Presbyopia : Its Cause and Treatment

August 12, 2017 17:50 | Good Vision

People living in civilization, in most cases there is a decrease accommodative ability of the eye up until the age of 60-70 years, it will not appear virtually lost.A person becomes completely dependent on their spectacles for near vision.As for the fact, whether such violation occurred in view of the primitive people, or whether it is, for people living in primitive conditions, in this respect there is very little information.Some ophthalmologists are of the opinion that the accommodative ability of people using their eyes mainly on short distances, is reduced, if not declining, at a slower pace than that of the peasants, sailors and other people using the eyes mainly for distance vision.Others ophthalmologists claim otherwise.

is known, however, that people who can not read, regardless of their age, will fail in near vision, if you ask them to look at the printed letters, although they may have excellent vision in the near-point for their familiar objects.Consequently, the fact that people aged 45-50

years of age can not distinguish printed characters, not a basis for concluding that their accommodative ability is reduced.Illiterate younger would do it no better.It should be noted that in this case the young man, who easily read at a short distance Latin script, always at first symptoms of imperfect sight when he tries to read Old English and Greek letters or Chinese characters.

When the accommodative ability of the eye is reduced to such an extent that when reading and writing experiences difficulties, the man said that he presbyopia , or, colloquially, "old man's eyes."As among the inhabitants, and in the scientific community believed that this condition is one of the inevitable inconveniences associated with aging.

Fall of accommodative power with age is usually attributed to seal the lens tissue, the effect of which is believed to be exacerbated in the future due to the flattening of the lens and reducing its refractive status, together with the weakening or atrophy of the ciliary muscle.This phenomenon is so common that are made even special tables showing the nearest point of clear vision, depending on age.It is believed that the basis of this table, you can almost certainly find glasses without verification of the person or, conversely, to determine a person's age to within 1-2 years, based on its points.

According disappointing data presented in one of these tables, a man of thirty years we should expect the loss of at least half of the original accommodative ability of the eye, the age of forty-two-thirds, and at sixty it is almost completely lost.

There are, however, many people who do not fit into this schedule.Many in the 40 years are able to read the fine print to 4 inches, although, according to the table, they had to lose that ability shortly after reaching the age of twenty.Moreover, there are people who refuse to become presbyopic.

One such case is mentioned by Oliver Wendell Holmes (Oliver Wendell Holmes), in his "autocrat of the breakfast table» (The Autocrat of the Breakfast Table »).

«In New York State, - he writes - is now living the old gentleman, who, realizing that his eyesight weakened, immediately began to exercise it to the smallest font and in a manner sufficiently able to compensate for the shortcomings of nature.Now the old gentleman is doing extraordinary things with his pen, showing that his eyes must be true pair of microscopes.I want to be precise, and because I am afraid to say how much it fits into an area measuring less than half a dime - the Psalms and the Gospel individually or all together. "

There are also people, which returns near vision after losing it for 10, 15 or more years.Some people have to some objects presbyopic vision, but for others - perfectly good.Dressmaker, for example, can be without glasses thread a needle.Retinoscope thus shows that their eyes are precisely focused on the object view.However, they can not without my glasses to read or write.

far as I know, no one I have not studied the last of these cases, and others known to every ophthalmologist, having some experience.They can be heard at congresses ophthalmic societies, even read in medical journals.But apparently, the credibility of the force is so great that when it comes to writing a book (or article), they are either ignored or they get off from the superficial explanations.Therefore, most of the treatises, new entrants in the press, repeats the old superstition that presbyopia is "a normal result of aging."Dry hand German science still dominates our minds and prevents believe the clearest evidence of our senses.German ophthalmology, still considered untouchable.No facts are not allowed to show her mistrust.

Fortunately those who consider themselves called upon to defend the old theories, myopia delaying the onset of presbyopia, and a decrease in pupil frequent in old age, leads to the same effect in the relief of the near-point.Consequently, from the said cases of people over the age of 50-55 years read without glasses, you can easily get rid of the assumption that they are likely to be myopic or their pupils extremely narrowed.If such a case is subjected to careful scrutiny, we find that this question is not as simple as it can be, that the person in this case was not myopic, but, for example, or gipermetropikom emmetropikom and has a normal sized pupil.It has no choice but to ignore such cases.

also believed that to preserve the near point of clear vision after the presbyopic age, or for its recovery after the initial loss responsible for abnormal changes in the shape of the lens.The swelling of the lens during cataract nascent enables a very plausible explanation of such cases.When premature presbyopia supposed existence of "accelerated sclerosis" of the lens and weakness tsiliar-term muscle.If we take the specific case of dressmakers who could thread a needle, but could no longer read the newspapers, there is no doubt that an explanation would be found for him in agreement with the point of view of German science.

same is true in respect of presbyopia is that it is not "a normal result of aging", as it can be and to prevent and eliminate.It is caused by not sealing the lens tissue, and the effort to see the near-point.The appearance of presbyopia is not associated with age, as it is sometimes

may come in ten years.At the same time, in other cases it does not occur at all, although a person may for a long time to cross the so-called presbyopic age.The lens does not harden with age, as is the case with the bones, and only change the structure of its shell, but as the lens is not a factor in accommodation, that fact is irrelevant.Furthermore, despite the fact that in some cases, part of the lens with age and becomes flatter or loses its refractive power, there were cases where it remained unchanged and absolutely pure form up to 90 years.Since the ciliary muscle is not a factor in accommodation, its weakness or atrophy can in no way help to reduce the accommodative power.

Presbyopia actually represents only a form of hyperopia, in which reduced primarily in the near-point vision, although distance vision also deteriorates, as opposed to what is generally accepted to believe.It is not always possible to distinguish between these two states.Maybe so that the person with hyper-Metropia succeed or fail on the fine print, while the man in the presbyopic age will read it without apparent inconvenience and yet have poor vision for distance.And in fact, and in another state vision in both locations worsens, though a person may not be aware of.

been shown that when the eyes strain to see a near point, the focus is always shifted forward (relative to what was previously) in one or in all meridians.By retinoscopy it can be shown that when a person with presbyopia tries to read the fine print and it is not possible, the focus has always moved forward with respect to the initial position.This suggests that the failure was caused by stress.Even the idea of ​​the application of this effort leads to tension, resulting in before, as will be seen the fine print, can change the refraction and have pain, discomfort and fatigue.

Moreover, if a person with presbyopia will give your eyes a break by closing them or making palming, he will always be able to for at least a few moments to read the fine print with a 6-inch, again demonstrating that his previous failure was associatednot to any disadvantage eye, and with an effort to see.If the voltage will be able to take off for a long time, and the presbyopia is corrected permanently.This happened more than one or two times, and in many cases, and at any age - up to 60, 70 and 80 years.

first patient that I cured of presbyopia was myself.Satisfied with the help of experiments on animals' eyes, that the lens is not a factor in accommodation, I realized that presbyopia must be curable.But I realized that I can not expect universal acceptance of a truly revolutionary conclusions to which I came, until I wear glasses because of a condition caused by, presumably, the loss of accommodative ability of the lens.

While I suffered the maximum degree of presbyopia.I had no accommodative power at all, so I had to keep a set of points, because the glasses, which gave me the opportunity to read the fine print, such as 13 inches, I could not read it from 12 or 14 inches.Retinoscope showed that when I tried without glasses to see anything close my eyes focused for distance vision and the other way around, when I tried to see something in the distance, they focused vision for the near-point.

Then came the problem of finding ways to change it to the opposite state and force the eyes to focus on the point that I have to see when I want it.I consulted various eye doctors, but my appeal to them was like the Conversion of Saint Paul to the grekam- stupidity."Your lens - they said - hard as a rock.Nobody can do nothing for you. "

Then I went to a neurologist.He examined me with retinoscope and agreed with the results of my observations on the nature of the return of my accommodation.But no ideas, what do I do with it, he did not.The doctor said that he would consult with some of his colleagues, and asked me to visit him again a month later, which I did.Then he told me that he had come to the conclusion that there is only one person who could cure me, and this man, Dr. William H. Bates of New York.

«Why do you say that?" - I asked.

«Because you seem to be the only person who knows all about this question", - was the answer.

Thus, being addressed to the own ingenuity, I was lucky enough to find a gentleman, not having medical education, but ready to do everything for me that he could.After long hours of tedious training, he still learned to freely use the retinoscope.Meanwhile, I was busy studying his case, trying to find at least some of the way to the accommodation at the time when I want to read, but not when I want to see something in the distance.

One day, looking at Gibraltar image hanging on the wall, I noticed on the surface of a few black spots.I imagined that these spots - the entrances to the cave, and they scurry to and fro people.When I did this, my eyes focused on the reading distance.Then I looked at the same picture with the reading distance, continuing to represent that spots are entrances to the caves, and the people are in them.At this time, the retinoscope showed that I realized accommodation.At the same time I was able to read the sign next to the picture.Thus, the use of their imagination to me really helped for a while.

Later, I found that when I imagine the letters black, I can see them so, and when they see black, I can discern their shape.My progress after this can not be called rapid.It took six months before I was able to read the newspaper with sufficient comfort for that, and the year before I reached my current implementation accommodation length of 14 inches (from 4 inches to 18).But this experience was extremely valuable, because in the future in other presbyopic I could watch every symptom in a pronounced form.

Fortunately for my patients, their cure is rarely takes me as long as it took my own.In some cases the complete and permanent cure was achieved in a few minutes.One patient, who wore sunglasses from presbyopia for about twenty years, was cured in less than 15 minutes, using his mental representation.

In the case described above, when the patient asked to read diamond type, he said he could not do it, because all the letters seemed to him exactly the same and gray.I reminded him that the font is printed with ink and that there is nothing blacker than it is.I asked him if he had ever seen ink.The answer was affirmative.Did he remember the degree to which she was black?Yes.Does he believe that these letters as black as ink, which he remembered?And again, he replied in the affirmative.That's when he finally read the letter, and as an improvement in his vision was permanent, he said that I just hypnotized him.

In another case as quickly and the same method was cured presbyopia decade ago.When presbyopic reminded that the letters that he can not read, are black, he replied that he knew it, but they still seem to him gray.

«If you know that they are black, and, nevertheless, see them gray, - I said to him, -So you must imagine them so.Imagine that they are black.Can you do it »

« Yes, - I said on.-I can imagine them black. "And then he was able to proceed with their reading.

Such cases are extremely fast recovery of rare.In nine out of ten cases progress has been much slower.At the same time it had to resort to all methods of achieving relaxation used in the treatment of other refractive errors.In more difficult cases of presbyopia ,null,null, people, when they try to read the fine print, often suffer from the same illusions of color, size, shape and quantity of as people with hyperopia, astigmatism and myopia when they try to read the letters from a distance on the test.When they are trying to see something in the near-point, they can not remember or even imagine such a simple thing as a small black dot, but can do it perfectly, if they do not put any effort to see.Their vision is to give often very imperfect and always below normal, although they may think that it is beautiful.Just as in the case with other refractive abnormalities, improved distance vision improves vision and the near-point.Despite, however, the difficulty of the case and the age of the person, you can always achieve some progress.However, if treatment is continued long enough, the vision is fully restored.

idea that presbyopia is a natural result of aging, bears the responsibility for many cases of low vision.When people who have reached the presbyopic age, have difficulty in reading, they are very likely to immediately resort to the aid of glasses, on the advice of professionals or not.In some cases, these people may actually be presbyopic.In other cases, difficulties may be temporary difficulties, which they would be little wonder if they were younger, and that would have been on their own, they let nature act independently.But if they once used the points, in most cases, they entail the emergence of the state, which were intended to eliminate.If it existed, the glasses make it even worse, sometimes, as it is known by any ophthalmologist, very quickly.