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Two vultures were sitting in a tree. “I’m getting old,” commented one of them. “I can still spot a rabbit a kilometre away, but I can’t read the newspaper anymore.” Most people over the age of 50 can relate to this anecdote which reminds us that aging is inevitable and is not reserved for humans! Age has an effect on the eyes just like it does on other parts of the body. As we get older, our joints become less flexible and so does the lens of the eye. Presbyopia, or ‘old eye’, is a universal condition that is part of the natural aging process. In young people, the lens of the eye is soft and flexible. With the help of the circular ciliary muscle, it is able to change shape and switch focus easily and rapidly from near to far vision. As people age, the lens gradually loses its elasticity, becoming more rigid and losing its youthful ability to accommodate. This process occurs due to a decrease in the length and strength of the ciliary muscle. Signs and Symptoms The age when people first notice changes in their vision varies depending on their lifestyle, activities, the presence of other eye conditions and certain chronic medications they may be taking. Typical signs of presbyopia include needing to hold reading material at arm’s length, difficulty reading labels with small print on cans or packets when shopping, blurred vision when reading numbers or words on the phone, decreased ability to see clearly when sewing, and the perception of colours being faded or less bright. Symptoms are generally worse in dim light, for example reading a menu in a dimly lit restaurant, or when a person is ill, tired or particularly stressed. Headaches or eye fatigue may occur as a result of the strain on the eyes when trying to focus clearly. |
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Diagnosis As well as being able to diagnose presbyopia, your optometrist may detect other eye conditions which may be age-related, such as cataracts or macular degeneration. In the initial stages of these conditions, symptoms may not yet be present but there may be early signs in the eyes. The sooner treatment begins, the better the long-term outcome. Contact your optometrist immediately if you experience sudden vision changes, eye pain, loss of vision, double vision, flashes of light or halos around lights. |
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Management of Presbyopia There is no “cure” for presbyopia but there are numerous options to manage it, from glasses and contact lenses to simple lifestyle changes. Reading glasses are a popular option and a first choice for many people. Your vision is likely to keep changing and you may need to change the strength of the glasses as it does. The best option is to have a pair of reading glasses with your specific prescription made up by your optometrist. If you already wear glasses for a vision problem such as shortsightedness, your optometrist may recommend bifocal or progressive lenses, which have both distance and near prescriptions in one lens. As a short-term or emergency solution, reading glasses are available over the counter and come in a range of strengths. Remember that over-the-counter glasses may not fit well and don’t take into account that you may need a different strength for each eye. Whether you already wear contact lenses or not, they may be another alternative to the management of presbyopia. Multifocal contact lenses, which come in soft or gas-permeable versions, work on the same principle as bifocal or multifocal glasses. Although they may take some adjusting to, monovision contact lenses have been found to be successful. One eye has a correction for distance, while in the other eye a contact lens with a near correction is worn and the brain compensates for the difference. A disadvantage of contact lenses is that many older women suffer from dry eye syndrome as a result of hormone changes and may find contact lenses uncomfortable. |
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Lifestyle changes include adjusting your reading distance, enlarging the font size on electronic devices and reading books with larger print, ensuring that lighting is adequate, and taking regular visual breaks. Presbyopia is a universal problem that affects quality of life as many issues around aging do. With all the options available, everyone can find a solution that works for them. |
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