What is presbyopia and what are its causes?
Presbyopia is nothing more than the physiological loss of the ability of the eye to focus, which is commonly called tired eyesight. The eye behaves like a camera where it has a focus system and that system of focus, from one age, is degenerating, is losing. The crystalline lens that with its movements is what the focus does, the muscle that is responsible for making that crystalline focus, is running out. And what happens is called presbyopia or eyestrain, that is, an inability to focus the objects at a certain distance. The main cause is not more than the exhaustion of that muscle by age. Therefore presbyopia usually occurs and appears from 40, 42 years and is progressive until 65.
What symptoms does it present?
The main symptoms of presbyopia, as we have said before, there is a depletion of the muscle that is dedicated to focus and, therefore, we begin to have problems in reading. In patients who do not have any glasses defect, this usually happens between 40, 42 years and is usually progressive and becomes maximum at 50, 55 years. So we have to put on some corrective glasses to replace that degenerating effect of that "little muscle" that prevents us from focusing. In patients who are myopic, technically it is curious, the short-sighted one sees well up close, but badly at a distance, whereupon he begins to remove his glasses from afar to be able to see closely. And the one who is hypermetropic the problem comes before even the 40 or 42 years, begins to have a problem from afar and that problem from afar increases in close to 35 or 36 years.
How are the treatments for presbyopia?
On the treatment of presbyopia, many medical treatments with vitamin complexes have been tried. Presbyopia is nothing more than an involutional and degenerative process from an age, which means that vitamin treatments have not worked. The treatment by antonomasia of the presbyopia, of the tired sight, is to correct that defect of approach with glasses, that is to say, to the 42 years we need, we have lost a focus of a diopter, because it is necessary to correct it with a diopter glasses , that's why we put on a gafita and with that we can read. From 42 to 65, we must increase as the focus defect increases, we must increase the graduation we have to correct, which varies between a diopter 40 - 42, two diopters and half or three diopters at 60 - 65 years.
And the surgical treatment?
About the surgical treatment of presbyopia fortunately, for 10 or 12 years now, we have surgical treatments for presbyopia. There are two big blocks: the laser treatment that was first tried, that is not useful for all patients, that is not definitive, that is to try a mono vision, that is, to leave a myopic eye for near and the dominant for far. In some patients it works for a long time, is a superficial treatment and is a non-aggressive treatment. But by antonomasia and by definition the most definitive treatment of presbyopia consists of the implant of diffractive intraocular lenses. What is this? Well, it is simply from the age of 55 that we propose the extraction of the crystalline lens, that lens that is no longer competent, because it no longer focuses, and replace it with an intraocular lens. But for a progressive intraocular lens, that is, it will allow the patient once operated to enjoy a good vision from afar, a good intermediate vision for the computer and a good close-up vision without using a goggle. Is this treatment useful for everyone? No, you have to do a very detailed study of each patient, just as you have to do a very detailed study of the lenses in the market that we are going to implant that patient, because the concept of premium lens, ie the best lens for each patient, you have to individualize it. But nowadays with the methods of aberrometry, with the methods that we have preoperatively to assess which is the patient and the ideal candidate and to assess which is the ideal lens for each patient, the degrees of satisfaction are very high. And it is a definitive treatment, that is, we have removed the lens, we have implanted a lens, there will be no more problems of presbyopia because presbyopia is no longer going to increase.