Presbyopia means loss of the ability to focus at near objects, caused by the progressive loss of elasticity of the natural lens of the eye.
Typically, it is a natural process that begins in middle and old age and needs to be corrected by glasses.
It is important because it means a visual impairment affecting everybody that causes a a major change in lifestyle from the age of 45 on, when nearby objects suddenly cannot be seen properly and have to be hold farther away in order to focus on them.
Common and important activities such as reading, operating a mobile phone, working with the computer become more and more difficult, unless glasses or contact lenses are used, or bifocals are added to an existing lens prescription.
- Conservative treatment consists of starting to use glasses, contact lenses or adding bifocals an existing lens prescription.
- Excimer Laser treatment: Excimer Laser treatment (techniques called “PresbyLASIK” and “Presbyond”) aims to remodel the curved shape of the cornea, in order to confer the optical qualities necessary to compensate the presbyopic condition. At the same time other optical defects defects such as nearsightedness, farsightedness and astigmatism can be corrected in the same operation. It is an ideal method for patients up to 50-60 years of age. >> More detailed info here.
- Lens surgery (PreLEX- Presbyopic Lens Exchange): The aim of this kind of treatment is to exchange the natural lens of the eye for an artificial intraocular lens with multifocal optics (bifocal or trifocal), providing good vision from far to near without having to use glasses.This type of treatment, originally developed for treating cataracts, can be considered after careful patient selection, even if there is no significant cataract formation. If indicated, it confers independency of glasses for most activities and daily routine. It also prevents the later formation of cataracts.It is a particularly suitable technique for :- People with nearsightedness or farsightedness and advanced presbyopia, – Patients not suitable for surgery with excimer laser, – Patients aged 50 and more, – Patients with eraly signs of incipient cataract or with familiar or other risk factors for developing cataracts.
- There are further treatment options available, but there is still little experience or no long term results with them, and are therefore not yet established as “golden” standards:
- Surgically implanted corneal inlays.
- Scleral band expansion (SBE)
- Conductive Keratoplasty