Presbyopia is an age-related disorder characterized by decreased near vision. It usually appears around the age of 40.

What symptoms do you experience in case of presbyopia?

The first and clearest symptom of presbyopia, once you are over 40, is the need to hold the close objects farther away in order to see well (book, phone, handicraft, etc).

But there are other symptoms that can indicate presbyopia, such as:

  • difficulty reading small letters, such as on the phone, in newspapers or magazines
  • difficulty in maintaining clear focus when reading
  • tired and strained eyes when reading for long periods
  • headache after a period of visual concentration on close objects

Presbyopia is seen as a sign of ageing, with many patients reluctant to admit that they have difficulty seeing. However, it is recommended that at the first signs, you see your ophthalmologist for an examination.

What are the risk factors for developing presbyopia?

Ageing is the main cause of presbyopia. The degree of damage and the development of presbyopia depends exclusively on the individual patient, on how quickly the lens itself loses its elasticity. Genetic factors, diet, general health and the existence of other systemic or ophthalmological disorders can influence the development of presbyopia, but to a lesser degree than other ophthalmological disorders. In general, people who live and work in low-light environments will require glasses sooner than those who work outdoors in good light.

How can presbyopia be prevented?

Presbyopia cannot be prevented, but you can remove its effects early through early diagnosis and correction with glasses or surgery.

What treatment methods exist for presbyopia?

There are several methods for treating presbyopia, the most common being the wearing of near-vision glasses with diopters. But there are also surgical options, such as lens implant surgery or Presbyond laser surgery, which is unique in the world and the only laser surgery dedicated to presbyopia.

Presbyond Laser Blended Vision surgery involves differentiated eye surgery. It is a technology developed by UK-based laser refractive surgery specialist, doctor Dan Reinstein.

Presbyond uses the Excimer laser to shape the cornea. The eyes are operated differently to see well at different distances, one at near (the dominant eye), the other at distance and intermediate (the non-dominant eye), and by overlapping, the patient will see well at all distances.

It is important to note that PRESBYOND addresses the symptoms of presbyopia (i.e. problems seeing near objects) and not the cause (i.e. the natural ageing process of the lens in the eye). Therefore, you can slow down the effects of eye ageing, but you cannot stop them completely.

PRESBYOND Laser provides a safe and effective intermediate step for patients with presbyopia. Furthermore, study data suggest that visual acuity (chance of seeing 20/20 at distance) after PRESBYOND (99%) is better than after lens replacement (90.9%).

The procedure is painless, although you may sometimes notice a feeling of pressure on your eyes. It usually takes 5-10 minutes for each eye and about 30 minutes for the whole procedure.

Presbyond laser treatment is recommended for people over the age of 40 who suffer from presbyopia, for whom conventional laser surgery is no longer recommended.

Lens implant surgery
Presbyopia can also be eliminated with lens replacement surgery. Refractive lens exchange surgery is a better option for people with presbyopia.

Refractive lens exchange (RLE) replaces the eye’s lens with an artificial intraocular lens to correct refractive error and achieve sharper focus, reducing your need to wear reading glasses or bifocals.

For patients with presbyopia, bifocal or trifocal lenses are recommended.
Bifocal lenses. A bifocal lens provides clear vision at 2 distances. They have built-in bifocal correction, providing clear distance vision when the eye is looking straight ahead, while allowing clarity of nearby objects. EDOF variants offer even better distance vision, providing greater independence from glasses.

Multifocal. These lenses are the most advanced and high-performance, offering full independence from glasses. They offer good near, distance and intermediate vision, completely eliminating the need for glasses. It is the first choice for patients who want to remove their diopters to get rid of glasses.

The lenses are customized for each individual eye, depending on their individual parameters and diopters.

Glasses and contact lenses
Prescribing glasses – the most convenient solution for vision correction is still wearing a pair of glasses. Lenses are prescribed by a specialist following an examination. The disadvantage of this option is the need to wear glasses all the time and the impossibility of carrying out a number of activities.
Contact lenses – this option is particularly effective if you no longer wish to wear glasses for purely aesthetic reasons. In this case, it is important how the lenses are applied and how they are stored overnight in a sterile environment using a specific solution.

Text medically reviewed by Dr. Teodor Holhoș, Ophthalmic Surgeon
Written by Dr. Holhos Team

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