Presbiopi

Presbyopia
Presbyopia is the gradual decline in the eye's ability to see close objects. This condition occurs
naturally as part of the aging process. Generally, a person only realizes that they have presbyopia
when they have to put their phone or book away to read it.
The lens of the eye is surrounded by elastic muscles. These muscles can change the shape of the
lens to focus light on the retina. As we age, the muscles around the lens of the eye become
inelastic and harden.
As the muscles around the lens harden, the lens becomes rigid and cannot change shape. Light
cannot fall precisely on the retina, resulting in blurred images.
Causes of Presbyopia
The process of seeing begins when the eye captures light reflecting off an object. The captured
light will then pass through the clear membrane of the eye (cornea) and be forwarded to the lens
located behind the rainbow membrane (iris).
The lens then directs the light to the retina. In the retina, the light will be converted into electrical
signals that will be sent to the brain. The brain then processes the signals into an image.
Whether the image received by the brain is clear or not depends on the ability of the lens to
direct light. If the light falls right on the retina, the brain will receive a clear image. Conversely,
if the light does not fall exactly on the retina, for example behind or in front of the retina, the
image will look blurry.
As explained, the fall of light on the retina is related to the muscles around the lens. In
presbyopia, the muscles around the lens are inelastic and harden naturally due to age. As a result,
the lens becomes rigid and does not change shape. This prevents light from falling directly on the
retina and causes images to look blurry.
Risk factors for presbyopia
Several factors can increase a person's risk of suffering from presbyopia, namely:
 Being 40 years old and above
 Taking certain medications, such as antihistamines, antidepressants, and diuretics
 Suffering from diabetes, multiple sclerosis, or heart and blood vessel disease
Presbyopia Symptoms
Presbyopia develops gradually. Therefore, people sometimes only realize the symptoms after the
age of 40.
Some common symptoms experienced by people with presbyopia are:
 Squinting habit
 Need brighter lights when reading
 Difficulty reading small letters
 Blurred vision when reading at a normal distance
 Headache or eye strain after reading at close range
 Tendency to hold objects further away to see them more clearly
For adults, it is important to have a complete eye test periodically. Generally, eye examinations
will be adjusted according to age, ie:
 ≤40 years: every 5-10 years
 40-54 years: every 2-4 years
 55-64 years: every 1-3 years
 ≥65 years: every 1-2 years
In people who are at risk of developing eye diseases, for example, due to diabetes, eye
examinations should be performed more frequently.
Diagnosis of Presbyopia
To diagnose presbyopia, your doctor will perform a refraction test. The refraction test can
determine whether the patient has presbyopia, another visual impairment, or both. Some visual
impairments other than presbyopia are nearsightedness, farsightedness, and astigmatism.
The doctor may also administer eye drops to dilate the pupils to make examining the inside of
the eye easier.
Presbyopia Treatment
Presbyopia treatment aims to help the eye focus on near objects. Some methods to treat
presbyopia are:
 Use of glasses
The use of glasses is a simple and safe way to treat presbyopia. Patients with good eye agreement
before developing presbyopia can wear reading glasses that can be obtained preposition the
optician. If the patient has experienced visual impairment before, the doctor will prescribe
glasses with special lenses.
Use of contact lenses
Patients who do not want to wear glasses can wear contact lenses. However, contact lenses
cannot be used in patients with eyelid disorders, tear duct disorders, and dry eye syndrome.
 Refractive surgery
Some of the surgical procedures that can be performed to treat presbyopia are:
1. Conductive keratoplasty
Conductive keratoplasty is a procedure to change the curvature of the cornea and improve
the focusing ability of the eye. It is performed by heating points around the cornea using
radiofrequency energy.
2. Laser-assisted subepithelial keratectomy (LASEK)
LASEK is a procedure to reshape the outer layer of the cornea. It is performed using a
laser beam.
3. Monovision laser-assisted in situ keratomileusis
This procedure, also known as monovision LASIK, is performed to establish monovision
vision. With this procedure, one eye functions to see distant objects, and the other eye to
see near objects.
4. Photorefractive keratectomy
Photorefractive keratectomy is a procedure to reshape the cornea using laser light.
Although similar to LASEK, photorefractive keratectomy aims to remove the entire outer
layer of the cornea.
Lens implant
The lens implant procedure aims to replace the lens of the patient's eye with a synthetic lens
(intraocular lens). Generally, these synthetic lenses are effective in improving the patient's vision
for both near and far vision.
However, in rare cases, the lens implant may reduce the eye's ability to see near objects and the
patient will still need reading glasses.
Corneal inlay
The corneal inlay is the act of inserting a small plastic ring into each cornea of the eye to change
the curvature of the cornea. This ring works to focus light on the cornea so that the patient
wording sees close objects.
Complications of Presbyopia
If left untreated, presbyopia can become more severe. As a result, people with presbyopia will
find it difficult to do their daily work and activities.
Untreated presbyopia can also make the eyes work harder than they should, especially when
doing high-precision work. Over time, this can lead to eye fatigue and headaches.
Prevention of Presbyopia
It is not yet known how to prevent presbyopia. However, the risk of presbyopia can be reduced
by maintaining the quality of vision, such as:
 Undergoing regular eye examinations
 Using adequate lighting when reading
 Wearing glasses that are suitable for your vision condition
 Wearing protective eyewear when doing activities that risk causing eye injury
 Managing diseases that can cause visual impairment, such as diabetes and high blood
pressure
 Eating healthy foods that contain antioxidants, vitamin A, and beta carotene

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Presbyopia

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