods applied in the world related to presbyopia treatment. Of course, each treatment method has many advantages as well as disadvantages.

The most common treatment is currently using presbyopia glasses. Presbyopia glasses are generally known as reading glasses. As a result of the loss of flexibility of the eye lens, external lenses are used because of the focusing work that it cannot do, and the image is dropped on the retina. Bifocal and multifocal glasses are generally used for eyeglass treatment.

Since presbyopia is seen in people of advanced age, patients usually do not have a problem getting used to glasses and can easily start using them. However, some people still have problems adapting the glasses, so different treatment methods are tried.

It is known that the lenses used as an alternative to the people who do not want to use glasses for years in the treatment of all kinds of problems in the eye carry more risks than glasses. Conversely, the use of lenses in presbyopia may be more advantageous than glasses in some cases. The use of lenses provides the patient with a wider angle of view than glasses.

The disadvantages and advantages of using lenses or glasses are discussed in detail with an ophthalmologist and a correct treatment method is decided. In addition to presbyopia, the patient usually has other eye problems, so the ability to treat both eye problems with the same eyeglass or the same lens positively affects the patient’s quality of life.

Another approach in the treatment of presbyopia is the surgical treatment method. Advances in surgical treatment methods continue today. Laser treatment and lens surgery applications to the intraocular lens are the most common surgical treatment methods for presbyopia. These surgical methods are generally applied to people who are not suitable for wearing glasses or lenses or who are not deemed appropriate to use due to their lifestyle and work.

What are Presbyopia surgeries?

When it comes to presbyopia surgeries, the first things that come to mind are laser application to the cornea or multifocal/trifocal or accommodative intraocular lens implantation. Successful treatment is possible with these methods. In the method known as laser application to the cornea, the cornea is drawn by laser. This method is generally appropriate for people over the age of 40, who do not want to use glasses or lenses, and who have different eye diseases besides presbyopia. Eye diseases seen with presbyopia can be myopia, hyperopia, or astigmatism. This procedure is performed with the drop anesthesia method and after the procedure, the patient can continue his normal life immediately. Other eye problems accompanying this disease can also be treated in this treatment method. There is an important point in applying the surgical treatment method; If the patient’s eye number, ie eye disorder, continues to progress, surgical treatment is only a temporary solution.

What can be done to prevent presbyopia from progressing?

People over the age of 40 should definitely have their eye checks done by a specialist. People between the ages of 40-55 should have an eye checkup once every 2-4 years, people between the ages of 55-65 once every 1-3 years, and those over the age of 65 once a year, even if they do not have any disease or symptoms. Presbyopia is a physiological problem that is not very dangerous, provided that the controls are carried out correctly and the eye health is taken care of. It is seen in many people with advancing age. It can be treated easily. The risk of the disease is the same between the person who has an eye problem and the person who does not have a genetic problem if they are of the same age. For eye health, which is one of the organs most affected by the aging process, it is of great importance not to miss routine checks.


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