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Presbyopia

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Presbyopia

  • See Also
  1. Refractive Error
  • Definitions
  1. Presbyopia
    1. Age-related loss of accommodation
  • Epidemiology
  1. Onset after age 45 to 60 years old
  • Mechanism
  1. Crystalline lens loses elasticity with normal aging
  2. Accommodation is less effective
    1. Lens no longer thickens on ciliary Muscle Contraction (near Vision, reading distance)
  • Symptoms
  1. Blurred Vision on reading fine print
  2. Eye strain and Headache may occur
  • Management
  1. Glasses or Contact Lens
    1. Single-Vision reading glasses (inexpensive $20, OTC)
    2. Bifocal glasses (clear far distance and reading distance)
    3. Trifocal glasses (clear far distance, middle distance such as a computer screen, and reading distance)
    4. Multifocal glasses (no-line lenses, with continuous range of correction for various distances)
  2. Monovision
    1. One eye corrected for near Vision
    2. Other eye corrected for distance Vision
  3. Pilocarpine 1.25% (Vuity)
    1. Mechanism: Constricts pupil
    2. Dose: One drop per eye once daily ($80/month)
    3. Onset of action within 15 minutes and duration of 6 hours
    4. Adverse effects include Headache, rare Retinal Detachment risk
    5. Limits night Vision
    6. (2022) presc lett 29(1): 1-2
  • References
  1. Trobe (2012) Physicians Guide to Eye Care, AAO, San Francisco, p. 146-7