Starczowzroczno\u015b\u0107<\/strong> is a deterioration<\/strong> of vision resulting from decreased lens flexibility and loss of accommodation ability. Imagine you are squeezing a rubber ball in your hand. When it is new, and your hands are young and strong, this is easy. Over time, as your muscles weaken with age, and the rubber degenerates and becomes more rigid, the task becomes more difficult. Likewise, presbyopia<\/strong> results from your body\u2019s natural aging process. It commonly affects people over 40<\/strong>\u2014 those who had never had any problems with vision as well as those with near- or far-sightedness. At first, the lens deteriorates suddenly, and accommodation loss is considerable. Then, it progresses more slowly. Every 2\u20133 years, the accommodation range decreases by 0.5 or 0.25 diopters, meaning that objects have to be further and further away to be seen clearly.<\/p>\n\n\n\n

The first signs of presbyopia<\/strong> you will notice might be headaches, eye fatigue, and having to hold your reading material further away to see it clearly. You may find your vision is blurry e.g. when texting on your phone or reading the paper. Sometimes presbyopia<\/strong> is accompanied by diplopia, or double vision, caused by impaired function of the muscles surrounding the eyeball. In consequence, activities that used to be easy and intuitive become problematic. Now imagine you are an accountant, or a teacher taking attendance, and one day you find \u201cyour arms have become too short\u201d! If you are middle-aged and have noticed similar symptoms, it is a sign you should visit an ophthalmologist or optometrist.<\/p>\n\n\n\n

Regularly spending multiple hours in front of a screen is a major risk factor for presbyopia<\/strong>. Its development can also be accelerated by taking antidepressants and antihistamines. Research also shows that presbyopia<\/strong> progresses faster in people with diabetes, especially when poorly controlled.<\/p>\n\n\n\n

Multiple methods for presbyopia<\/strong> correction exist. First choices include progressive eyeglass lenses and multifocal contact lenses. These two methods are the most popular. Lens or cornea surgery can also be performed. If you notice presbyopia<\/strong> symptoms, it is important to visit an ophthalmologist or optometrist, who will help you choose the right correction method.<\/p>\n\n\n\n

Presbyopia<\/strong> can also be corrected surgically during cataract treatment. Cataracts, occurring mostly in older individuals, cause the lens to become opaque, so it has to be removed by phacoemulsification (i.e. broken down using ultrasound). The removed lens is replaced with an artificial implant. Patients undergoing this surgery may receive a monofocal or multifocal lens. A monofocal lens replaces the cataractous lens and ensures good distance vision \u2014 which means you still have to wear glasses for near vision. Technologically advanced anti-presbyopic lenses correct vision at all distances (near, intermediate, and distance vision), so you can e.g. work comfortably on a computer. They usually provide very good quality of distance vision, but only reasonable near vision, sufficient for basic tasks such as answering your phone or checking prices at the store. For longer periods of reading, you may still need glasses. If you have presbyopia<\/strong> and another visual defect, you can undergo laser corneal surgery.<\/p>\n\n\n\n

More and more people worldwide choose to have their own, unopacified lens replaced with an artificial multifocal lens to correct refraction errors (especially high myopia), presbyopia, or both. Thanks to advances in lens surgery, resulting in increased accuracy and fewer complications, these types of procedures are becoming an increasingly preferable alternative. Interestingly, the method was invented by a Pole, Wincenty Fuka\u0142a, in the 1880s, and is known as \u201cFuka\u0142a\u2019s operation\u201d. Of course, intraocular lenses were not yet known in his times, and the procedure was only performed for refractive correction. <\/p>\n\n\n\n

There are also two main concepts of pharmaceutical presbyopia correction<\/strong>. One involves narrowing the pupil, creating an optical setting favoring better vision. The vision improvement achieved this way is partial, temporary, and associated with certain side effects, such as headaches and poorer vision under low light conditions. The other method involves using pharmaceuticals to increase the flexibility and accommodation ability of the lens. This category includes a drug known as \u201cEV06\u201d. EV06 eye drops are now undergoing clinical trials, but initial results are quite promising, especially for mild and moderate presbyopia. Importantly, the method is noninvasive and no serious side effects have as yet been observed.<\/p>\n\n\n\n

In summary, a number of methods are now available for managing presbyopia<\/strong>. They may be noninvasive \u2014 like selecting and buying appropriate progressive glasses or multifocal contact lenses \u2014 or invasive, like intraocular lens implantation (e.g. during cataract surgery) or laser correction (combined with correction for refractive errors).<\/p>\n\n\n\n

The need for education is enormous. New technologies are both a blessing and a challenge to all physicians taking care of their patients\u2019 eyesight. In April 2016, a new initiative \u2014 the Polish \u201cPresbyopia 21\u201d Club<\/strong> \u2014 was launched in Pozna\u0144, Poland. The club, headed by Professor Andrzej Grzybowski<\/strong>, has undertaken numerous projects to promote knowledge and raise awareness among physicians and their patients. On September 12, 2020, the fourth edition of our Presbyopia scientific conference is taking place, with contributions from leading Polish ophthalmologists, sharing their expertise on presbyopia.<\/p>\n\n\n\n

The Polish \u201cPresbyopia 21\u201d Club<\/strong> has also created the first Polish educational platform on presbyopia<\/strong>, dedicated to patients and ophthalmologists. At www.prezbiopia.pl<\/strong>, patients can find information on all available methods for presbyopia correction, as well as discussions and opportunities to exchange knowledge and experiences with other users.<\/p>\n\n\n\n

The Polish \u201cPresbyopia 21\u201d Club<\/strong> has also launched efforts to develop, in cooperation with leading Polish experts, standards for each of the four top methods of presbyopia<\/strong> correction, i.e. progressive eyeglasses, contact lenses, corneal refractive surgery, and intraocular surgery. If you are interested in the Club\u2019s activities and want to support us, follow our Facebook page \u2014 Presbiopia21<\/strong>.<\/p>\n\n\n\n