Presbyopia: Its Causes, Symptoms, And Cures

Presbyopia is a visual condition which every person should be concerned about; it affects everyone to a certain extent, at some point in life. Individuals who have presbyopia usually find it difficult to focus on objects and images up close, thereby keeping them within arm’s length in order to focus. This results in migraines and eyestrain if the effort is prolonged. There is currently no available cure for presbyopia, although there are numerous procedures to correct it. Treatment is still on the research stages, but will be hopefully available in a few years.

The exact reason as to why presbyopia occurs is still not determined, but it is common for the eye lens to harden and lose its flexibility with age, affecting its ability to focus properly. One theory on presbyopia proposes that the lens fibers stiffen and lose their ability to change shape. Another maintains that the lens becomes too big, losing its flexibility as a consequence. Numerous other factors are attributed as causes of presbyopia as well, including, lifestyle, trauma, and an individual’s chosen occupation.

Individuals with presbyopia usually require management of both their close-up and distant vision, and there are several treatment options for achieving such. Eyeglasses and contacts are obviously the first choice for most people. There are four basic types of eyeglasses. Reading glasses are used for focusing on images or objects up close. Glasses with two focusing points are called bifocals, with the top part of the lens used to correct conditions such as myopia or astigmatism, and the lower part used for correcting near vision. There are glasses with three focus points, called trifocals; one point is for improved near vision, another for immediate vision, and the third for distant vision. Another type (progressive addition lenses) also uses varying focus points, but manages to gradually change them so that the sections between focus points are hardly noticeable. Contact lenses in bifocal and monovision types can also be used. Monovision lenses correct one eye for near vision, and treats the other for distant vision, thus forcing the brain to adapt on using one eye for specific tasks, depending on the distance.

Surgery procedures for correcting presbyopia include CK, or conductive keratoplasty, and LASIK, or laser-assisted in situ keratomileusis. These procedures provide the patient with monovision, particularly with LASIK wherein the modifications to the cornea are permanent. LASIK changes the shape of one eye’s cornea while leaving the other eye untreated, providing for an improved near vision. LTK and CK employ different approaches but have the same aim of changing the cornea’s shape with the use of thermal conduction, as applied to certain areas of the cornea.

Several other treatments are still under the testing stages. Surgical Reversal of Presbyopia is a process wherein Scleral Expansion Bands are fitted into the sclera, consequently causing the muscle fibers responsible for focusing the lens to tighten. Anterior Ciliary Sclerotomy makes several incisions around the eye, providing for extra space for the lens as its changes its shape. Laser Presbyopia Reversal uses an infrared laser on the sclera in order to make it smaller. Still another treatment removes the lens altogether, and replacing it with an artificial lens. These are still under development, but in the near future will provide more effective alternatives for presbyopia treatment.

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