Presbyopia: A General Overview

As years pass, there is a gradual drop in the eye lens’s ability to change its shape, causing various refractive disorders. Usually, people with presbyopic eyes find it difficult to perform day-to-day activities like reading books, working on a desktop, or using a smartphone. The saddest part is when such a condition is left unchecked for extended periods. Various symptoms, like eye strain, headaches, fatigue, etc., arise that worsen with time, disrupting the quality of life. Hence, you must prioritize routine eye checkups to manage presbyopia effectively!

How common is presbyopia?

According to current statistics, more than 90% of middle-aged adults suffer from presbyopia. As previously mentioned, this is a natural ageing process, and one can, at the most, slow down the onset of symptoms by adopting proper preventive measures.   

Presbyopic conditions: What are the types?

Depending on how much the condition has progressed, presbyopia can be subclassified into the following types:  

• Incipient presbyopia: This is the early stage of presbyopia when people cannot read small-sized letters. It is also known as borderline or pre-presbyopia. 
• Functional presbyopia: Occurs when presbyopia has progressed a bit from the early stage. It can be easily corrected with a plus-powered contact lens or glasses.
• Premature presbyopia: Typically occurs before hitting the mid-age. Possible reasons for this are - untreated hypermetropia, chronic simple glaucoma, early staged nuclear sclerosis, and weakened ciliary muscle. 
• Absolute presbyopia: Characterized by complete loss of focus on near objects, irrespective of the presence of light. Happens mostly to senior people above the age of sixty.
• Nocturnal presbyopia: It is like a dimmer switch on your vision. In this condition, people struggle to see objects in low light, often due to an increased pupil size and decreased field depth.

Signs and symptoms of presbyopia

Here is a list of common symptoms to expect if you have presbyopia.

• Blurriness of eyesight: It indicates a gradual decline in the eye’s ability to focus on nearby objects. Also, this hampers reading and similar activities that require a close-up view.
• Straining of eyes:If you suffer from squinting or experience severe eye strain while reading books or working over a computer screen, you may have presbyopia. This happens when the eye muscles work harder to manage the shape of the lens.  
• Persistent headaches:Do you constantly struggle to keep your head up to see close-up views? This is one of the prime symptoms of presbyopia, putting unnecessary pressure on your eye muscles and straining them.
• Not able to see small print:If you face difficulty seeing prints in newspapers or books, visit a certified ophthalmologist soon.

Presbyopia symptoms if checked on time can be managed with corrective spectacles. However, if the condition has already become severe, refractive surgery is needed.  

Presbyopia: Possible Causes Explained

One of the leading causes of presbyopia is when the eye lens becomes extremely stiff, resulting in loss of flexibility. Normally, the lens can change its shape depending on how near or far your intended object is located. But, in presbyopia, the lens's ability is reduced, making you unable to focus on nearby things. Here's a list of causes that may trigger presbyopic eyes in you.  

Protein deficiency in the eyes: As one ages, the necessary proteins within the eye's lens change. This leads to a loss of elasticity and makes the lens more rigid. Such reduced flexibility can easily impact one's close focus on objects.

Decreased accommodative ability: As a person suffers from presbyopia, the ability to adjust focus between near and far-away objects diminishes. Moreover, the ciliary muscles become weak and less efficient over time.

Age-related problems: Certain degenerative disorders of eye structures, such as the hardening and thickening of the lens, can result in presbyopia. This may damage the surrounding eye tissues over time and make it challenging to focus on close objects.

Do not worry anymore—arrange for a quick visual check so you can embark on a journey of crystal-clear vision soon!

What are the risk factors for presbyopia?

Many other factors contribute to presbyopia, including increasing age. However, you must consult an ophthalmologist soon if you meet any of the risk criteria below.

• Chronic diseases: Certain chronic health conditions, such as high blood pressure, arterial clogs, or multiple sclerosis, can significantly increase the risk of developing presbyopia at a younger age. If you have any of these, you must be proactive about your eye health and get a checkup.
• Medications: Some therapeutic drugs, such as antidepressants, antihistamines, and diuretics, can increase the likelihood of getting premature presbyopia. 
• Eye injury or head trauma: Having a history of sudden fall and hurting your eyes or head can lead to the emergence of presbyopic symptoms.
• Lens-based surgery: If you have undergone early surgery on your eye lens, such as cataract or glaucoma surgery, chances are high that you will develop presbyopia shortly.  
• Excessive alcohol intake: Having alcohol in high amounts can increase the chances of getting presbyopic eyes. Additionally, it can disrupt your optic nerve and lead to permanent blindness.
• Location factors: Although this will not affect like the above factors, if you happen to live close to the equator, chances are that you may develop early presbyopia. This is due to the fact that there is a higher temperature around the equatorial regions with greater exposure to harmful UV rays.  
• Genetic predisposition: If you have anyone in your family suffering from presbyopia, you may develop the same in near future. However, chances are not very high and a timey check can avert potential complications from arising.

Possible complications for a prolonged untreated presbyopia

Mild presbyopia cases are easy to manage with corrective glasses and lenses. However, if it progresses into the advanced stage, treatment becomes difficult and may result in severe consequences. Here's what you may expect if you delay treatment.  

• Headaches and eyestrain
• Frequent need to change glasses
• Fatigue-like symptoms
• Increased risk of other eye problems such as astigmatism, hyperopia, or myopia

If you find trouble to see things clearly, we are more than happy to help. Arrange an appointment with our optometrist and get early treatment.

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Diagnostic procedures for presbyopic eyes

After you visit an eye clinic, the doctor will follow the following steps to check whether you suffer from presbyopia.

1. Assessing eye health history:

The ophthalmologist will ask for all the necessary information about your eye symptoms. Typical questions include:

• What symptoms are you currently facing?
• How long have you been facing such?
• Do you have any headaches or similar symptoms?  
• Do you sense any discomfort surrounding the eye?
• Did you have any eye disease previously?
• Is there any eye infection or allergy present?
• Have you undergone any surgery recently?
• Do you smoke or take alcohol?
• How many times do you wash your eyes and maintain hygiene?

2. Testing the eyes

Eyecare specialists will conduct the following procedures to check your visual health's normalcy.

• Visual acuity test: This involves reading letters of different font sizes from Snellen's chart. It is highly beneficial to prepare a customized treatment plan that best suits your needs.
• Refraction Test: A refraction test helps measure the eye's prescription required for maintaining optimal vision. It can also evaluate whether your eyes are able to focus on both nearby and far objects with the same visual clarity.
• Retinoscopy: This involves using a lighted retinoscope to measure the refracting index of the retina. The doctor adjusts the lenses in front of the eyes, thus identifying if any refractive error is present.
• Slit-lamp examination: It can give detailed insights into the inner eye structures, including the lens. This, in turn, allows the doctor to plan a suitable treatment plan for your presbyopic eyes.  

How do you treat presbyopia?

Although presbyopia cannot be fully cured, the ophthalmologist may employ several ways to manage it. Common treatments include:

Corrective glasses

• Reading glasses/Readers: Easily available in medical stores, these glasses can magnify or enlarge the objects you view.  
• Bifocals: They are beneficial for both nearsightedness and farsightedness and are hence very popular. The upper portion of the specs is for distance vision, while the lower portion is for close views.  
• Trifocals: As the name suggests, this helps manage three purposes - for viewing in close-ups, faraway objects, and visualizing objects midway.
• Progressive lenses: Similar to bifocals, these lenses are a blended version of the two prescriptions for nearsightedness and farsightedness. The only difference between a bifocal and progressive lens is the presence of separate sections.

Presbyopia lenses

Contact lenses are also beneficial for treating presbyopia. Here are some examples of presbyopia lenses:

• Multifocal lenses: They are available in soft or gas-permeable versions.
• Monovision lenses: One lens helps see distant objects at a distance, while the other is meant for close-up vision.

Presbyopia eye drops

Pilocarpine eye drops are available in the market and can effectively treat presbyopia. Here's how they work: They constrict the pupil, thus improving focus on nearby objects. However, there may be some side effects, such as headaches (which generally resolve after some time), retina detachment, etc. Inform the doctor if you face abnormal changes in your vision, such as halos or flashy spots in front of your eyes.  

Presbyopia surgery

Laser surgery for presbyopia is the best way to correct one eye for seeing at a distance and the other for viewing near objects. Includes three main types:

• Laser-assisted in situ keratomileusis (LASIK): Helps improve eyesight by changing corneal shape. The cornea constitutes the outermost layer of your eye through which light passes into the retina. You can easily opt for this surgery if you have prolonged astigmatism, nearsightedness or farsightedness.
• Photorefractive keratectomy (PRK): In this procedure, laser light is used to flatten the cornea surface, allowing light rays to focus correctly on the retinal layer. While the recovery time is longer than LASIK, this method is particularly suitable for people with rougher and thinner corneas.
• Small-incision lenticule extraction (SMILE): This innovative procedure involves using a laser to remove a corneal portion in the shape of a small disk, effectively reshaping the cornea and significantly improving vision. It's a great option for individuals with astigmatism or nearsightedness.

Presbyopia lens implants

Involves implanting an artificial intraocular lens (IOL) in your eye. Commonly, there are three presbyopia-correcting IOLs for improving focus power. Depending upon the severity of your issue, your ophthalmologist will recommend any of the following:

• Multifocal IOLs: These are beneficial in improving both near and distance focus.
• Accommodative IOLs: These help change the shape of the cornea, imitating your natural eyes' ability to focus on objects at varying distances.
• Extended depth-of-focus lenses: These are similar to multifocal lenses but have one corrective zone instead of multiple zones. However, they are still beneficial for seeing both near and far away with the same visual acuity.

Presbyopia corneal inlays

These cause minimal invasion and can improve all types of refractive errors, including presbyopic eyes. In this procedure, the surgeon will surgically implant the corneal inlays, helping you achieve clear vision. However, this procedure is not recommended if you have undergone cataract-removal surgery previously.

Preventive steps you can adopt

Although presbyopia is a part of the natural ageing process, you can follow the steps below to delay the appearance of potential symptoms. These include:

• Getting regular eye exams: Consult a certified eye doctor to know how often you need a visual checkup. This generally depends on factors such as current eye health and age.
• Protective eyewear, such as sunglasses, is a simple yet effective measure to prevent UV damage. Always wear them when you're out in the sun to shield your eyes from harmful rays that can damage the lens.
• Keeping a check on medical prescriptions: If you suffer from excessive eye strain or face discomfort while carrying out regular activities, ensure you maintain your contact lenses or glasses.  
• Doing eye exercises: These are good for maintaining overall eye health and can improve vision in the long run. Also, helpful in keeping up flexibility of eye muscles and reducing strain. However, it is best to ask your doctor which exercises to do and what to avoid.
• Managing other systemic conditions: If you have hypertension, high blood sugar, or similar conditions, monitor them!
• Avoiding eye injuries: Always put on protective eyewear before participating in a sport activity. This will reduce the chances of accidents and other injuries.
• Eating healthy: Add foods rich in essential micronutrients like carotene, and Vitamin A and C to your diet. Some examples are citrus fruits, green leafy vegetables, milk products, carrots, egg yolks, etc.  

Homely Tips for Preventing Presbyopia

• Do your tasks in a well-lit room: Maintain appropriate lighting environments for tasks requiring close-up vision. Keep the light source near you as much as possible to reduce glares and shadows.
• Maintaining proper eye hygiene: Consider washing your eyes at least three times a day, preferably after returning from outside. This helps remove dirt and harmful particles from your eyes and ensures clear vision.
• Putting anti-glare coatings: These coatings, when applied to your eyeglasses, can significantly reduce reflections, thereby enhancing your visual clarity. This is especially useful when you're spending long hours in front of digital screens, making it a practical solution for your daily life.

When do you need to visit the doctor?

If you develop presbyopia, your ophthalmologist will guide you on the steps required to prevent worsening of symptoms. Also, he will ask you to visit for follow-ups as and when needed. The frequency of medical visits typically depends on the severity of your issue. However, prioritize doctor visits if you face any of the following symptoms:

• Appearance of new symptoms (for example such as headaches and eye pain worsening over time)
• Aggravation of existent symptoms
• Side effects from current medications

Final words

By now, you know that presbyopia is a condition that cannot be fully recovered. At the most, prescription of corrective treatments and surgery procedures is possible. However, if you have been facing trouble seeing objects near you for extended periods, do not sit back. Feel free to contact Vision Cure Clinic and check your eyes at the earliest!

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