A 59-year old male presents with dimness of near vision. On examination, the media was clear in both the eyes. What would be the next step?
Ans. a. Refraction with near add (Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">A 59-year-old male presents with dimness of near vision. On examination, the media was clear in both the eyes. For diminuation of vision this age. one should think for cataract; but in this case, media (cornea/aqueos/lens/vitreous) is clear, so cataract is ruled out. As there is dimness of near only; the next most likely cause would be presbyopia. The treatment for presbyopia is refraction and near addition.PresbyopiaThe term presebyopia means "oldie" and is a vision condition involving the loss of the eye's ability to focus on close objectsQ.Presbyopia is a condition that occurs as a part of normal ageing and is not considered to be an eye diseaseQ.Symptoms are usually noticeable by age 40-45 and continue to develop until the process stabilizes some 10-20 years later.Causes:As individuals age, the lens becomes less flexible and elastic, and the muscles become less powerfulQ.Because these changes result in inadequate adjustment of the lens of the eye for various distances, objects that are close will appear blurry.Major cause: Loss of elasticity of the lens of the eyeQ.Loss of ciliary muscle power, however, is also believed to contribute to the problemQ.Symptoms:Individuals typically have difficulty in reading small print, and may need to hold reading materials at arm's lengthQ.Symptoms include headache and eyestrain when doing close work, blurry vision, and eye fatigueQ.Symptoms may be worse early in the morning or when individuals are fatigued.Dim lighting may also aggravate the problemQ.Diagnosis:Diagnosed during an eye examination conducted by eye specialists, such as optometrists or ophthalmologists.Part of the examination will assess vision while reading by using various strength lenses.Treatment:Presbyopia cannot be cured, but individuals can compensate for it by wearing reading, bifocal, or trifocal eye glassesQ.A convex lensQ is used to make up for the lost automatic focusing power of the eye.Half-glasses can be worn, which leave the top open and uncorrected for distance vision.In addition to glasses, contact lenses have also been found to be useful in the treatment of presbyopia.
Refraction with near add
Refraction under atropine
Radial keratotomy
Cataract surgery
Types of Errors of Refraction