Presbyopia

PRESBYOPIA

PRESBYOPIA

Presbyopia is a vision condition in which the crystalline lens of eye loses its flexibility.
Difficult to focus on the objects closer to the eye.
Presbyopia is not an error of refraction but a condition of physiological insufficiency of accommodation leading to a progressive fall in near vision.
Presbyopia is an age related problem, therefore also called eye sight of old age.
Symptoms are usually seen after 40 years of age.
Presbyopia is not a disease, rather a natural part of the aging process of the eye.

Treatment

Prescription is the prescription of appropriate convex glasses for near work.

Spasm of accommodation (PSEUDOMYOPIA)

Pseudomyopia is caused by excessive ciliary muscle tone.
Causes an increase in accommodation & this in turn results in crystalline lens to have more plus power.
Found mainly in children who attempt to compensate their refractive error.
Myopes are more affected than hypermetrops.
Other causes of spasm of accommodation are: Drugs causing ciliary spasm (cholinergic drugs), prolonged near work.
Patients present with diminution of distant vision while near vision is good (due to artificial myopia as result of excessive accommodation) & marked eye strain.

CYCLOPLEGIA

Causes are:

Drug induced paralysis of ciliary muscles- Atropine, homatropine, parasympatholytic drugs.
Internal ophthalmoplegia (paralysis of ciliary muscle & sphincter papillae)- Diptheria, Syphillis, Diabetes etc.
Complete third nerve paralysis

Presbyopia is due to loss of elasticity of lens capsule, weakness of ciliary muscle & weakness of suspensory ligament.
Hyperopia is the refractive problem most closely resembles presbyopia.
Treatment of presbyopia is by use of Convex lens.
Excessive accommodation may result in Pseudomyopia.
Pilocarpine drug causing spasm of accommodation.
Paralysis of accommodation also called cycloplegia.

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