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Presbyopia – or Is It Hyperopia?

If the eyes cannot see small things in detail, whether or not it’s due to Presbyopia or Hyperopia has a lot to do with age. Both are described via their main symptom as being farsightedness.

If you could at one time see the numbers in the phone book but now have some difficulty, or you have problems choosing something from a menu in a restaurant because the lighting is so dim, then you are probably witnessing the onset of Presbyopia. Typically this will start on average around 44 years of age and our favourite comment that comes with the presbyopia is: “My arms are not long enough anymore”.

There’s a clue in the name, if you know your ancient Greek. Presbys means old man, and opia means something to do with the eyes. So literally Presbyopia means “old man’s eyes”, or perhaps today we should correct that by saying “old person’s eyes”.

Presbyopia is a disorder that creeps up on “old” people at forty or fifty when the lens of the eye undergoes changes in flexibility and/or the muscles operating the lens weaken, so that the eye cannot be focussed to the extent needed in order to see small things in detail. Reading and especially computer work become increasingly difficult.

Often patients ask: “Why is this happening to me?”  Our response is: “It’s a date of birth problem!”  This at least gets a laugh.  Telling someone: “What do you expect at your age”, typically gets a frown, so we stick with the date of birth problem.

The symptoms of Presbyopia are almost identical to those of Hyperopia but the group of people it affects is quite different, with Hyperopia mostly affecting children.

So then:-

•    Presbyopia is age related and appears in later life along with the facial wrinkles

•    Hyperopia is something you are born with, but may disappear or continue to cause reading difficuties – it depends on the severity.

Symptoms of Presbyopia

The first signs are going to be difficulty reading small print, especially when not in good light near a window or under a reading lamp – you’ll notice that you need to “take things to the light to see better” as you’ve no doubt heard older people say.

Eye strain is a common symptom, together with a fuzzy feeling in your eyes when you change the viewing distance, typically going from reading for quite a while then looking at fairly distant television screen, the eyes needing time to catch up!

Treatment

A full eye examination by an optometrist will provide a person developing presbyopia with a range of treatment solutions:

•    Eyeglasses

Spectacles will always be the first choice, with further options of either being prescribed solely for reading, or as bifocal lenses to wear continually when needing to see at normal distances with occasional close up work, as with say cooking in the kitchen and referring to a recipe.

•    Contact lenses

The use of contact lenses to correct vision has increased markedly with advances in materials and cost, especially in the area of disposables. Optometrists nowadays pay a great deal of attention to monitoring a patient’s progress when first adopting “contacts”.

Bifocal options are again available, as well as something not often heard about  (because it’s probably only a few people who would like to try it) – having one eye with a contact lens for reading and another for distance – it’s called Monovision. It would be interesting to meet someone who is using the technique wouldn’t it?

•    Surgery

Surgery, usually laser surgery as it’s very simple, quick, effective and above all safe, is an option frequently considered today; and new methods are always under development. For example Laser Blended Vision emulates the Monovision concept used in contact lenses, but allows a better three dimensional depth of vision.

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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