Presbyopia - age related long sightenness

There are a lot of people who suffer from presbyopia during their early forties. It is a refractive error. The word presbyopia comes from the Greek word ageing eye. This disorder happens when the crystalline lens of the eye loses its flexibility or when the muscles that pull the eye into focus lose its power. When the disorder progresses the ability to see deteriorates. People who have this condition will have a hard time focusing, will experience blurry vision, and will have tired eyes more often. People with presbyopia will have trouble reading in poor light conditions, they will have trouble changing their focus from near to far, and they will keep repositioning reading material in order to see things properly. Those with presbyopia will need reading glasses when they do their work up close.

What are the types of age-related long-sightedness?

Here are the five types of age-related long-sightedness

  • Premature presbyopia – this is when the symptoms of presbyopia start in the thirties or even earlier
  • Functional presbyopia – in this kind of presbyopia, your eyes will lose the ability to focus on nearby objects
  • Incipient presbyopia – this is the kind of presbyopia in the early stages. One of the things you will notice with this kind of presbyopia is that you will exert more effort when you do work up close or when you try to read small print
  • Nocturnal presbyopia – this type of presbyopia is when you are unable to focus on nearby objects when it is dark
  • Absolute presbyopia – this kind of presbyopia entails the complete inability to focus on objects up close. The lens in the eye is unable to focus the light rays of objects up close

What are the symptoms of presbyopia?

Here are some of the usual symptoms that can be noticed from age-related long-sightedness

  • you will have sore and tired eyes
  • you may have to remove your eye glasses when you read up close
  • you will have blurry vision
  • you will feel tired or drowsy after you do work up close
  • you will have a hard time looking at objects up close
  • you will squint a lot
  • you will have headaches
  • there will be a delay in focusing on nearby objects
  • you will have double vision
  • there will be a delay when you focus on objects at a distance
  • you will need brighter lighting when you read

What are the causes of presbyopia?

Some people may think that presbyopia is a disease. It is merely the effect of ageing. It is normal and it is expected. When you grow older, your lenses will naturally deteriorate. Presbyopia will affect almost everyone whether they are wearing glasses or contact lenses.

Ageing is the most common and it is the most expected cause of presbyopia. When you reach the age of forty, there will be changes in the lens of your eye. You will notice that there are changes in your vision like blurring or double print when you read.

Those who live in a hot climate and who are exposed to high levels of sun are at a greater risk of developing presbyopia in their earlier years. This is called premature presbyopia. You are also at risk of presbyopia if you have a job that requires a lot of close up work. Those who are long-sighted or hypermetropic, who wear contact lenses, or who wear corrective glasses are also at risk of developing presbyopia at a younger age.

How is presbyopia diagnosed?

Normally, presbyopia is diagnosed by an optometrist. They will ask you about the difficulties you are encountering with your eyesight and they will test your ability to see objects up close and maybe objects at a distance.

How is presbyopia treated?

Treating presbyopia is about fixing the inability or the lack of ability on focusing on objects up close. Among the treatments of presbyopia are wearing corrective lenses, going through refractive surgery, and availing of lens implants.

Using corrective lenses

Here are some of the ways corrective lenses can be used

  • prescription reading glasses – you can use these prescription reading glasses if you do not have other problems with your vision aside from reading
  • bifocals – bifocal means bi for two and focal for focusing. You can focus two different ways. There are a lot of bifocals available in the market today but they mostly fall under two types. There are the ones with a visible horizontal line and there are the ones without a visible line. The ones without a visible line are known as progressive bifocals. The way the bifocals work is intuitive. When you look straight, you will be able to use your distance vision while when you look lower, the focus is on objects up close
  • trifocals – trifocal means tri for three and focal for focusing. You can focus on three different levels. You can use distance vision when you look straight, middle-distance vision for computer screens, and you can also use the close up vision when you want to read up close
  • bifocal contacts – bifocal contacts have the ability to focus on objects up close and on objects at a distance. The bottom portion of the contact is heavier so that the contacts are always in their proper position. One of the drawbacks of bifocal contacts is their difficulty in fitting. They often do not satisfy the users
  • monovision contacts – when you use monovision contacts, you use one contact lens for looking at objects at a distance and another contact lens when you look at objects up close, one for each eye. The one that is used for looking at objects at a distance is for the dominant eye while the other one which is used for looking at objects up close is for the non-dominant eye. Normally, the dominant eye is the one you use when you take pictures
  • modified monovision – with modified monovision, one of your eyes has a bifocal, meaning it can focus on objects at a distance and on objects up close, and your other eye has a lens that focuses on objects at a distance. The lens that focuses on objects at a distance is placed on the dominant eye. In time, your brain will learn how to use both eyes for looking at objects at a distance and one of the eyes for reading and focusing on objects up close

Going through Refractive Surgery

During refractive surgery, the shape of your cornea is changed. Refractive surgery may be used to treat presbyopia. It is normally used to treat the non-dominant eye. The non-dominant eye is used for looking at objects up close. Before someone goes through refractive surgery, it is highly recommended that they use monovision contact lenses first.

Refractive surgery was initially developed in order to treat nearsightedness, farsightedness, and astigmatism but there have been studies that refractive surgery could also help those with presbyopia. Refractive surgery helps those with presbyopia by reducing their reliance on corrective lenses. Right now, there aren’t many studies on the long term effectiveness of monovision refractive surgery on people with presbyopia, Moreover, those who go through the refractive surgery may still need to use corrective lenses when they read.

Here are some of the refractive surgical procedures that can be performed in order to treat presbyopia

  • Laser-assisted in-situ keratomileusis – This is abbreviated as LASIK. In this process, the doctor will make a thin circular hinged cut into your cornea by using a special instrument called a keratome. A laser can also be used to make this type of cut. The surgeon will raise the flap and then use an excimer laser to sculpt the shape of the cornea underneath the flap. An excimer laser is a sort of laser that does not produce heat and it is ideal for this kind of surgery.
  • Laser-assisted subepithelial keratomileusis – This is abbreviated as LASEK. In this kind of surgery, a thin layer of cornea is folded back. This is done so that the eye will not get as much harm compared to an absolute exposure. If you are into sports or if you are at risk of injuring your eyes then this type of surgery is a better option for you.
  • Photorefractive Keratectomy – This is abbreviated as PRK. In this type of surgery, the outer protective layer of your cornea is separated. Afterwards, a laser is used to fix the curvature of your cornea.
  • Conductive Keratoplasty – This is abbreviated as CK. In this sort of surgery, radiofrequency energy is used for applying heat in tiny spots in the cornea area. The type of effect of this radiofrequency is comparable to a plastic wrap being stretched with heat. The transformation in the curvature of your cornea will depend on the spacing of the spots, the number of the spots, and the way the cornea will heal after the procedure. Results from CK differ from person to person.
  • Using lens implants – some of the ophthalmologists will simply remove your natural lens and replace it with a synthetic one. This is known as an intra-ocular lens implant. These intra-ocular lens implants will enable you to see objects from afar and up close. There has been trouble with these lens implants lately though. Patients have been complaining about glare, blurring, and the risks associated with such implant which include infections, inflammations, glaucoma, and bleeding.

Blended Vision for Presbyopia treatment

LASIK, PRK, and LASEK can be used to treat Presbyopia or aging eyes. During presbyopia surgery, one of your eyes will be treated to view objects which are near to you while the other eye will be treated for viewing objects at a farther distance. The brain will be able to put the two images together and allow the individual to experience depth in their focusing and an overall improvement in their vision. The patient need not wear any glasses or lenses anymore.

What is the difference between blended vision and monovision?

You should not confuse monovision with blended vision. Monovision is when one eye has a contact lens to see the near objects while the other eye has a contact lens to see the farther objects. Blended vision which is used for presbyopia is entirely different. The near eye with blended vision can still see clearly at a far distance as compared to the near eye with monovision. It is the same with the far eye. The far eye with blended vision can still see clearly when it is viewing objects up close. With monovision, the far eye may already have a blurred image. Blended vision is milder than monovision and people can adjust to blended vision much easier. This is why ninety five percent of people with a focusing disorder are better off having blended vision treatment as compared to only fifty percent for a monovision treatment.

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