PRESBYOPIA

When an eye patient starts experiencing poor vision, it is usually caused by two major factors; one is diseases in the eyes like Cataract, Glaucoma etc., which can be treated with ophthalmic drugs or with surgery.  The other one is what we call refractive errors like Myopia (short-sightedness), Hyperopia (long-sightedness) and astigmatism.  These refractive errors are corrected with eye glasses.  There is one unique one that is neither refractive error nor a disease; this is called “Presbyopia”.

The word Presbyopia is coined from Greek and Latin words ‘presby’ meaning old and “opia” meaning sight, hence presbyopia means “old sight”.  Before we define presbyopia, we need to understand what accommodation is.

Accommodation is a mechanism that helps us to focus at a near object in a bid to see it clearly.  Then, Presbyopia is defined as a slow, normal, naturally occurring, age-related, irreversible reduction of accommodation leading to a progressive fall in near vision.

Presbyopia is a part of the natural aging process of the eye.  It is not a disease.  It is one of the earliest and most predictable signs of middle age.  Presbyopia does not discriminate against age, race or gender and no one is safe from the effects of presbyopia.

It is as natural as wrinkles and it affects everyone at some point in life.  It is often confused with far-sightedness, but the two are different.  I can just refer to presbyopia as “old sightedness” in trying to compare the two.  Presbyopia occurs when the natural lens in the eye loses flexibility while far sightedness occurs as a result of the natural shape of the eyeball, which causes light rays to bend incorrectly on entering the eye.  Ability to focus on near objects declines throughout life that is why it is natural for presbyopia to worsen overtime, as you grow older, the power of your reading glasses increases.

CAUSES OF PRESBYOPIA

1. Decrease in elastic of the crystalline lens: When you are younger, the lens of the eye is soft and flexible, allowing the tiny muscles inside the eye to easily reshape the lens to focus on close and distant objects but as you grow older, the lens hardens and loses elasticity.  With this loss of flexibility, your eyes are less able to adjust properly to focus near objects.

2.Uncorrected hypermetropia (long sightedness): This can lead to premature presbyopia

3.Loss of power or weakness of the ciliary muscle

4.Chronic simple glaucoma

 

SIGNS AND SYMPTOMS OF PRESBYOPIA

1.A tendency to hold reading material farther

2.Blurred vision at a normal reading distance

3.Bye strain or headaches after reading or doing close-work

4.Squinting to focus on near objects

5.Eye fatigue or general fatigued feeling especially at the end of the day

6.Inability to pass the threads through the needle head

7.Inability to separate tiny stones from grains

8.Inability to see figures or letters on your cell phones

You may notice these symptoms are worse if you are tired, have had alcohol or if you are in an area with dim illumination.

 

AGE OF ONSET OF PRESBYOPIA

The average age of onset of presbyopia is between 36 – 40 years.  This age of onset varies from person to person and also depends on factors like general health condition, occupation, near point visual task, and basic refractive errors prior to its development.  Many people with myopia (short sightedness) can read comfortably without glasses even after 40 years, while presbyopia among bankers, teachers, tailors, accountants and civil servants set in earlier than their age mates who are hunters, farmers, drivers etc., because the former have higher near visual demands than the later.

 

WHEN TO SEE AN EYE DOCTOR

If you are having difficulty reading tiny prints or doing any close work especially in dim illumination or if blurring close-up vision is keeping you from enjoying normal activities and you are up to 36 years and above, see an eye doctor immediately who can determine whether you have presbyopia or not and advice you of your options.

 

TREATMENT OF PRESBYOPIA

Presbyopia cannot be cured; instead prescription glasses, contact lenses, reading glasses or bifocals can only help correct the effects of presbyopia.

 

PREVENTION OF PRESBYOPIA

Since Presbyopia is neither a disease nor a refractive error, rather a part of the natural aging process of the eye, therefore, it cannot be prevented.

 

COMPLICATIONS OF PRESBYOPIA

From the free eye projects we have carried out in the rural areas of Nigeria, we observed that a lot of people who are learned and have passed the age of onset of presbyopia have continued to read tiny prints or write with their naked eyes, convincing themselves that they can read clearly without glasses when they are actually straining their eyes so much and most times, they do stretch their arms far away to read tiny prints clearly, not knowing they have reached presbyopia state and must read with glasses.  This is as a result of ignorance.  Presbyopia if left untreated, will rob sufferers of the ability to read at arm’s length.  Overtime activities such as driving, reading or working may become very difficult.

Furthermore, presbyopia can present a danger.  You might have trouble reading important labels on drug prescription, you might have trouble checking nutrition labels to identify ingredients, you or your family may have allergy to or you might loose millions of Naira in your business when you can’t see some figures well that can lead to wrong calculation of your money.

A lot of people go to the market to buy their reading glasses or get one by the roadside, without going to the eye doctors to have their eyes examined first and then the power of their glasses determined.  These quacks will give you glasses that can make the letters bigger but they must either over-correct your eyes or under-correct you because they can’t determine exactly the power of your eyes.  This will result to serious complications that can damage your eyes permanently, if not now, later in life.  If you are using glasses not given to you by an eye doctor or you are borrowing another person’s own to read, please stop that immediately and visit any eye clinic close to you to obtain your own glasses that can reduce the effect of presbyopia for you.  Please don’t forget, you are not supposed to use your glasses for more than two years.

 

Dr. Mrs. Gemma Henry-Ibe

Ophthalmology Department

Imo State University Teaching Hospital, Orlu

Phone Number:

E-mail:

 

 

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