What is it?

It is a visual condition, generally associated with the aging process, in which the ability to focus on nearby objects is lost. Presbyopia is known, in colloquial terms, as “eyestrain“.

It can appear from the age of 40 and is characterized by difficulty in performing jobs / activities that require good near vision (seeing closely), such as reading, sewing, viewing screens, etc.

Symptoms

The main symptom is difficulty to perform tasks that require good near vision. The patient often experiences difficulty reading, which improves as the paper moves away from his face. Sometimes presbyopia begins manifesting itself as a slowness to change focus (focus) between near and far, or vice versa.

If the effort made to see closely clearly is constant and sustained, an uncorrected presbyopia can also lead to symptoms such as headaches (headache) or fatigue and visual fatigue, which are perceived with greater intensity at the end of the day.

Can presbyopia be prevented?

There is no way to stop or reverse the normal aging process that presbyopia causes. However, presbyopia can be corrected by optical correction (glasses, contact lenses) or surgery.

Diagnosis

Once symptoms appear, a standard ophthalmologic exam can diagnose it. Once diagnosed, the ophthalmologist will prescribe the solution that best suits the needs / characteristics of each patient.

Prognosis

The evolution and progression of presbyopia varies from its onset in the fourth decade of life to approximately 60-62 years, at which time presbyopia is usually developed and remains stable.

In some cases, the patient may experience a “certain improvement” in his near vision, which is usually associated with the onset of a cataract.

Treatment

There are different therapeutic strategies to address the problem of presbyopia.

1.      Optical correction with glasses:

a.       Patients without previous refractive errors:

                                                              i.      Monofocal glasses: They are simple glasses with a graduation that ranges between +1 and +3 and are indicated in those patients who do not present other refractive errors. They are used only for specific tasks that require good near vision.

b.      Patients with previous refractive errors:

                                                              i.      Bifocal glasses: They are glasses that correct near and far vision. A line that can be seen or not, divides the lens. The lower part of the lens allows you to see up close, while the upper part allows you to see far.

                                                            ii.      Trifocal glasses: They are glasses that have three areas in the lens to correct near vision (reading, sewing, etc.), intermediate vision (computer), and distance vision.

                                                          iii.      Multifocal glasses: Multifocal or progressive glasses correct near, intermediate and far vision. Its graduation varies from the upper zone, dedicated to far vision, to the middle zone, for intermediate vision, and the lower zone of the glass for near vision. Generally speaking, the visual quality is better with these glasses.

2.      Correction with contact lenses.

3.      Optical correction by surgery:

a.       Bilateral laser: Refractive laser surgery is performed in both eyes, using techniques similar to those used to correct myopia, hyperopia, and astigmatism.

b.      Unilateral laser: Only one eye is operated, so what is known as “monovision” is achieved (one eye sees well up close and another one sees well from far away).

c.       Intraocular lenses: An extraction of the lens is performed (similar to cataract surgery) and a graduated intraocular lens is implanted for far and near distances (bifocal lenses) or for multiple distance-medium-near distances (lenses multifocal).

d.      Corneal implants: There are implants that are inserted in the thickness of the cornea and allow presbyopia to be corrected.