Presbyopia

Presbyopia means aging eye in Greek. Like all tissues in the body, eye tissues also age over time. As a result of this aging, some vision problems may occur. There are many vision problems that arise for this reason.

Presbyopia is a problem of not being able to see clearly near people that occurs due to age. Age-related nearsightedness problem usually begins after the age of 40 and reaches its highest level at the age of 60.

Research reveals that nearly 2 billion people around the world have age-related near vision problems. It is a visual disorder that seriously reduces the quality of life and production potential of people over the age of 40, especially in various regions where they have difficulty accessing various services and treatments related to eye health. It is a serious problem in terms of people's ability to continue their daily lives, especially in some underdeveloped countries where access to healthcare is low and traditional production methods are still effective in the economy.

Presbyopia and hypermetropia are compared with each other. However, the reasons for the two eye problems are completely different. To understand the problem of presbyopia, it is necessary to first understand the working principle of the intraocular lens.

Accommodation is a natural ability of the intraocular lens. In order to focus at different distances, our intraocular lens can increase its refraction by becoming curved and focuses at different focal distances. It is the fibers that hold the lens inside the eye that enable it to make this stretching movement.

Presbyopia occurs when these fibers lose their flexibility with aging. A rapid adaptation and clear vision cannot be achieved, especially in situations where sudden focus changes occur and in situations that require close focusing from medium or long distance.

Even people who have never had vision problems in the past can experience this disease. In fact, some people over the age of 40 who use distance glasses or contact lenses because they are myopic may notice that their near vision is blurry after wearing their glasses or lenses.

Presbyopia. It can be different sizes for everyone. If the person does not currently wear glasses, they may start using glasses or need a second pair of glasses. Presbyopia is an age-related near vision disorder and the effects of this problem can often be noticed when looking at devices such as phones, tablets and reading books.

The diagnosis of presbyopia can be made with a standard eye examination. It is appropriate for people diagnosed with the disease to undergo a general eye examination every 2 years.

The problem disappears with the use of close-fitting glasses. In addition, for people with myopia problems, a single view can be obtained for different focal lengths by using bifocal lenses prescribed by the ophthalmologist. The only method that will permanently solve the age-related problem of not being able to see clearly is surgery.

What is Presbyopia?

Presbyopia is a nearsightedness problem that occurs in people over the age of 40 as a result of the lens of the eye losing its adaptability, that is, its flexibility, due to aging. The progression of the presbyopia problem continues until the mid-60s.

The intraocular lens has the ability to accommodate objects at different focal lengths. This means that the lens can flex and lengthen and shorten to focus at different distances. The intraocular lens begins to harden very slowly, especially during adolescence.

Presbyopia usually begins in the early 40s. This is because this hardness increases with the age of 40 and the eye loses its ability to see clearly near the eye as a natural result of aging. This process continues until the mid-60s.

This process stagnates in the early 60s. Especially after the age of 65, the eye's ability to focus either actually stops or decreases to a minimum. After this stage, glasses are required to see near.

The problem that arises with presbyopia and hypermetropia Although they are actually the same, the reason for the problem is different in both. Both hyperopia and presbyopia are eye refractive problems, and the image coming into the eye from the outside falls behind the focal point on the retina.

While hyperopia is caused by the eyeball being shorter than normal, presbyopia is the lens hardening and losing its flexibility with aging. Especially after the age of 40, people should not neglect regular eye examinations. It is important for the diagnosis and early treatment of age-related nearsightedness.

What are the symptoms of presbyopia?

Presbyopia begins in the 40s and progresses slowly and causes few symptoms at the beginning of this age. The period in which presbyopia progresses accelerates is between the ages of 46-52. Symptoms and complaints become increasingly evident in patients in this age range.

If patients have hyperopia problems before they begin to experience age-related nearsightedness, their complaints may appear at an earlier stage; if they have myopia problems, their complaints may appear at a later stage. Presbyopia may not show any symptoms in some people over the age of 40, but the disease can be diagnosed with a simple eye examination. Because this disease is likely to be accompanied by other vision problems. Other vision problems mentioned can hide various information indicating presbyopia.

Presbyopia symptoms Not being able to see the text clearly, especially when reading newspapers and books, not being able to do tasks that require close focus, such as threading a needle, and It starts with not being able to clearly see the object held nearby.

Presbyopia patients experience the problem of not being able to see clearly when they bring objects closer than 50 cm. Most patients do not have a decrease in their ability to see from afar. For this reason, they can see objects by moving them away from them.

In the later stages, in addition to blurred vision of nearby objects, headache and pain around the eyes may also accompany this problem. Because this action is becoming more and more tiring.

Frequently seen presbyopia symptoms are as follows:

• 50 cm Desire to move away from a close object while looking at it,
• Pain in the head and temple area due to not being able to see clearly for a long time in the advanced stages of the disease,
• Need for intense light while reading books and newspapers,
• Having difficulty seeing some distant objects clearly after doing a job that requires close vision or reading are symptoms of presbyopia.

In addition, all these complaints may increase when tired and in a dimly lit environment.

Why does the age-related problem of not being able to see relatives clearly occur?

Presbyopia is a natural result of advancing age. Although the cause of the disease has not yet been fully found, some opinions have been put forward as a result of some studies. The natural eye lens has a transparent and flexible capsule-shaped structure and works in harmony with the other elements that make up the eye. The disease usually occurs between the ages of 38 and 45.

Presbyopia, as the lens of the eye hardens and loses its flexibility over time, the capsule in the structure of the lens begins to deteriorate and the lens that helps it flex. It occurs due to many reasons such as deformation of fibers as a result of aging. Eye cells cannot renew themselves due to their structure. If the conditions mentioned above are not treated from the moment they occur, they cannot heal on their own. For this reason, people with symptoms of the disease should consult an ophthalmologist.

How is the disease diagnosed?

Presbyopia, it is important that the patient first notices the symptoms or is noticed by the ophthalmologist after having regular eye examinations since the age of 40. A vision test is first performed on a person who consults an ophthalmologist or has a regular eye examination as a result of their symptoms. During eye examination, people with the disease have difficulty in seeing objects clearly that are closer than 50 cm.

If the disease is diagnosed, the Snellen eye test is applied in the next stage. In the Snellen eye test, the patient tries to read various letters on the chart from a certain distance. It is measured whether the person can read letters from a certain distance. As a result of this test, the patient can be diagnosed.

How is Presbyopia Treated?

There are different methods for presbyopia treatment. These methods are glasses, contact lenses and intraocular lens options.

The most common of these treatments is presbyopia glasses. These glasses are also commonly known as “reading glasses”. These glasses are used to improve near vision. Thanks to these glasses, the image falling behind the retina is ensured to fall on the vision point, thus restoring the patient's near vision ability.

There are also glasses with progressive, bifocal or multifocal line-free lenses. Both types of glasses improve the patient's vision at multiple focal points. Photochromatic lenses would be a good option for these patients as they will become more sensitive to glare and light, another consequence of aging.

For patients who do not prefer to use glasses, contact lenses are first used by their relative and then by It is another alternative without seeing other distances clearly. Although the use of glasses carries less risk than the use of contact lenses, the contact lenses used for presbyopia treatment offer the patient a wider angle of vision compared to glasses.

Multifocal contact lenses have different rings at different focal points. There is a slight loss in image quality. They provide the same clear vision at long and close distances. The brain can adapt itself to this abnormal situation over time.

In monovision contact lenses, one eye is adjusted for far distance and the other eye is adjusted for near distance. If the patient can adapt to this method, it can be continued.

Glasses and contact lens treatment can be combined if necessary and possible. Thus, the patient can have better vision at both long and near distances.

Each method has its own advantages and disadvantages. The ophthalmologist decides which treatment method will be suitable for the patient.

In both treatments, it is very possible for the eye number to increase over time, so glasses or contact lenses may need to be changed at regular intervals.

Another treatment method for presbyopia is surgery. There are different applications in the surgical method.

Presbyopia Surgery

When it comes to surgery in the treatment of presbyopia, multifocal intraocular lens and laser treatment options are among the available options. The ophthalmologist decides which of these treatments is more suitable for the patient after a comprehensive eye examination. During the process of making this decision, the ophthalmologist performs a series of advanced tests on the patient.

Laser treatment and intraocular multifocal lens operation can be applied to patients over the age of 40 who do not want to wear glasses or lenses.

Laser eye surgery In the procedure, the eye is first anesthetized with drop anesthesia method. During the procedure, laser treatment is applied to the cornea, the outermost region of the eye. If the patient has another refractive error other than age-related clear vision problems and meets the appropriate conditions, it can also be corrected with laser treatment. The critical point about laser treatment is that the patient's eye numbers should not continue to progress. If eye numbers continue to progress, laser treatment is a temporary solution.

The only permanent solution for presbyopia treatment is smart lenses (intraocular trifocal lenses). Thanks to smart lenses, the patient can obtain clear vision at near, far and medium distances. Since the problem of presbyopia is caused by the natural intraocular lens losing its flexibility, by replacing this lens with an artificial and multifocal lens, the problem of nearsightedness, along with other eye refractive problems, is radically solved.