You read with your arm outstretched and can barely decipher the SMS on your mobile phone display? If objects that are close to your eyes start to blur, this could be a sign of presbyopia. Presbyopia diminishes the elasticity of the lens so much that the so-called near-point shifts. The distance in which you can see objects sharply moves farther and farther away. This is because the eye loses the ability to accomodate. That is, it can no longer focus on different distances and needs support for it. A classic in such cases is the reading glasses, but there are other ways to correct presbyopia.
The cause of presbyopia is in the lens. More precisely: in their loss of elasticity. The closer an object gets to the eye, the more the lens must bulge so you can see it clearly. This is done by relaxing the "suspension" of the lens so that the lens becomes more spherical. However, with increasing age, usually from the middle of 40, the lens has often hardened so much that this process no longer works optimally. The consequence of this so-called presbyopia: things that are "at the wrong distance" from the stiffened lens are no longer sharply displayed on the retina. The panoramic view remains unimpaired.
This stiffening process of the lens theoretically begins in the baby age, but makes itself felt only from the middle of the fourth decade or later. Presbyopia is therefore not a disease, but simply a symptom of the natural aging process - and in older age with an estimated 95 percent, the most common form of visual impairment. On average, Germans need 1.5 diopters at the age of 48 to compensate for the first effects of presbyopia. At the age of 60, this average has risen to 2.75 diopters, and over-60s average more than 3 diopters to balance. By the age of 60, the process of lens hardening is usually completed and presbyopia does not deteriorate further.
Even if the name similarity suggests it: presbyopia and farsightedness are two different things. While in the case of presbyopia, the lens is no longer elastic enough to focus close objects on the retina, in the case of a "classic farsightedness" either the eyeball is usually too short or the visual apparatus is misformed. Here is not the elasticity of the problem, but a modified refraction of the lens or cornea.
There are several symptoms that can help you to recognize presbyopia. The most common is likely that sufferers book, cell phone, food labels, etc. on the outstretched arm away from themselves in order to increase the distance to the eye and decipher the font better.
Another indication of presbyopia may be headache and / or dull pressure around the forehead and eyes. The pain often occurs during the day or increase throughout the day. This is because age-diligent eyes have to exert much more effort when reading and recognizing objects, thereby fatiguing faster. You should have your eyesight checked if you notice the following symptoms:
- They keep newspapers, labels, books, etc. away from themselves in order to read the scripture; The fine print is barely or not at all decipherable for you
- Reading is increasingly difficult for you, it's hard on your eyes
- They often get headaches during the day and / or feel pressure in the eye / forehead area
Your suspicion of presbyopia can be confirmed at home by a (printable) test poster or an online test. Nevertheless, you should always have your eyesight checked by an expert. An optometrist can do some tests and suggest corrective options. But especially if you have not been to the ophthalmologist for a long time, an optician will advise you to have an ophthalmological examination. An ophthalmologist can then measure the intraocular pressure. This is a characteristic by means of which, for example, it is possible to detect or exclude glaucoma at an early stage, which is a frequent cause of the loss of sight in old age.
It is important for both the optician and the ophthalmologist to describe your vision problems in as much detail as possible. Also references to hobbies and professional requirements can be important. Occasionally there is a need for correction in comparison to a standard reading distance.
Afterwards, ophthalmologists or opticians examine the ability to accommodate and refine the eyes. This often happens first on a classic visual board with letters or numbers of different sizes that you must recognize and read out loud. The expert then usually repeats this test with a pair of test glasses or a device that can be adjusted to different dioptric powers (phoropter). On the basis of these results, ophthalmologists or opticians will point out the various options for correcting them and, together with you, choose the individually fitting ones.
Can not really stop or cure presbyopia, but compensate. Ways to correct poor eyesight are glasses, contact lenses or surgery. All have advantages and disadvantages, different restrictions and possibilities.
Corrected by glasses
A classic for correcting presbyopia is glasses. Concerned are different variants to choose from.
It represents the simplest form of correction if there is no ametropia. The reading glasses are, as the name suggests, only worn to be able to see the proximity. In the case of long or short-sightedness, the respective dioptric number must be counted towards the reading glasses strength. As a result, two to three diopters of short-sightedness with minus can balance out the two visual deficiencies. You can often see between 55 and 60 without glasses in close range. But most older people need or need two pairs of glasses: one to see in the distance, and one for near vision. In such cases or even astigmatism, we recommend multi-vision or progressive spectacles.
Here one differentiates between two (Bifokal-) and three-strength (Trifokal-) glasses. In the former there are two so-called concentration zones, in the latter three. These zones make it possible to satisfy several vision correction needs with a glass. In addition to the distance and near vision existing middle zone in the Trifokalbrille is necessary if the accommodation capacity of the eye has decreased so far that a separate correction for distances between 50 centimeters and one meter is necessary. For example, price tags and sheets of music can be read or manual activities carried out. You can wear the glasses all day long and do not have to switch to reading or driving. The areas of the multi-vision goggles that can be recognized by fine separating edges in the glass are arranged in such a way that you automatically see through the appropriate correction area. Because you look into the distance, lift your eyes and lower it for objects that are close to you. Only when you lower your head abruptly, for example, when you go up a curb, does the gaze fall through the "wrong" area. You have to get used to that, but that should have happened within a few days.
In the case of progressive spectacles, the lenses are ground so that the transitions from one correction value to the other are fluent. This means that you can switch from remote to near-vision without the "jump in the image" of multi-vision goggles. However, if the gaze leaves the viewing channel, for example, if you look to the side, blurring may occur. This also requires a bit of getting used to, as, for example, the side view requires the entire head to be turned in order to stay in the correct correction zone. Headaches and dizziness can also occur in the beginning. These complaints should settle after a few weeks.
Correction by contact lenses
A presbyopia can also be corrected by means of contact lenses. This is for example an option in sports or for people who do not feel comfortable with glasses. Important in this form of correction is that the doctor measures the exact eyes, so that the lenses are sitting properly. And: Older people often do not tolerate contact lenses as well as the tear film gets thinner in old age and the eyes dry. Here eye drops can help. The following options for contact lenses are available at presbyopia:
They work like a bifocal lens - look through the upper part, look at the distance sharply, look through the lower, to the near. Trifocal lenses have a built-in medium correction level. So that such lenses do not move in the eye, you usually have a small additional weight.
Simultaneous contact lenses: Here, concentric rings are arranged around the center point, which focus on different distances. In this variant, the brain takes a while to get used to the lenses, because at the same time several sharp and blurred images are created, and it has to filter out the desired image.
Note: Both types of these so-called multifocal lenses can only be used if there is no serious eye disease and no astigmatism. The costs must be borne by the patient.
Contact lenses with monovision principle
It is possible to distribute the correction zones on both eyes. It is usually the case that presbyopia is not equally pronounced in both eyes. One eye is the dominant one, on which one places the contact lens for the distance vision, on the other one for the near vision. The brain superimposes both images so that both far and near objects are in focus. Disadvantage: With this form of correction, spatial vision may be limited.
Correction by operational measures
If the affected person does not want to wear glasses or contact lenses at presbyopia, the visual impairment can also be operated on and the sight can be improved. One possibility is the laser therapy by means of which the lens elasticity is to be restored. The therapy is not reversible, with 800 to over 3,000 euros per eye very expensive and there are no scientific long-term results on the consequences.
Alternatively, the presbyopic can use an artificial lens. Rigid art lenses are made of solid plastic with multiple rings for different sharpness zones. The problem with this genre: In the intermediate range, the vision is often not optimal, which, for example, makes it difficult to work on the computer and when driving around light sources around can create reflections (halos). Deformable art lenses, which change their position and thus the refractive power behind the pupil, could remedy these disadvantages, but are still in the test phase here in Germany. The advantage of artificial lenses is at the same time their disadvantage: they can be exchanged. In view of the fact that presbyopia increases with age, at least one additional procedure will be necessary.
Since presbyopia is a process, it usually begins hardly noticeably and intensifies over several years. The average distance in which the eye focuses is still about ten centimeters in an adult at the age of 20, increases to 25-35 centimeters at the age of 40 and can grow up to two meters in a mid-sixty-year-old. How fast the near vision decreases is individually different. At age 65, however, age-blindness is fully developed and no longer becomes stronger.
According to current knowledge, presbyopia can not be completely prevented. There are theses that eye training can counteract the process, or slow it down. In this training you will practice focusing on objects at different distances, which should strengthen your muscles. However, some experts doubt the effectiveness of the eye training in presbyopia, since with presbyopia, the eye muscles work so normal and only hardens the lens. Whether the diet affects the aging process of the lens is controversial. The healthy function of the eyes can generally be supported with vitamin A (eg in carrots) and lutein (in green leafy vegetables).
Globuli: So effective is alternative medicine for presbyopia
There is no clear study on the effect of homeopathic remedies and globules on presbyopia. It could be that homeopathic remedies in the follow-up treatment of a laser correction stimulate the self-healing powers of the eye and thereby accelerate recovery. However, experts recommend that Globuli and Co. should only be used concomitantly and in consultation with the attending ophthalmologist.