Presbyopia And Near Reading
*Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
**Department of Ophthalmology, Chonburi Hospital, Chonburi, Thailand
Siriraj Medical Bulletin 2022;15(4): 260-265
Prapasson Sangsre*, Weeraya Watcharaphalakorn**, Thammanoon Surachatkumtonekul*
Abstract
Presbyopia is a condition that eyes cannot focus on near objects clearly even with people who has em-
metropic eyes (visual acuity equals 6/6) because of the changing of ocular physiology that usually begins after 40
years of age. The characteristic of crystalline lens is soft and flexible at young age, then the lens becomes more
rigid after age 40. This degeneration is a normal part of aging which isn’t stopped or reversed. Additionally, when
focusing on the near objects there are not only lens’s changing but also the pupil’s constriction (miosis) as well as
inward movement of both eyes. These functions are called “accommodation”. However, the crystalline lens is a
transparent and flexible structure that can gradually lose function over time. As a result, the eye loses its ability
to focus on the near object. This condition is known as “loss of accommodation”. People might notice symptoms
of presbyopia when they need to hold a book or a mobile phone at arm’s length, when reading. Also, having a
headache or eye strain while working. Moreover, some medical conditions can increase risk of presbyopia such
as diabetes mellitus, multiple sclerosis and cardiovascular disease, taking some medicines such as antihista-
mine, antipsychotic drug or diuretic drug. Presbyopia is diagnosed by near chart reading “Rosenbaum near vision
card”. Patient will hold the card at 14-inches distance. The treatment options include wearing glasses (reading
lenses, bifocal lenses or progressive lenses), wearing contact lenses (mono-vision or multifocal), corneal inlay,
laser surgery or eyedrops. In 2021 the pilocarpine 1.25% was approved by U.S. Food and Drug Administration
(FDA) for presbyopia treatment.
Keywords: near reading; accommodation; presbyopia; near vision card
Correspondence to: Thammanoon Surachatkumtonekul
Email: si95thim@gmail.com
Received: 4 February 2022
Revised: 1 July 2022
Accepted: 25 July 2022
http://dx.doi.org/10.33192/smb.v15i4.256055
260 ี่� 15 ฉั่� 4 ุลาคม - ันวาคม 2565
Original Article
Review Article



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



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





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Siriraj Medical Bulletin












































Siriraj Medical Bulletin
262 ี่� 15 ฉั่� 4 ุลาคม - ันวาคม 2565
Original Article
















9











9




9


Review Article



 



263
Siriraj Medical Bulletin

































Siriraj Medical Bulletin





264 ี่� 15 ฉั่� 4 ุลาคม - ันวาคม 2565
Original Article











3






































 
 
 
 
 
 








































Review Article
265
Siriraj Medical Bulletin





















































Siriraj Medical Bulletin