Presbyopia is a condition where the eye gradually loses the ability to focus on close objects . This condition occurs naturally as part of the aging process.

Basically, the lens of the eye is surrounded by elastic muscles. These muscles can change the shape of the lens to focus light so that it falls exactly on the retina. As we age, the muscles around the lens of the eye will lose their elasticity and harden.

As a result, the lens becomes rigid and cannot change shape. Even light cannot fall directly on the retina so that the received image becomes blurred. Generally, a person only realizes that he suffers from presbyopia, when he has to put the book or mobile phone away in order to be able to read it.

Causes of Presbyopia

The process of seeing begins when the eye catches light reflecting off an object. The captured light will then penetrate the clear membrane of the eye (cornea), and continue to the lens located behind the membrane of the rainbow (iris).

Further, the lens is responsible for directing light to the retina, which will convert light into electrical signals. This electrical signal will then be sent to the brain, which will process the signal into an image.

It is clear whether or not the image received by the brain depends on the ability of the lens to direct light. If the light falls right on the retina, the brain will receive a clear image. On the other hand, if the light does not fall exactly on the retina, for example behind or in front of the retina, then it will be seen as a blurry image.

The lens of the eye is surrounded by elastic muscles. These muscles work to change the shape of the lens, so that light falls exactly on the retina. However, as we age, the muscles around the lens of the eye will lose their elasticity and harden naturally.

The hardening of the muscles around the lens causes the lens to become stiff and unable to change shape. As a result, the light cannot fall directly on the retina and the received image becomes blurred.

Presbyopia Risk Factors

There are several factors that can increase a person's risk of suffering from presbyopia, namely:

  • Aged 40 years and above
  • Taking certain medications, such as antihistamines, antidepressants , and diuretics
  • Suffering from diabetes, multiple sclerosis , or heart and blood vessel disease

Symptoms of Presbyopia

Presbyopia develops gradually. Because of this, a person sometimes only becomes aware of the symptoms after passing the age of 40. Some of the symptoms commonly experienced by presbyopia sufferers are:

  • The habit of squinting
  • Need a brighter light when reading
  • Difficulty reading small letters
  • Blurred vision when reading at a normal distance
  • Headache or eye strain after reading at close range
  • Tend to hold objects further away to see them more clearly

When should you go to the doctor?

Check with an eye doctor if your vision is blurry when reading or doing other normal activities. The doctor will conduct an eye examination to determine if you have presbyopia or other eye disorders.

Immediately consult a doctor if you experience the following complaints:

  • Sudden blurred or foggy vision
  • Sudden loss of vision in one eye, accompanied by pain in the eye
  • Flashes of light, black spots, or circles appear when looking at a light source
  • Seeing two images of one object (double vision)

Have a complete eye examination regularly. Generally, an eye doctor will recommend an eye examination according to age as follows:

  • ≤40 years: every 5–10 years
  • 40–54 years: every 2–4 years
  • 55–64 years: every 1–3 years
  • ≥65 years: every 1–2 years

In patients who are at risk of suffering from eye diseases, for example due to suffering from diabetes, eye examinations should be done more often.

Diagnosis of Presbyopia

To diagnose presbyopia, the doctor will conduct a refraction test. A refraction test will determine if the patient suffers from presbyopia and/or other eye disorders, such as farsightedness, nearsightedness, and astigmatism .

The doctor may also give eye drops to dilate the pupil of the eye, so that it is easier to examine the inside of the eye.

Treatment of Presbyopia

Presbyopia treatment aims to help the eye to focus on near objects. Some methods to overcome presbyopia are:

Use of glasses

The use of glasses is a simple and safe way to deal with presbyopia. Patients with good eye condition before experiencing presbyopia, can wear reading glasses that can be obtained at the optician. If the patient has had vision problems before, the doctor will prescribe glasses with special lenses.

Use of contact lenses

Patients who do not want to wear glasses can wear contact lenses. However, contact lenses cannot be used in patients with eyelid disorders, tear duct disorders, and dry eye syndrome .

Refractive surgery

Some of the surgeries that can be done to overcome presbyopia are:

  • Conductive keratoplasty
    Conductive keratoplasty is a procedure to change the curvature of the cornea and improve the ability of the eye to focus, by heating the points around the cornea using radiofrequency energy.
  • Laser-assisted subepithelial keratectomy (LASEK)
    LASEK is a procedure to reshape the outer layer of the cornea using laser light.
  • Monovision aser-assisted in situ keratomileusis
    This procedure, also known as monovision LASIK , is performed to form monovision vision , so that one eye functions to see distant objects, and the other eye to see near objects.
  • Photorefractive keratectomy
    Photorefractive keratectomy is a procedure to reshape the cornea using laser light, but the technique is different from LASEK.

Lens implants

The lens implant procedure aims to replace the patient's eye lens with a synthetic lens (intraocular lens). In general, these synthetic lenses are effective in improving the patient's vision, both for far and near vision.

However, in rare cases, lens implants can cause a decrease in the ability to see up close, so patients still need reading glasses.

Corneal inlay

Corneal inlay is the act of inserting a small plastic ring on each cornea of ​​the eye to change the curvature of the cornea. This ring works to focus light on the cornea, so that the sufferer is able to see objects at close range.

If the patient feels the result of the corneal inlay is not satisfactory, the patient can ask the doctor to remove the ring and choose another procedure.

Complications of Presbyopia

If left untreated, presbyopia can get worse. As a result, presbyopia sufferers will experience many difficulties in doing their jobs and daily activities.

In addition, presbyopia that is left will cause the eyes to work harder than they should, especially when doing work with high accuracy in seeing. Over time, this can cause eye strain and headaches.

Prevention of Presbyopia

It is not yet known how to prevent presbyopia. However, you can maintain the quality of your vision by:

  • Have regular eye exams
  • Use good lighting when reading
  • Wear glasses that are suitable for vision conditions
  • Wear protective glasses when doing activities that risk causing eye injury
  • Overcome diseases that can cause vision impairment, such as diabetes and high blood pressure
  • Consume healthy foods that contain antioxidants, vitamin A , and beta carotene
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