What is Presbyopia? Causes, Symptoms, Diagnosis and Treatment

Presbyopia means "aged eye" in Greek. Like all organs in the body, the eye ages over time. As a result of this aging, some vision problems can occur.

Presbyopia is a problem of not being able to see near in people over 40 years of age, which occurs as a result of the loss of flexibility of the eye lens due to aging. The development of presbyopia continues until the mid-60s.

This process stabilizes in the early 60s. Especially after the age of 65, the eye's ability to focus either stops completely or decreases to a minimum. After this stage, glasses are required for near vision.

What Causes Presbyopia?

Presbyopia is caused by changes in the properties of the crystal in the eye with age. Normal eye function requires the eye to focus and clearly perceive the image on the retina. This focusing process takes place using the elasticity of the lens of the eye. In a person with presbyopia, this elasticity decreases and causes the eye's ability to focus to deteriorate.

The main factors that cause presbyopia are:

• Decreased elasticity of the lens: The natural lens (the lens) inside the eye hardens and becomes less flexible with age. This makes it difficult to see close objects clearly.

• Muscle weakness: The muscles that control the focusing process of the eyes weaken with age. Weakness of these muscles causes the crystal to not focus properly.

• Aging: Presbyopia usually begins after age 40 and progresses with age. A large number of people under the age of 65 experience presbyopia.

Symptoms of Presbyopia

Presbyopia begins in the 40s, progresses slowly, and causes few symptoms at this age. The period when presbyopia accelerates is between the ages of 46-52. Symptoms and complaints are increasing in patients in this age range.

If the patients had a hypermetropia problem before the age-related myopia problem, their complaints may appear at an earlier stage, and if they have a myopia problem, their complaints may appear at a later stage. In some people over the age of 40, presbyopia can be diagnosed with a simple eye exam, even if it shows no symptoms. Because this refractive error is likely to be accompanied by other vision problems. Other vision problems mentioned can hide different information that indicates presbyopia.

• Blurry of Near Objects: The most common symptom is blurred vision of near objects. Difficulty reading close objects, such as books, magazines, telephone or computer screens, or doing fine work

• Need to move objects away: They try to move objects away to see more clearly.

• Eye strain: You may get tired quickly when you work closely or read a book for a long time. Your eyes may feel sore or tight.

• Headaches: People with presbyopia may experience headaches as they strain their eyes to see close objects clearly.

• Need for eyeglasses: Presbyopia usually develops with age and may require optical corrections such as reading glasses or bifocal/multifocal lenses if needed.

What is the Difference between Presbyopia and Hypermetropia?

Although the problem occurring in both is the same, the cause is different. Both hypermetropia and presbyopia are refractive errors of the eye, in which the image entering the eye from the outside is focused behind the retina.

While hypermetropia is caused by a congenitally shorter than normal eyeball, presbyopia is caused by the hardening and loss of elasticity of the lens with aging.

Diagnosis:

The diagnosis is made by evaluating your symptoms and eye examination. The main steps in the diagnosis process are:

• Assessing symptoms: First, your doctor will ask you questions about the eye problems you are experiencing to understand the symptoms. You should note whether you have difficulty seeing close objects or any other eye problems.

• Eye Exam: An ophthalmologist or optometrist will examine your eyes. This exam may include:

• Eye pressure measurement

• Refraction test: In this test, the doctor will use different lenses to evaluate your eye's ability to focus. As a result, near and far vision problems can be identified.

• Retinal examination: An ophthalmologist will look inside the eye using an ophthalmoscope to assess the condition of the retina. This is needed to diagnose any other potential problems inside your eye.

• Reading tests: A doctor may perform tests to read near objects to assess your ability to see clearly at close distances.

How is Presbyopia Treated?

Treatment may vary depending on the individual's age, eye health, and lifestyle. Get to know several treatment options for presbyopia:

• Reading eyeglasses: Reading glasses are a common method of correction used to see near objects more clearly.

• Bifocal or Multifocal lenses: Bifocal or multifocal contact lenses are lenses that allow you to see clearly both near and far objects. These lenses have one or more focal points and can be tailored to your eye needs.

• Laser Surgery: Laser surgery techniques used to correct presbyopia include LASIK (Laser Assisted In Situ Keratomileusis) and PRK (Photorefractive Keratectomy). These surgical techniques can correct near and far vision by reshaping the front surface of the eye.

• Intraocular lens: If presbyopia worsens with age and contact lenses or laser surgery are not suitable, intraocular lens surgery may be recommended by an ophthalmologist. In this procedure, the natural eye lens is replaced with an artificial lens (intraocular lens).