Everyone develops presbyopia (presbyopia) — regardless of whether they have never had a vision problem before or were short-sighted or far-sighted. It starts around the age of 45 to 50 and is expressed by the fact that small print texts initially appear blurred at close range and can only be read with reading glasses.
The so-called accommodative capacity of the natural lens, i.e. the ability of the lens to focus at different distances, has continued to decline since childhood, even in the second half of life.
Most people experience presbyopia at around 45 years of age, because the accommodation is then so low that it is no longer sufficient to see objects sharply within a reading distance. A first pair of reading glasses is needed to be able to read in a relaxed way.
The eyeglass lens focuses light rays in such a way that even closer objects are reproduced sharply on the retina. Since the natural lens can still partially accommodate at first, reading glasses with 1.0-1.5 diopters are sufficient. Later, stronger glasses with up to 3 diopters will be required to be able to read even smaller texts at short distances.
Short-sighted people with a visual defect of -1 to -2.5 diopters notice presbyopia only in an attenuated form. The short-sighted person can often see well even in old age without glasses nearby. However, he needs a visual aid for the distance and the intermediate area. People with greater short-sightedness of more than 3 diopters can only see at close range without glasses and therefore only benefit from their short-sightedness to a limited extent.
On the other hand, people who were able to “accommodate away” mild farsightedness (hyperopia) in adolescence without problems notice the reduced ability to accommodate much earlier than normal-sighted people. Long-sighted people therefore need reading glasses earlier. This must then be regularly adjusted or reinforced up to around 60 years of age. After that, glasses for the distance are usually also required to be able to relax watching TV or driving a car.
Presbyopia cannot be stopped by eye training or medication. There are eye drops that constrict the pupils and thus allow a better depth of focus, which can improve close vision. Due to side effects, including poor vision in poor lighting conditions, these drops are only used in individual cases.
Normal-sighted people who become age-sighted initially only need reading glasses, which they can wear to read or work and, for example, while watching TV or playing sports.
At the beginning, presbyopic people who are also slightly short-sighted can remove their binoculars to read in order to see sharply.
So-called progressive lenses can be adjusted to prevent the glasses being constantly put on and taken off. The upper part of these lenses includes, if necessary, a correction for the distance. A so-called sewing addition is cut into the lower part of the lenses, which helps to compensate for the lack of accommodation in presbyopic people.
In the beginning, blurred vision, dizziness, shoulder and neck pain and poor depth perception are normal, even with progressive glasses that are perfectly tailored to your needs. To avoid dangerous situations, progressive goggles should never be worn in traffic, climbing stairs or playing sports during the acclimatization phase.
It has been proven that wearing progressive glasses significantly increases the risk of accidents. Some patients are unable to get used to the progressive optics throughout their lives and are forced to look for another solution for their presbyopia.
There are various surgical procedures to enable vision at a distance and up close.
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