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Presbyopia: Evaluation and Treatment

PresbyopiaPresbyopia, sometimes referred to as age-related presbyopia, is the normal worsening of vision with age, especially near vision. As you approach middle age, the lenses in your eyes begin to thicken and lose their flexibility. The ability of the lens to bend allows our eyes to focus on objects at varying distances (accommodation). The loss of this ability means that vision gets worse and objects cannot be brought into focus. This typically becomes noticeable some time around age 40 when you realize that you have to hold a book or newspaper farther from your face to focus on it.

Normally, a muscle surrounding the lens in your eye expands or contracts, depending on the distance to the object you’re focusing on. With presbyopia, the muscle still works, but it may not work as well. Also, the lens loses much of its flexibility and won’t bend enough to bring close objects into focus. Images are thenfocused behind the retina instead of directly on it, leaving close vision blurred. Putting greater distance between the object and your eye brings the object into focus. For example, holding a newspaper farther from your face helps you see the words. For this reason, presbyopia is sometimes called “long-arm syndrome.”

What causes presbyopia?

Presbyopia is a natural part of aging. As you grow older, the lenses in your eyes thicken. They lose their elasticity, and the muscles surrounding the lenses weaken. Both these changes decrease your ability to focus, especially on near objects. The changes take place gradually, though it may seem that this loss of accommodation occurs quickly.

What are the symptoms?

The main symptom of presbyopia is blurred vision, especially when you do close work or try to focus on near objects. This is worse in dim light or when you are fatigued. Presbyopia can also cause headaches or eyestrain.

How is it treated?

Eyeglasses with bifocal or progressive addition lenses (PALs) are the most common correction for presbyopia. Reading glasses are another choice. Unlike bifocals and PALs, which most people wear all day, reading glasses are typically worn just during close work. There are several types of contact lenses that are avaiable for people with presbyopia also.

Surgical options for the correction of presbyopia also exist. Because the field of vision correction surgery is changing rapidly, ask your eye doctor for the latest information about surgery for presbyopia

Because changes in the lens of your eye continue as you grow older, your eye doctor will prescribe a stronger correction for near work as you need it.

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