What is Presbyopia, symptoms, treatment, surgery and lenses


What is presbyopia?

Difficulty reading messages on cell phones, seeing the validity of a product, hours on a watch or even doing makeup because you can’t see things up close, are indications of presbyopia (ICD H52.4), also known as “tired view” .

The name presbyopia comes from the Greek word presbus and means “old man”, therefore, it is associated with aging. The lack of near vision develops from the age of 40, progressing gradually and reaching its highest level around the age of 55.

Is presbyopia the same thing as hyperopia?

Although both diseases present the same symptoms, such as the difficulty of seeing closely – unlike myopia , in which the affected does not focus on objects from a distance -, they are different.

Presbyopia, as already mentioned, is a natural disorder that occurs due to aging, appearing in the second stage of life. Hyperopia is caused when the cornea is straighter than usual or when the eyes are smaller than normal. It is diagnosed in childhood or adolescence, being linked to heredity.


In the human eye, there is a lens called crystalline (gelatinous and crystalline like water, hence the name) responsible for focusing on objects that are close by. The lens increases in size within the eye throughout our life. It adjusts to leave the image sharp on the retina, when switching between near and far foci.

However, after completing 40 years, growth is not supported, that is, it is no longer possible to accommodate it, causing it to lose its flexibility. As a consequence, nearby objects are out of focus.

Risk factors

In addition to age as responsible for tired eyesight, some health conditions can accelerate the onset of dysfunction:


The pathology reduces red blood cells, also known as erythrocytes, in charge of transporting oxygen to all cells. When the transfer is not done, the visual cells do not operate normally, facilitating the appearance of presbyopia.


Disease related to the high level of glucose (sugar) in the blood and that blocks small blood vessels in the back of the eyes. As a result, the retina does not receive oxygen and suffers damage.

Cardiovascular diseases

Diseases that affect the heart – such as heart failure, infarction , among others – are characterized by a lack of satisfactory blood circulation to the organs. Therefore, the insufficient amount of blood in the eye contributes to presbyopia.

Multiple sclerosis

Multiple sclerosis causes disturbance in the nerve cells that control movement. Over time, eye cells can be affected, causing objects seen from close up to blur.


Certain medications, including antidepressants, diuretics and those against insomnia and anxiety , can also develop the disease.

Factors such as not having a balanced diet or intraocular surgeries also facilitate the onset of the disease.


The symptoms of presbyopia are less easily perceived when in sunlight, as are other refractive diseases. This is because the pupil naturally decreases its size. Because of this, in closed or artificially lit places, pay more attention to the following signs:

  • Need to move away from something you are reading, known as “short arm syndrome”;
  • Eye fatigue;
  • Blurred vision;
  • Spots of near vision;
  • Difficulty seeing in low light;
  • Pain around the eyes;
  • Burning;
  • Redness and watery eyes;
  • Headaches.

How is the diagnosis made?

The patient undergoes a thorough eye exam. The ophthalmologist verifies the gradual worsening of vision, as well as performing a physical examination to analyze visual sensitivity, the effectiveness of refraction – when the beam of light, coming from an external environment, penetrates the eyeball creating vision in the retina – and ability of the lens to shape itself over varying distances.

Is presbyopia curable?

Presbyopia has no cure, but there are different treatments that make it possible to lead a normal life. Contact lenses and prescription glasses are recommended, as they act in the same way as the lens, that is, the image is correctly reflected on the retina. Another option is laser surgery and radiofrequency.


The treatments used are responsible for repairing the refractive error:


The glasses are suitable for those who are not used to contact lenses or find it difficult to insert them in the eyes. Progressive glasses also address the need to correct near and far vision.

To preserve it, it is recommended that you wash it with neutral liquid soap and store it in boxes, to avoid scratches or breaks.

Contact lenses

According to the diagnosis by the specialist, the use of a lens may be indicated for one eye or both. The lens can have the function for near or far or serve both purposes at the same time (bifocal lenses).

There is a wide variety of lenses for the improvement of presbyopia, reaching up to 4.0 diopters (unit of measurement of the refractive power of the lenses, popularly known as “degree”).

The use of contact lenses requires special care, since they are exposed to physiological conditions, such as tears, and environmental conditions, such as pollution. Therefore, it is important to know how cleaning and maintenance is done correctly, in addition to paying attention to the expiration date. Misuse can cause eye irritability, infection and loss of lenses.

Refractive Surgery

The refractive procedure is performed by means of a laser, using a device known as the Excimer Laser, which can be Photorefractive (PRK) or LASIK, which varies for each patient.

The use of the laser allows the operation to be done quickly and more accurately, allowing the individual to return to their social and professional activities in less time.

Laser Assisted In Situ Keratomileusis (LASIK)

LASIK has been used since the 1990s and is one of the most performed surgeries in the world. The laser is inserted into the cornea, in one of the inner layers, in order to make it the correct size, so that it compensates for the lack of flexibility of the lens.

This process benefits the refraction of the light rays, that is, the images are produced more clearly. The result appears in about 24 hours.

Photorefractive Keratectomy (PRK)

The laser is applied directly to the corneal tissue, replacing the crystalline lens with an artificial internal lens. Recovery tends to be more uncomfortable and with a longer healing time compared to LASIK.

Radio frequency

The procedure temporarily corrects presbyopia. It is done by means of a small probe connected to the radiofrequency apparatus and which modifies the curvature of the cornea. The patient does not feel pain, as he receives anesthesia with drops of eye drops. Sessions must be held every three or five years.

Living with presbyopia

Presbyopia does not prevent the person from carrying out their daily activities as long as they receive adequate treatment. Some exercises help to rest and strengthen the eye muscles:

Eye Massage

To start, make yourself comfortable. Place your palms over your closed eyes. Breathe and inhale for a minute or two for a long time. Then, remove your hands and open your eyes. This will help to rest your eyes.

Conscious tension

The intense strain on the eye muscles is one of the factors that generate fatigue eye. In this activity, the eyes will be pressed in a conscious way and then relaxation will be employed.

Close your eyes and notice the pressure on your eyelids and eyeballs. Switch between relaxation and tension (squint for a few seconds).

Roll your eyes

Look at the tip of the nose, the movement helps to work the muscles of the eye. Do this for up to 15 seconds and then rest your vision.

Movements in circles

Move your eyes in a circular fashion, both clockwise and counterclockwise. This contributes to the functioning of the eye muscles.

Toggle points of view

Exercising your vision is also a tip. Go in search of panoramic environments, such as mountains and the beach, and then focus your eyes on closer details, such as some flower or stone.

Tonify the eyes with water

Splashing the water in the eyes relaxes and tones the optic musculature, in addition to reducing redness in the eyes. This process can be done several times a day.


If the disease is not properly treated, the vision will be gradually damaged, accentuating the symptoms and impairing your routine.

How to delay presbyopia

Since presbyopia occurs naturally and is linked to aging, it cannot be prevented or prevented. However, some habits help to delay its appearance:

  • Read and perform tasks in well-lit environments;
  • Read with a higher letter resolution;
  • Take long breaks and blink several times in a row when in front of a computer. This favors the lubrication of the eyes, avoiding dryness;
  • Give preference to monitors that have anti-glare features and a better resolution of images;
  • Consult the ophthalmologist regularly.

Presbyopia is a natural condition and cannot be avoided. However, its symptoms can be controlled, without prejudice to daily chores.

Watch for possible signs of the disease and share this information!