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“Old men's eyes are like old men's memories; they are strongest for things a long way off.”
-George Eliot

You can use make-up, you can get cosmetic surgeries done, but you can’t hide your age all the time. The minute you see someone pull away the newspaper or menu card or book to an arm’s length away from their eyes… you know it. Their age? Approximately above 40. The condition? Presbyopia.



What is Presbyopia?

Presbyopia is an age related eye condition in which the lens of your eye loses its ability to focus actively on nearby objects. It is a natural part of aging and often becomes noticeable around the age of 45 and continues to worsen until 65.


Do I have Presbyopia? (Signs and Symptoms)

You would know you that you have presbyopia by the fact that you tend to hold a book or the newspaper further away in order to focus on them.
Blurred vision at normal reading distance
Eyestrain or headaches after doing close work or reading
Worsening of these symptoms when you are tired or working in an area with dim lighting

What causes Presbyopia?



When you ‘see’ close objects your lens and cornea help in bending the rays of light to form a sharp image on the back of your eye. The cornea is the transparent dome shaped front surface of your eye. The lens is a clear bi convex structure in the eye.

When you are young, the lens of your eye is soft and flexible. The lens of the eye changes its shape or length when it has to focus on smaller objects or objects which come closer to your eye or when objects move farther away. This is called elasticity of your lens.

This elasticity is slowly lost as you go on aging and your lens becomes more and more rigid. Age related changes also occur in the muscles surrounding the lens. As a result, there is a slow loss in the ability of the lens to change its shape and focus on closer objects.
Interestingly, a person who has nearsightedness may have lesser problems with presbyopia.

However, some people can develop presbyopia before the age of 0. This is called premature presbyopia. This can be due to:
Diseases like diabetes, heart diseases or multiple sclerosis

Certain drugs like certain anti-depressants (drugs given for depression), diuretics (drugs that increased urination) or anti-histaminics (anti-allergy).


What are the tests for Presbyopia?

Your Ophthalmologist will perform a basic eye examination which will include
Slit Lamp Examination
Visual Acuity testing
Refraction Testing
Muscle Integrity Testing
Retinal Examination


How is it treated?

Corrective lenses:

Prescription Reading glasses: If you have no other vision troubles, you can use glasses for reading only

Bifocals: the lower portion of the glasses can be used for doing close work while the upper part can be used for distance vision.

Progressive addition lenses are similar to bifocals except that the transition from distance vision at eye level to reading vision at the bottom is very gradual.

Trifocals: These glasses have corrections for distance vision, close work and mid-distance vision like computer screens.




Bifocal contact lenses: These provide for both near and distance vision. You can give these a trial to see if they can provide you with satisfactory vision.

Monovision contact lenses: Here a contact lens for distance vision is worn in your dominant eye and a contact lens for close vision in the other eye.

Modified monovision: In this, you use a bifocal contact lens in your non dominant eye and a contact lens for distance vision in your dominant eye. You do not require to consciously choose one eye for reading; your brain learns to favour one eye for reading and both for distant vision.


Refractive surgery:

This includes:

LASIK (Laser epithelial keratomileusis)
LASEK (Laser assisted in situ keratomileusis)
Conductive Keratoplasty (CK)
Photorefractive keratectomy (PRK)
Lens Implants: Here, your natural lens is removed and an artificial lens is placed inside your eye.