Presbyopia And Near Reading

Abstract

Presbyopia is a condition that eyes cannot focus on near objects clearly even with people who has emmetropic 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 antihistamine, 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.