In Presbyopia, a person’s eye progressively diminishes in its ability to focus on near objects with age. The exact mechanism that causes this “loss” in focusing ability is not completely proven. However, most researchers believe that the crystalline lens inside the eye loses its flexibility with age as an early cataract begins to form.
Presbyopia occurs as a patient begins to enter their late 30s or early 40s. It is characterized by an inability to use the muscles inside the eye to move the image from behind the retina onto the retina. This is often corrected with lenses that have a bifocal in them.
This loss in flexibility directly causes a loss in a person’s ability to focus. Similar to grey hair, presbyopia is a symptom that everyone experiences as they age.
The first symptoms most people notice are difficulty reading the fine print, particularly in low light conditions, eyestrain when reading for long periods, blur at near or momentarily blurred vision when transitioning between viewing distances. Many extreme presbyopes complain that their arms have become “too short” to hold reading material at a comfortable distance.
Presbyopia symptoms, like other focus defects, become much less noticeable in bright sunlight due to the action of the iris closing to a smaller diameter. This is a similar effect that occurs with a camera. A small pupil increases the depth of field for the observer and offers some help for the observer.
A delayed onset of seeking correction for presbyopia has been found among those with certain professions. For instance, homemakers and farmers work in broad lighting conditions and are not stuck on a computer all day, so they tend to seek out help a few years later than engineers and computer programmers who are looking at small print much more frequently.
Treatment for presbyopia has advanced significantly in recent years with many options now available to our patients. Some of the following options you may find helpful:
1. Reading Glasses – Over the counter reading glasses are sold to may people in drug stores and in dollar stores. They are an effective form of treatment for people who see well in the distance. Of course, these do not work for nearsighted individuals and only work well for far-sighted individuals who have small degrees of farsightedness.
2. Contact Lenses – Have you ever seen the president of the United States wearing glasses? The reason why you never see this occurring is that every president of the United States has monovision contact lenses and or bifocal contact lenses. This is a very effective form of treatment that can be tried during a contact lens examination.
3. Bifocal Glasses – This works very well for most people. The top portion of the glasses are for seeing in the distance and the bottom portion of the lenses are for seeing up close. The two main types of bifocal glasses are glasses with and without a line. A progressive addition lens does not have a line. Lots of people prefer the “no line” or progressive lens because it is cosmetically pleasing. However, we prefer the lined bifocal because it is easier for a patient to adapt too. During the routine eye examination, a prescription is always given to the patient, and bifocal glasses are an excellent option for glasses.
Cataracts are hard to see through because they cause clouding of the lens within the eye. Cataracts most often affect both eyes and cause glare sensitivity and blurred vision.
A cataract is a normal part of ageing. As we age, the normally clear crystalline lens within our eye can become yellow or opaque. Clinically significant cataracts occur when the patient is bothered by glare or blurred vision.
Most cataracts are caused by age and progress slowly. The following risk factors can increase the chance or progression of cataract:
1. Accumulated exposure to ultraviolet radiation
3. Some diseases of the eye
4. Some medications
5. Systemic diseases such as diabetes
6. Poor nutrition
In the early stages, your optometrist will monitor your cataract(s). Often your vision can be improved by making a change in your eyeglass prescription. However, if the cataract progresses and causes your vision to become too blurry a referral to an Ophthalmologist for cataract surgery will be arranged by your Optometrist. To Slow down the formation of cataracts we recommend protection from the sun and a balanced diet.
Regular eye examinations by the optometrist to check the health of your eyes
Glaucoma is a disease of the optic nerve, which causes loss of peripheral vision initially, and can lead to tunnel vision and then blindness.
In most types of glaucoma, the nerve damage occurs slowly and creates blind spots in peripheral vision, but as the disease progresses, these blind spots enlarge and grow together. It is common for a person not to notice they are afflicted until the later stages of the disease when the central vision becomes affected. At this point, severe and irreversible vision loss has occurred.
In a less common form of glaucoma, called acute angle-closure glaucoma, patients may experience a sudden onset of a red, painful eye with blurred, steamy vision and seeing haloes or rainbows around lights. This is a Medical Emergency and requires immediate urgent treatment to lower the eye pressure and prevent blindness.
1. Age (More Common after 50)
3. Increased Pressure in the eye
4. High Hyperopia ( for Acute Glaucoma)
6. Some Medications
7. Family History
8. Trauma to the Eye
9. Infections and Inflammation
Most cases of glaucoma, if detected early, can be successfully controlled, provided the patient is compliant with using their medication and returning for regular monitoring and follow-up care.
1. Eye Drops Used Daily to lower the Pressure in the Eye
2. Laser Surgery
3. Oral Medicine (for acute cases of Glaucoma)
4. Ocular Microsurgery
NOTE: Glaucoma patients require to be monitored life-long