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Many people have some misconceptions about presbyopia. I think presbyopia happens when you’re older.
In fact, presbyopia can appear and become apparent from the early to mid-40s, and can be noticed [1,2]. But at this point, we’re still in early adulthood (25-49 years old). In low – and middle-income countries, presbyopia may appear as early as the 30s [3].
Why can’t you see it up close?
Have you ever had this experience? Reading a book or staring at an object at arm’s length, such as a phone screen, for a little longer, the eyes begin to rebel: dry, tired, and even blurred. It’s as if all of a sudden your eyes are no longer subject to your control.
In severe cases, try reading tiny fonts and you will find that your eyes almost lose their ability to focus. You may even involuntarily pull the reading material further away or look up to reduce the regulatory pressure on your eyes.
If you do, you probably have presbyopia.
What went wrong?
Our eyes are relaxed when looking far away, and need to be adjusted when looking close.
Think of your eyes as cameras. The lens of the camera can automatically focus on objects near and far. We do this by the cornea (the transparent outer “window” of the eye), the lens, the vitreous body, and the retina.
When looking at a nearby object, light enters the eye. The cornea bends the light first, and then the muscles and ligaments around the lens contract to change the shape of the lens so that the light is focused on the retina. The retina then converts light into electrical signals that are sent to the brain. In this way, we see objects that are close by.
However, the lens is actually growing all the time, and the newly generated lens fibers are wrapped in layers like an onion and compressed toward the center, which causes the lens to become hard and elastic on the one hand, and the lens to become thick (axial thickness) on the other hand, which together lead to the decline of the lens adjustment ability [3].
Presbyopia is not a disease
When young eyes look at close objects, they can easily adjust or increase the curvature of the lens by contracting the ciliary muscle to focus the image of what they are about to see.
This change in the adjustment system of the human eye with the increase of “working years” eventually leads to a physiological decline in the adjustment ability of our eyes to see nearby objects.
Therefore, the main manifestation of presbyopia is that it is easy to see near fatigue and see near unclear. But presbyopia is not a refractive error like myopia [4].
Generally, this phenomenon begins in the late 40s of early adulthood (25-49 years).
Not to be confused with other conditions
Importantly, presbyopia is completely different from other eye diseases that occur with age, such as age-related cataracts, glaucoma, and macular degeneration.
Therefore, if there is a near-vision blur or other symptoms such as blurred vision, flashing lights, it is best to seek medical attention in time, and ask the doctor to clarify the situation through a comprehensive eye examination.
Is there a way to delay it?
Postponement is a false proposition. Loss of adjustment is a natural phenomenon, but proper eye habits can help our eyes last longer. For example, wear sunglasses to protect your eyes from UV rays and watch your diet.
What does it work?
We can ensure the stability of the normal metabolic and physiological state of the eye by adjusting the daily intake of nutrients.
Vitamin A maintains the normal dark vision of the eye by participating in the synthesis of rhodopsin. Liver, egg yolks, full-fat milk, carrots, sweet potatoes, mangoes, pea shoots, etc. can provide vitamin A to the human body.
Ensuring an adequate supply of B vitamins is very helpful in alleviating eye fatigue, because heavy eye use tends to increase the consumption of B vitamins. B vitamins are commonly found in animal viscera, beans, milk and eggs, livestock, poultry, fish and meat, coarse grains and other foods.
Polyunsaturated fatty acids such as DHA and minerals such as calcium, zinc and chromium are also important for maintaining eye health. Fatty fish, shrimp and shellfish can provide DHA, calcium supplement foods are mainly dairy products, soy products, green leafy vegetables, and nuts, whole grains, meat, seafood and other foods contain relatively rich zinc, chromium.
Lutein and zeaxanthin help prevent macular degeneration. Egg yolks, green leafy vegetables, yellow-red vegetables, fruits are good sources of lutein and zeaxanthin.
Anthocyanins can promote rhodopsin synthesis and antioxidant. You can eat more purple potatoes, purple cabbage, blueberries, mulberries and other purple and black food.
Work/life balance
Especially for people who use computers or electronic screens for a long time, reasonable adjustment of the pace of work, such as proper rest and closing the eyes, can help alleviate eye fatigue.
[1] Cleveland Clinic-Presbyopia[EB/OL]. (2023-07-06)[2023-10-16].
[2] Mayo Clinic-Presbyopia[EB/OL]. (2021-11-20)[2023-10-16].
[3] Patel I, West SK. Presbyopia: prevalence, impact, and interventions. Community Eye Health. 2007 Sep; 20(63):40-1. PMID: 17971909; PMCID: PMC2040246.
[4] UpToDate- Presbyopia
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