What helps against presbyopia?

Glasses, contact lenses or surgery - advice most important factor

01/29/2015

In addition to wrinkles, the presbyopia is one of the unmistakable signs of „To become old“. From about mid-40, the sight begins to diminish. In the beginning, most people still help themselves by keeping a newspaper or a book out of their mouth or squinting their eyes to narrow slits. First, the little tricks still provide relief, then only in optimal lighting conditions and later no longer. At the latest, those affected need help. In addition to classic reading and progressive spectacles, presbyopians today also have modern contact lenses available. In addition, ophthalmology offers alternatives with various surgical procedures. Dr. Kaweh Schayan-Araghi, Board Member of the Professional Association of Ophthalmologists and Medical Director of the Artemis Eye Clinic in Frankfurt, Germany, presents the procedures.

For classic: reading or progressive lenses
Reading glasses restore sharp vision nearby. Depending on the vanity and strength of the individual's poor vision, they are among the cost-effective alternatives, even if they are basically where they are not needed. „If presbyopia is accompanied by further visual impairment, such as short-sightedness, farsightedness or astigmatism, patients need two vision aids“, explains Dr. Schayan-Araghi. „If you do not want to handle two glasses, you need a pair of progressive lenses.“ These consist of a lower area that corrects the presbyopia and an upper area against the other poor eyesight. Properly adjusted, these glasses promise very good vision - but you can expect distortions at the edge of the field of vision. Some do not get along with it, have a headache, are irritated while driving or get dizzy.

For modernity: Multifocal contact lenses
A first alternative is contact lenses, which compensate for myopia and hyperopia as well as astigmatism. Bifocal or multifocal variants, combine several strengths in one lens and can compensate for presbyopia. Whether soft or hard lenses are suitable depends on the cornea and should be discussed with an ophthalmologist. The fine plastic shells must also be carefully maintained. „The acclimation time is slightly longer in both forms than with conventional contact lenses“, explains Dr. Schayan-Araghi. „The brain has to get used to the new vision.“ With prolonged reading or screen work it can sometimes also lead to headaches or fatigue.

For Independents: surgical correction
Anyone who wants to be permanently independent of visual aids can also undergo surgery. An operation that actually helps against the cataract, namely fixes the presbyopia. „We replace the natural lens with a special multifocal lens“, knows Dr. Schayan-Araghi. „The procedure is one of the safest procedures in medicine.“ Above all, the modern form, the trifocal lens, then reliably corrects the near and far areas as well as the intermediate area. This allows patients to read well on the computer, which has a distance of about 65 centimeters. These lenses have the disadvantage that they can - albeit very small - cause glare effects at night. Multifocal lenses, in contrast to all other methods, can really fulfill the desire for a life without glasses. „But the most important thing today is good advice“, emphasizes Schayan-Araghi. „Each method has advantages and also minimum disadvantages, which physicians and patients have to balance together and compare with the personal situation.“ (Pm)