Presbyopia: Treatment, Cost and Side Effects

Presbyopia meaning ‘old eye’ in Greek is a condition that impairs ability of eye to focus on nearby objects. The condition occurs with aging. So, as people reach mid 40s they tend to develop long-sightedness and have difficulty in reading small print and have to hold objects farther away to read or see prints distinctly. The condition worsens till they reach about 65 years. Apart from this they also experience headaches and eyestrains. It happens due to an abnormality of the lens of the eye. The lens which is solely responsible for focus light onto the retina, is located behind the coloured iris in the eye is soft and flexible during young age. In the early years the lens is able to change its shape and size depending upon the objects and the light that it focuses on the retina. But with increasing age, or more specifically, when people cross 40 years, the lens starts becoming rigid and it becomes difficult for it to change its shape according to the objects and light. This is the reason why people perceive it difficult to carry out close-up tasks like reading or threading a needle. Although there is no way to reverse the process of making the lens flexible again or stop the aging process, there are treatments which can make it easier for the person to focus clearly and get rid of eye strain and headaches. Doctors treat presbyopia with corrective eyeglasses, contact lenses, refractive surgery, lens implants or corneal inlays. Eyeglasses can either be prescribed by your ophthalmologist or you can also use over-the-counter reading glasses which are non-prescription. In case, simple eye glass correction does not work you may need to consult your ophthalmologist to get surgery or implants done.

Eyeglasses are the first and foremost corrective option recommended to patients with presbyopia. This is in fact the simplest and safest method of correction. Before opting for prescribed glasses you can also go for over-the-counter non-prescribed reading glasses whose power ranges from +1.00 diopter to +3 diopter (D), with the consent of your doctor. But if the non-prescription reading glasses also do not work or become inadequate for you to focus on the objects, it is apparent that you will require prescription reading glasses. Your ophthalmologist can prescribe you with reading glasses to aid in easy reading. You are not required to use these glasses when you are not reading. Another type of lenses that are recommended is bifocals wherein the lens is distinctly divided horizontally into two parts- the upper part which is used for distance correction and the lower part for reading correction. Trifocals are glasses that correct close-up tasks, middle distance work like reading from computer screens and distant vision as well. Progressive multifocal lenses are glasses which have different strength for focusing aided by different areas of the lens. Office progressives are also prescribed wherein the lenses are used for nearby corrections and computer distance also. There is an option of using contact lenses if you do not want to use eyeglasses. Contact lenses like bifocal contact lenses are used for both distant and close up correction of the eye as the lens have weighted reading portions of the lens. In monovision contact lenses, one lens is used for correcting distant vision and the other lens is used for correcting close-up vision. Another type of contact lens is modified monovision wherein one lens is bifocal or multifocal for one eye and close-up vision corrective for another. Refractive surgery is used to correct close-up vision in your non-dominant eye. The types of refractive surgical procedures are conductive keratoplasty, Laser-assisted in situ keratomileusis (LASIK), laser assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK). Opthalmologists use lens implants and corneal inlays also for corrective sight procedures. Lens implants can be of different types depending upon the particular type of correction that you require. In this the lens of the eye is replaced with a synthetic lens called intraocular lens. The last type of corrective procedure is done by inserting a small plastic ring with an opening in the centre into the cornea of the eye. This procedure helps to focus light rays to aid in view closer objects or prints distinctly.

People above 40 years who find it difficult to focus on nearby objects or find it difficult to read or thread a needle or any close-up work that needs precision are eligible for the treatment.

Anybody who experiences the symptoms of presbyopia like difficulty in focusing on close-up objects or reading, or any precise close-up work are eligible for the treatment. So, there is no ineligibility for presbyopia treatment.

There is no side effect for using eyeglasses and contact lenses for eyesight correction. Although, surgery and lens implants can have some possible side effects. The side effect of conductive keratoplasty is that the results may not last long and corrective action may be required soon. Lens implants come with possible side effects like glare and blurring of the eye lens and can also cause infection, inflammation, glaucoma and bleeding. Other corrective procedures are considered safe and normally do not have any serious side effect.

After undergoing surgery for presbyopia it is recommended to the patients not to drive for a few days, not to lift heavy objects, not to bend over to avoid putting stress on the eyes, avoid sneezing and coughing or vomiting, avoid swimming or using a bath tub to prevent the eyes from infection, not to rub the eyes and avoid exposing the yes to wind, dust and grime. It is also important to eat right after the surgical corrections like avoiding spice or unhealthy food so that you do not vomit and pressurize your eyes. Also avoid having foods like ice-creams or any cold causing food so that you don’t need to sneeze.

Treatment methods like simple eyeglasses or contact lenses are prompt in giving results. Your vision is corrected as soon as you put on the right eyeglasses or contact lenses. Surgical methods or lens implants are done when the simpler options work no more. It takes a few weeks to recover from a presbyopia surgery or lens implant or corneal inlay.

Corrective options like eyeglasses and contact lens including consultation fees for opthalmologists cost about Rs. 300 to Rs 1,000. Corrective options that include surgery and implants cost in the range of Rs. 50,000 to Rs, 1,50,000.

Eyeglasses and contact lenses work effectively until they are sufficient to help the patients do all their work properly. As soon as they start feel inadequacy with these methods, they would require surgery or implants. These methods are normally effective for a very long time but even after these methods eyeglasses are required to be worn.

As already said, presbyopia occurs sue to age as the lens in the human starts becoming rigid as we age. After the onset of 40s, the lens gradually loses its ability to change its size as oer the size of the objects and the light. But still the eyes can be protected and the vision can be kept under check by following the given tips like going for routine eye check-ups, controlling chronic health conditions like high blood pressure or diabetes, protecting the eyes from direct exposure to sunlight and its UV rays, preventing eye injuries, eating healthy foods rich in vitamin A, beta carotene and antioxidants, using good lighting in your home while reading and practicing good reading habits and maintaining appropriate distance while working in the computer.