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Presbyopia is a condition that occurs as a part of normal aging and is not considered to be an eye disease. The process occurs gradually over a number of years. Symptoms are usually noticeable by age 40–45 and continue to develop until the process stabilizes some 10–20 years later. Presbyopia occurs without regard to other eye conditions.
In the eye, the crystalline lens is located just behind the iris and the pupil. Tiny ciliary muscles pull and push the lens, adjusting its curvature, and thereby adjusting the eye's focal power to bring objects into focus. As individuals age, the lens becomes less flexible and elastic, and the muscles become less powerful. Because these changes result in inadequate adjustment of the lens of the eye for various distances, objects that are close will appear blurry. The major cause of presbyopia is loss of elasticity of the lens of the eye. Loss of ciliary muscle power, however, is also believed to contribute to the problem.
Symptoms of presbyopia result in the inability to focus on objects close at hand. As the lens hardens, it is unable to focus the rays of light that come from nearby objects. Individuals typically have difficulty reading small print, such as that in telephone directories and newspaper advertisements, and may need to hold reading materials at arm's length. Symptoms include headache and eyestrain when doing close work, blurry vision, and eye fatigue. Symptoms may be worse early in the morning or when individuals are fatigued. Dim lighting may also aggravate the problem.
Presbyopia is officially diagnosed during an eye examination conducted by eye specialists, such as optometrists or ophthalmologists. After completing optometric college, doctors of optometry screen patients for eye problems and prescribe glasses and contact lenses. In contrast, ophthalmologists are medical doctors who specialize in eye diseases. They perform eye surgery, treat eye diseases, and also prescribe glasses and contact lenses.
A comprehensive eye examination requires at least 30 minutes. Part of the examination will assess vision while reading by using various strength lenses. If the pupils are dilated with drugs to permit a thorough examination of the retina, an additional hour is required. The cost of eye examinations can range from $40–$250 depending on the complexity and site of the examination and the qualifications and reputation of the examiner. Some insurers cover the cost of routine eye examinations, while others do not. A thorough eye examination is recommended at regular intervals during the adult and aging years to monitor and diagnose eye conditions. However, individuals frequently self-diagnose presbyopia by trying on inexpensive mass-produced reading glasses until they find a pair that permits reading without strain.
Author Info: Elaine Souder PhD, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Medicine, 2002This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.
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