Presbyopia in the context of Refractive surgery


Presbyopia in the context of Refractive surgery

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⭐ Core Definition: Presbyopia

Presbyopia is a physiological insufficiency of optical accommodation associated with the aging of the eye; it results in progressively worsening ability to focus clearly on close objects. Also known as age-related farsightedness (or as age-related long sight in the UK), it affects many adults over the age of 40. A common sign of presbyopia is difficulty in reading small print, which results in having to hold reading material farther away. Other symptoms associated can be headaches and eyestrain. Different people experience different degrees of problems. Other types of refractive errors may exist at the same time as presbyopia. While exhibiting similar symptoms of blur in the vision for close objects, this condition has nothing to do with hypermetropia or far-sightedness, which is almost invariably present in newborns and usually decreases as the newborn gets older.

Presbyopia is a typical part of the aging process. It occurs due to age-related changes in the lens (decreased elasticity and increased hardness) and ciliary muscle (decreased strength and ability to move the lens), causing the eye to focus light right behind rather than on the retina when looking at close objects. It is a type of refractive error, along with nearsightedness, farsightedness, and astigmatism. Diagnosis is by an eye examination.

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👉 Presbyopia in the context of Refractive surgery

Refractive surgery is an optional eye surgery used to improve the refractive state of the eye and thereby decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.

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Presbyopia in the context of Blindness

Visual or vision impairment (VI or VIP) is the partial or total inability of visual perception. In the absence of treatment such as corrective eyewear, assistive devices, and medical treatment, visual impairment may cause the individual difficulties with normal daily tasks, including reading and walking. The terms low vision and blindness are often used for levels of impairment which are difficult or impossible to correct and significantly impact daily life. In addition to the various permanent conditions, fleeting temporary vision impairment, amaurosis fugax, may occur, and may indicate serious medical problems.

The most common causes of visual impairment globally are uncorrected refractive errors (43%), cataracts (33%), and glaucoma (2%). Refractive errors include near-sightedness, far-sightedness, presbyopia, and astigmatism. Cataracts are the most common cause of blindness. Other disorders that may cause visual problems include age-related macular degeneration, diabetic retinopathy, corneal clouding, childhood blindness, and a number of infections. Visual impairment can also be caused by problems in the brain due to stroke, premature birth, or trauma, among others. These cases are known as cortical visual impairment. Screening for vision problems in children may improve future vision and educational achievement. Screening adults without symptoms is of uncertain benefit. Diagnosis is by an eye exam.

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Presbyopia in the context of Refractive errors

Refractive error is a problem with focusing light accurately on the retina due to the shape of the eye and/or cornea. The most common types of refractive error are near-sightedness, far-sightedness, astigmatism, and presbyopia. Near-sightedness results in far away objects being blurry, far-sightedness and presbyopia result in close objects being blurry, and astigmatism causes objects to appear stretched out or blurry. Other symptoms may include double vision, headaches, and eye strain.

Near-sightedness is due to the length of the eyeball being too long; far-sightedness the eyeball too short; astigmatism the cornea being the wrong shape, while presbyopia results from aging of the lens of the eye such that it cannot change shape sufficiently. Some refractive errors occur more often among those whose parents are affected. Diagnosis is by eye examination.

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Presbyopia in the context of Near visual acuity

Near visual acuity or near vision is a measure of how clearly a person can see nearby small objects or letters. Visual acuity in general usually refers clarity of distance vision, and is measured using eye charts like Snellen chart, LogMAR chart etc. Near vision is usually measured and recorded using a printed hand-held card containing different sized paragraphs, words, letters or symbols. Jaeger chart, N notation reading chart and Snellen's near vision test are the commonly used charts for measuring and recording near visual acuity. Near vision testing is usually done after correcting visual acuity at a distance.

Eye conditions like presbyopia, accommodative insufficiency, cycloplegia etc. can affect the near visual acuity. According to the World Health Organization, the near visual acuity less than N6 or M0.8 at 40 cm is classified as near visual impairment.

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Presbyopia in the context of Corrective lens

A corrective lens is a transmissive optical device that is worn on the eye to improve visual perception. The most common use is to treat refractive errors: myopia, hypermetropia, astigmatism, and presbyopia. Glasses or "spectacles" are worn on the face a short distance in front of the eye. Contact lenses are worn directly on the surface of the eye. Intraocular lenses are surgically implanted most commonly after cataract removal but can be used for purely refractive purposes.

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Presbyopia in the context of Blurred vision

Blurred vision is an ocular symptom where vision becomes less precise and there is added difficulty to resolve fine details.

Temporary blurred vision may involve dry eyes, eye infections, alcohol poisoning, hypoglycemia, or low blood pressure. Other medical conditions may include refractive errors such as myopia, high hypermetropia, and astigmatism, amblyopia, presbyopia, pseudomyopia, diabetes, cataract, pernicious anemia, vitamin B12 deficiency, thiamine deficiency, glaucoma, retinopathy, hypervitaminosis A, migraine, sjögren's syndrome, floater, macular degeneration, and can be a sign of stroke or brain tumor.

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Presbyopia in the context of Near point

In visual perception, the near point is the closest point at which an object can be placed and still form a focused image on the retina, within the eye's accommodation range. The other limit to the eye's accommodation range is the far point.

A normal eye is considered to have a near point at about 11 cm (4.3 in) for a thirty year old. The near point is highly age dependent (see accommodation). A person with hyperopia or presbyopia would have a near point that is farther than normal.

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Presbyopia in the context of Laser scanning

Laser scanning is governed by the LiDAR technology and is defined as the controlled deflection of laser beams, visible or invisible. Scanned laser beams are used in some 3-D printers, in rapid prototyping, in machines for material processing, in laser engraving machines, in ophthalmological laser systems for the treatment of presbyopia, in confocal microscopy, in laser printers, in laser shows, in Laser TV, and in barcode scanners.Applications specific to mapping and 3D object reconstruction are known as 3D laser scanner.

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Presbyopia in the context of Accommodative insufficiency

Accommodative insufficiency (AI) involves the inability of the eye to focus properly on an object. Accommodation is the adjustment of the curvature of the lens to focus on objects near and far.

In this condition, amplitude of accommodation of a person is lesser compared to physiological limits for his age. AI is generally considered separate from presbyopia, but mechanically both conditions represent a difficulty engaging the near vision system (accommodation) to see near objects clearly. Presbyopia is physiological insufficiency of accommodation due to age related changes in lens (decreased elasticity and increased hardness) and ciliary muscle power.

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Presbyopia in the context of Cycloplegia

Cycloplegia is paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation. Because of the paralysis of the ciliary muscle, the curvature of the lens can no longer be adjusted to focus on nearby objects. This results in similar problems as those caused by presbyopia, in which the lens has lost elasticity and can also no longer focus on close-by objects. Cycloplegia with accompanying mydriasis (dilation of pupil) is usually due to topical application of muscarinic antagonists such as atropine and cyclopentolate.

Belladonna alkaloids are used for testing the error of refraction and examination of eye.

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