II. Definitions
- Presbyopia
- Age-related loss of accommodation
III. Epidemiology
- Onset after age 45 to 60 years old
IV. Mechanism
- Crystalline lens loses elasticity with normal aging
- Accommodation is less effective
- Lens no longer thickens on ciliary Muscle Contraction (near Vision, reading distance)
V. Symptoms
- Blurred Vision on reading fine print
- Eye strain and Headache may occur
VI. Management
- Glasses or Contact Lens
- Single-Vision reading glasses (inexpensive $20, OTC)
- Bifocal glasses (clear far distance and reading distance)
- Trifocal glasses (clear far distance, middle distance such as a computer screen, and reading distance)
- Multifocal glasses (no-line lenses, with continuous range of correction for various distances)
- Monovision
-
Pilocarpine 1.25% (Vuity)
- Mechanism: Constricts pupil
- Dose: One drop per eye once daily ($80/month)
- Onset of action within 15 minutes and duration of 6 hours
- Adverse effects include Headache, rare Retinal Detachment risk
- Limits night Vision
- (2022) presc lett 29(1): 1-2
VII. References
- Trobe (2012) Physicians Guide to Eye Care, AAO, San Francisco, p. 146-7