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15/12/2017

 The appearance of presbyopia

Although many of us think forty is the new twenty, at the age of forty five we might have to hold our mobile phone at arm's length just to read a text on our mobile phones. That's how we get to know our new travel buddy: presbyopia. Also known as tired eyesight, those who have far-sightedness will experience it earlier and those who are short-sighted will experience it later in life, paying the price of having to remove their glasses just to be able to read. It progresses in all cases until the age of 70 when it stops. Interestingly, some patients start to feel an improvement as the years go by, but this is usually due to cataracts in the majority of cases.

Remedies for presbyopia

The most common remedy is to use varifocals or bifocals. Regular checks are very important, but a good initial check-up is also fundamental, so that the best correction method can be prescribed and adaptation problems are prevented, particularly in the case of progressive lenses.

Perhaps the fact that there is such a high prevalence (1.8 million people), due to the fact that the majority of us will experience it, has awoken an interest in correcting the problem through the use of surgical techniques like special intraocular lenses, laser treatment or even intracorneal implants.

Other problems

There are other important circumstances to take into account:

Eyelids. Sun exposure may cause eyelid lesions that turn into a cancerous pathology. This situation is more frequent among those who have fair skin or spend a lot of time in the sun. They usually show up as lesions that do not heal, and look like either a wound or a small protuberance under the skin.

Ocular surface. Any ophthalmologist will come across patients in their practice who suffer from dryness, and the fact that it is one of the most common reasons people see a specialist is not in vain. Anyone suffering from this condition usually experiences symptoms like the feeling of grit in their eyes, mild and unspecific pain or blurred vision that improves with blinking. Although there are many causes, one of the most significant is hormonal changes and that's why we see it during the menopause. A thorough overall analysis may mitigate the symptoms.

Glaucoma. Glaucoma is an disease that affects the visual field due to an optic nerve disorder, usually secondary to intraocular pressure. A diagnosis isn't always easy as the symptoms are not easily perceived. In fact, a lot of nerve fibres must be lost for our visual field to change. On the other hand, there are people who cannot bear pressure within normal parameters. Apparently the changes can give us a clue, which is why, although those at a higher risk of suffering glaucoma are the over 60s, your ophthalmologist should record your eye pressure and optic nerve characteristics in their best conditions so as they can detect any subsequent changes.

Retina. The majority of the eyeball contents consist of a transparent liquid that gives the eye its volume, called the vitreous. When we are born, this substance is as thick as egg white and as the years pass, it may degenerate and de-construct into those well-known floaters. They manifest themselves as annoying specks or transparent threads that feel like they are somewhere outside our visual field, however, they are always located in the same region of our visual field.  They are usually harmless, but at times they may predispose serious pathologies that an early diagnosis could offset. A lack of prevention may lead to serious lesions like retinal detachment.

Necessary check-ups

Lastly, it's important to know that our eyes may reflect pathologies in our bodies including high blood pressure or diabetes. Such patients will be given a multidisciplinary treatment to help prevent complications derived from such pathologies.

In all cases, a thorough check-up will help to prevent and treat the majority of these issues.

Dr. José Lamarca

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