Presbyopia

Clinical Description

A condition in which the eyes gradually lose the ability to focus on near objects due to age- related sclerosis of the lens.

Signs and Symptoms

• Blurred vision at normal reading distance, eyestrain, headache associated with doing near work and holding reading material at arm’s length.

Diagnosis of refractive errors

• Perform refraction for near and distant vision
• In addition to dry refraction, ALL children should have a wet refraction (give cyclopentolate eye drops before refraction)

Treatment

Management of Refractive errors

• Correct with spectacles. Reading glasses (readers) if presbyopia
• Can prescribe multifocal- bifocals, trifocals or progressive lenses, or contact lenses.
• Consider monovision correction - one eye corrected for near and the other eye for distance in special cases.
• Refractive surgery.

Management/control of myopia progression

• Spectacles and contact lenses
• Consider pharmacological means in children
• 0.05% atropine in children at bedtime 3 to 4 nights a week for a period of 6 Months.
• Behavioral
• Increase outdoor time and exposure to sunlight.
• Reduce the time spent doing near work.