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Presbyopia
The small print of an ingredients list is hard to read for a person with
presbyopia.
headaches, eyestrain[1]
eye[1]
method
Presbyopia is a condition associated with the aging of the eye that results in progressively worsening ability to focus clearly on close
objects.[1] Symptoms include difficulty reading small print, having to hold reading material farther away, headaches, and eyestrain.[1] Different
people will have different degrees of problems.[1] Other types of refractive errors may exist at the same time as presbyopia.[1]
Presbyopia is a natural part of the aging process.[1] It is due to hardening of the lens of the eye causing the eye to focus light behind rather than on
the retina when looking at close objects.[1] It is a type of refractive error along with nearsightedness, farsightedness, and astigmatism.[1] Diagnosis is
by an eye examination.[1]
Treatment is typically with eye glasses.[1] The eyeglasses used have higher focusing power in the lower portion of the lens.[1] Off the shelf reading
glasses may be sufficient for some.[1] Contact lenses may also occasionally be used.[2]
People over 35 are at risk for developing presbyopia and all people become affected to some degree.[1] The condition was mentioned as early as
the writings of Aristotle in the 4th century BC.[3] Glass lenses first came into use for the problem in the late 13th century.[3]
Contents
Mechanism[edit]
See also: Accommodation (eye)
Presbyopia
The cause of presbyopia is lens hardening by decreasing levels of α-crystallin, a process which may be sped up by higher temperatures.[7]
In optics, the closest point at which an object can be brought into focus by the eye is called the eye's near point. A standard near point distance of
25 cm is typically assumed in the design of optical instruments, and in characterizing optical devices such as magnifying glasses.
There is some confusion over how the focusing mechanism of the eye works.[clarification needed] In the 1977 book, Eye and Brain,[8] for example, the lens
is said to be suspended by a membrane, the 'zonula', which holds it under tension. The tension is released, by contraction of the ciliary muscle, to
allow the lens to become more round, for close vision. This implies the ciliary muscle, which is outside the zonula, must be circumferential,
contracting like a sphincter, to slacken the tension of the zonula pulling outwards on the lens. This is consistent with the fact that our eyes seem to
be in the 'relaxed' state when focusing at infinity, and also explains why no amount of effort seems to enable a myopic person to see farther away.
The ability to focus on near objects declines throughout life, from an accommodation of about 20 dioptres (ability to focus at 50 mm away) in a
child, to 10 dioptres at age 25 (100 mm), and levels off at 0.5 to 1 dioptre at age 60 (ability to focus down to 1–2 meters only). The expected,
maximum, and minimum amplitudes of accommodation in diopters (D) for a corrected patient of a given age can be estimated using Hofstetter's
formulas: expected amplitude (D) = 18.5 - 0.3 × (age in years), maximum amplitude (D) = 25 - 0.4 × (age in years), minimum amplitude (D) = 15 -
0.25 × (age in years).[9]
Treatment[edit]
In the visual system, images captured by the eye are translated into electric signals that are transmitted to the brain where they are interpreted. As
such, in order to overcome presbyopia, two main components of the visual system can be addressed: the optical system of the eye and the visual
processing of the brain.
1. Image capturing in the eye – Solutions for presbyopia have advanced significantly in recent years, thanks to widened availability of
optometry care as well as over-the-counter vision correction.
2. Image processing in the brain – Scientific solutions for overcoming the symptoms of presbyopia were developed in recent years and
tested successfully in multiple studies. These solutions are available thanks to significant progress in the understanding of human brain
plasticity and the field of perceptual learning.[10]
Corrective lenses[edit]
Corrective lenses provide a range of vision correction, some as high as +4.0 diopter. Some with presbyopia choose varifocal or bifocal lenses to
eliminate the need for a separate pair of reading glasses; specialized preparations of varifocals or bifocals usually require the services of an
optometrist. Some newer bifocal or varifocal spectacle lenses attempt to correct both near and far vision with the same lens.[11]
Contact lenses can also be used to correct the focusing loss that comes along with presbyopia. Multifocal contact lenses can be used to correct
vision for both the near and the far. Some people choose contact lenses to correct one eye for near and one eye for far with a method
called monovision.
Surgery[edit]
Laser surgery has been done to create multifocal corneas.[12] Concerns with this surgery include people's eyes changing with time.[12]
Etymology