Presbyopia

21:55 - 4 May , 2021

Disease

What is Presbyopia?

It is an ocular pathology typical of aging in which the eyes gradually lose the ability to establish a correct focus at short distances, mainly because the lens with age becomes increasingly rigid and finds it difficult to change the way to focus light on the retina to be able to see close-up images. Presbyopia begins to appear after the age of 40 and is usually noticed when we try to read and need to move objects away to focus properly. Although it is a disease typical of the age, some factors contribute to its appearance, such as:
  • Farsightedness.
  • Diabetes.
  • Multiple sclerosis.
  • Heart conditions.
  • Antidepressants.
  • Antihistamines.
  • Diuretic.

Symptoms

The characteristic symptoms consist of: 
  • Blurred vision when trying to read.
  • Eyestrain
  • Strain your eyes to try to focus on nearby objects.
  • Headaches.
  • Move reading material away to bring it into focus.
Symptoms are often worse in dimly lit places or with fatigue.

Diagnosis and treatment

The ophthalmologist will perform a general eye exam, which consists of a series of tests that give them elements to assess your visual capacity and your eyes’ anatomy, among them, a refractory evaluation, to make an accurate diagnosis. During the procedure, you'll likely be given dilating eye drops, which can cause some sensitivity to light hours later. Once the diagnosis is defined, they will establish the most appropriate treatment for you, but in general, it should include the use of framed glasses, contact lenses, or, in some cases, refractive surgery or lens implants. If you wear glasses to correct other eye problems, you will now require bifocal, trifocal, or progressive lenses to correct near vision, intermediate vision, and distance vision. Through the surgical procedure, the cornea is shaped to improve near vision in the non-dominant eye. The most used techniques are:
  • CK (Conductive Keratoplasty): It is a non-laser technique that uses mild heat energy to reshape the cornea and improve vision.
  • LASIK (Laser-assisted in situ keratomileusis): it is the most used procedure due to its speed and comfort for the patient, in addition to the fact that the postoperative recovery time is less than that of other surgeries. A corneal flap is produced and the cornea curvature is corrected with a laser.
  • LASEK (Laser-Assisted Subepithelial Keratectomy): a flap is produced in the corneal epithelium and the corneal layers are formatted with the laser and the curvature is corrected, repositioning the epithelium.
  • Photorefractive keratotomy (PRK): using a laser, the cornea is modified so that light refraction is correct.
In specific cases, your doctor may recommend inserting a small plastic ring with an opening in the center into the cornea of one eye or removing the lens of each eye to replace it with a synthetic or intraocular lens. However, you may still need reading glasses. Each of these surgeries have possible complications and side effects, which your ophthalmologist will explain and recommend the most suitable for you. At ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes:

  • aao.org
  • oftalmoseo.com/
  • mayoclinic.org
  • medlineplus.gov
  • cigna.es
  • medigraphic.com
  • Camacho-Cano F, Sámano-Guerrero A, Castillo-Gómez F, et al. Cálculo de lente intraocular en un paciente con antecedente de cirugía LASIK bilateral y colocación de implante intracorneal para presbicia. Rev Mex Oftalmol. 2018;92(3):160-164.
  • Solorio-Smith R, Villanueva G. Queratoplastía conductiva (CK) para presbicia, experiencia en México. Rev Mex Oftalmol. 2010;84(1):34-38.
  • Zamora-de-la-Cruz D, Garzón M, Chávez-Mondragón E. Comparación de resultados visuales y de calidad de visión después del implante bilateral de lentes intraoculares trifocales frente a lentes intraoculares bifocales. Rev Mex Oftalmol. 2018;92(2):75-83.
  • Hernández MXM, Chiang IW, Fabars SS. Insuficiencia de convergencia: opciones terapéuticas en dos féminas. MediSan. 2016;20(07):985-989.

						
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