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Presbyopia

Cataract & Refractive Surgery

Key Points

  • •Presbyopia is a universal, age-related, physiological loss of accommodation affecting 100% of people by age 50 - it is NOT a disease
  • •The primary cause is lens hardening (sclerosis) - the ciliary muscle actually hypertrophies with age but cannot deform the rigid lens (Helmholtz mechanism)
  • •Symptoms begin when amplitude of accommodation falls below +3 D (typically age 40–45), which is the minimum needed for comfortable reading at 33 cm
  • •Typical near additions: age 40–45 = +1.00 to +1.50 D; age 50 = +2.00 D; age 60+ = +3.00 D (maximum)

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  • Definition
  • Epidemiology
  • Aetiology and causes
  • Pathogenesis
  • Classification
  • Risk factors and associations

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