What is presbyopia?
Presbyopia is the decrease of your eyes’ ability to focus on nearby objects due to aging. This phenomenon is a natural part of the aging process.
Presbyopia comes from a Greek word which means ‘old eye’. Presbyopia occurs in the mid-forties and continues to progress until the age of 60. It usually stops progressing in the mid-sixties.
What causes presbyopia?
Our eyes contain a structure called the lens. The task of the lens is to ensure that the rays coming into the eye are focused on the retina and to sharpen the vision. The lens performs its focusing function by changing its shape thanks to its flexible structure.
In young people, the lens is flexible and soft. In this way, it easily changes its shape and performs the focusing function. After the age of 40, it loses its flexibility. It can no longer change its shape easily and its focusing power decreases.
As a result, the images of nearby objects appear blurry as soon as they hit the retina. It is difficult to do tasks that require near vision, such as reading a book, sewing, and looking at the phone.
There is no way to stop or reverse presbyopia, as it is part of the normal aging process. Presbyopia can only be corrected with one of the methods such as glasses, contact lenses or surgery.
What are the symptoms of presbyopia?
Presbyopia begins in the forties and progresses very slowly. The fastest progression is between the ages of 46-52. For this reason, the complaints of the patients become more evident at these ages and they apply to the doctor in this period.
If there is an visual impairment such as hyperopia (farsightedness), the symptoms appear earlier ages, whereas if there is a problem of nearsightedness such as myopia, the symptoms appear at a later age. The most common complaints are as follows:
- Inability to see clearly at normal reading distance
- Trying to see clearly by moving objects such as phones and books away
- Pain in the head and around the eyes after working or reading at close range
Complaints become more pronounced in a dim environment or when tired.
What is the treatment for presbyopia?
The aim in the treatment of presbyopia is to provide a vision similar to the vision when the eye focuses. For this, treatment methods such as glasses, contact lenses, refractive surgery and intraocular lens placement surgery can be applied.
Glasses:
Glasses are the simplest and safest treatment for presbyopia.
- Reading (monofocal) glasses: If your eye does not have any other refractive errors, only reading glasses will suffice. Otherwise, you may need to use both distance and reading glasses.
- Bifocal glasses: In these glasses, two different focal points, near and far, are separated by a line on the glass. It may cause complaints in intermediate distance.
- Trifocal glasses: To reduce the complaints in bifocal glasses, it has 3 foci: near, intermediate and far. Near focus is set for reading, medium focus is set for computer use.
- Progressive glasses: In these glasses, the focal points are not separated by a line. Different regions have different focal points.
Contact Lens:
People who do not want to wear glasses can use contact lenses.
- Monovision contact lens: One eye is adjusted for distance vision and the other eye for near vision. In this method, the patient’s adaptation is tried. Not every patient can get used to seeing with one eye.
- Multifocal contact lens: These lenses have different rings at different focal points. There is a slight loss of vision quality. Both far and near vision are equally sharp. Although this situation is not normal, our brain adapts over time and suitable patients use it comfortably.
Refractive Surgery:
- Laser refractive surgery: In this method, laser treatment is applied to the eyes so that one eye can see far and the other eye near. So monovision is performed. The patient has to get used to this situation. Before the operation, the patient’s compliance can be tried with mono vision contact lenses.
- Corneal inlays: A small ring-shaped piece called inlay is placed inside the corneal layer. Thanks to this piece, the rays passing through the cornea are refracted and nearby objects are seen more clearly.
Intraocular lenses (Smart lenses):
These lenses have multiple focal points in the form of rings. In this way, they show both near and far distances clearly. In recent years, trifocal lenses, also called smart lenses, have increased vision clarity at intermediate distances. With these lenses, the vision at all distances falls on the retina clearly at the same time.
Sometimes, complaints such as light scattering and wavy vision may occur. This happens because it is different from the image our brain is used to. Patients may find this situation strange at first.
But after a certain time, our brain gets used to this situation and the complaints disappear. This method is used most frequently all over the world for the treatment of presbyopia.