Losing near vision with age or presbyopia is part of the normal aging process . It happens to most people, even to those who have never had any vision problems. The first complaints usually begin only after the age of 40, both in women and men. One of the first symptoms of presbyopia is the need to move a book, newspaper, telephone or other reading support away to be able to see the letters clearly and to read. Over time, eye fatigue and the inability to focus on letters and nearby objects increase. What are the causes of presbyopia? Presbyopia is due to lens aging: The lens is one of the structures of the eye; It is located inside the eyeball, between the pupil and the vitreous humor; It is approximately circular, works like a lens with two convex faces and is clear; Its main function is to transmit and focus light on the retina to create clear images of what we observe at various distances. Lens is the main structure of the accommodation reflex: Accommodation is the ability of the eyes to adapt being able to clearly see objects at various distances; When objects are close the lens curvature increases, the focusing capacity increases (the ocular refraction capacity) and the pupil contracts; To see far-focused objects, the lens remains flatter and the pupil more dilated. In children and younger people, the lens is soft and flexible. Therefore, it changes shape (increases and decreases its curvature) easily and quickly. Over time, the lens becomes more rigid and is no longer able to adapt easily to respond to the activation of the accommodation reflex increasing its curvature. In other words, lens loses its ability to accommodate. It is not possible to stop the aging process that causes presbyopia, but it can be corrected with glasses, contact lenses and surgery. Correction of presbyopia Anyone who begins to have problems with their near vision should consult an ophthalmologist. The ophthalmic exam carried out by the doctor will confirm that it is indeed presbyopia. If so, the doctor can advise about the best correction approach. Glasses When presbyopia is similar in both eyes and there is no other vision problem, it can be resolved with simple reading glasses, which do not require a medical prescription and can be purchased, for example, in pharmacies. The ophthalmologist, based on the examination carried out, will tell you the eye power. For people who do not have the same presbyopia in both eyes, glasses prescribed by an ophthalmologist are necessary. When there are vision problems other than presbyopia, for example myopia, hyperopia or astigmatism, other types of glasses lenses may be recommended. Contact lenses There are two types of contact lenses that can be used to correct presbyopia. Those that correct near vision in one eye and maintain the other for distance vision (monovision); Those that allow to use both eyes for near and far vision (multifocal). Any of these types of lenses require a training period to get used to it. Surgery Presbyopia can be corrected by surgery, and several techniques are currently available to do so. Carrying out these procedures requires a detailed prior assessment that includes several exams to check whether the correction is possible and which technique should be carried out. Where to start You are in your 40s and do you think something is wrong with your near vision? Isn't the length of your arm enough to push away what you want to read so you can do it? It could be presbyopia, but you need to be sure and know the best way to resolve it. Your ophthalmologist is the best person to help. Author: Rui Andrés Meet the ophthalmology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
