Aging Case Studies


CASE 2: Presbyopia


Clinical History:

A 46-year-old man has had increasing difficulty with reading, particularly the fine print. In fact, everything seems to resemble fine print, because has to hold objects farther away in order to get them into focus. This problem has been getting worse for a couple of years. He still has no problems driving or with activities of daily living. He has resisted going to an optometrist, because he has never worn glasses and does not want to start now.
  1. What is the most likely reason for these findings?

    2. With aging, the lens loses its elasticity and distensibility, becoming more spherical. No matter how hard the ciliary body tugs on the lens fibers, the lens will not focus propeprly. The lack of focus results in a near point that gets farther and farther away. This effect is particularly pronounced with activities that require close vision, such as reading.

  2. What can be done?

    3. "Reading glasses" or contact lenses that increase the power of magnification, or bifocal glasses for those who already use glasses, will correct the problem. Persons who were myopic to begin with, having a "long" eyeball, will have some improvement in vision, for a time, from presbyopia.

  3. What is the incidence of this condition?

    4. Virtually everyone begins to develop this problem in their 40's.