It is estimated that practically 100% of people over 50 years of age suffer from presbyopia or eyestrain. The possibilities to counteract it range from the use of different types of lenses to surgery. Presbyopia or eyestrain is an eye disease caused by the aging of the lens and the ciliary muscle, the two structures of the eye that serve to focus through a process called accommodation. This ailment, also known as presbyopia, affects approximately 17 million Spaniards over 45 years of age, being the most common visual problem in Spain. It is estimated that between 95% and 100% of people over 50 years of age suffer from it. The lens, located at the back of the iris, is a biconvex and transparent lens that allows us to focus on objects at different distances correctly. This lens is suspended inside the eyeball by suspensory ligaments (zonular fibers) attached to the ciliary body (ciliary muscles). When this ciliary muscle contracts, the fibers above relax to allow the lens to change shape, becoming thicker to focus on the closest objects. In contrast, for the vision of distant objects, the lens is sharpened to the maximum. As a consequence of aging, there is a loss of elasticity of the natural lens of the eye (crystalline) and the failure of elasticity and power of the ciliary muscles in a process that ends up generating increasing difficulty for the clear vision of nearby objects. That is why something typical of this visual problem is that our eyes get more and more tired when reading, sewing, or doing any routine activity requiring close vision. Commonly, a solution is not sought at the beginning of these first symptoms, which causes the affected person to have to exert himself to try to better focus on the objects within his reach, something that can end up causing visual fatigue and headaches. However, there are effective options to treat this problem, from resorting to lenses or contact lenses, to outpatient surgical treatment, either through the implantation of a multifocal intraocular lens or laser. In all cases, recovery is usually quick. Symptoms and diagnosis of presbyopia Usually, presbyopia or tired eyesight begins to be detected when the difficulty arises to read the small print or focus on nearby objects that lead to having to move them away to see them correctly (hence many know it as “the syndrome of long arms”). In addition, the person suffering from this eye problem may suffer other symptoms of presbyopia, such as occasional headaches and eyestrain. Presbyopia can appear accompanied by refractive errors such as myopia, astigmatism, or hyperopia. Although it affects people with myopia as well as hyperopia, it appears earlier in seconds. It should also be borne in mind that it affects people who have never been required to wear glasses since it is an age-related problem. Diagnosis of presbyopia A comprehensive dilated eye exam can detect eyestrain. For this reason, specialists recommend annual visual check-ups starting at the age of 55. People are more likely to suffer from other ophthalmological diseases such as cataracts, glaucoma, or AMD from this age on. During the medical consultation, the ophthalmologist will study the specific case and indicate the most appropriate treatment depending on the patient’s age, the previous defect that he has, and the state of the lens. Treatment of presbyopia The eyestrain, being a physiologic defect associated with the aging of organs, is impossible to prevent. A few years ago, the most common way to correct presbyopia was through glasses or contact lenses. It also has a definitive surgical solution through two techniques: the implantation of a multifocal intraocular lens and the presbyopia laser. Optical treatment of presbyopia using lenses People with presbyopia can use different types of lenses; among them, we find: Single vision lenses: indicated for those who have tired eyes but see well from afar. They are helpful if you have to do a job that requires a close-up vision for a long period. The disadvantage of these lenses is that they offer blurred distance vision, which can make you dizzy. Bifocal lenses: the upper part of the lens allows you to focus on objects from a distance, and the lower part will enable you to see close objects well. The problem is that they prevent objects located in an intermediate zone from being seen clearly, and they are also not very aesthetic. Trifocal lenses: unlike bifocals, they cover not only distance and far vision but also intermediate vision. The impediment they present is that it is difficult to adapt to them, and aesthetically the three different optical zones of the lens are noticeable. Progressive lenses and progressive or multifocal contact lenses: the complete solution, since it allows a correct vision from any distance simply by varying the inclination of the head or gaze, without penalizing aesthetics. Of course, adapting to this type of lens is more expensive. Surgical treatments for tired eyesight Presbyopia can be operated in two ways, using an intraocular lens or with a laser. Both treatments are outpatient, are performed with topical anesthesia, and allow you to quickly stop depending on glasses and contact lenses, eliminating their use for distant vision and being able to achieve a degree of near vision suitable for everyday life. All this with hardly any hassles. Let’s see what they consist of: Intraocular lens treatment (multifocal vision): consists of replacing the lens with a multifocal intraocular lens, which works as an artificial lens. This lens offers two planes of focus, near and far, being the brain choosing the most suitable plane depending on whether we want to see up close or far. This operation also makes it possible to eliminate associated defects such as myopia, hyperopia, and astigmatism and prevent the appearance of cataracts. Laser treatment (combined vision) is similar to that used to correct myopia, which we know as Laser-Combined Vision or Monovision ( Blended Vision ). It allows correcting tired eyesight, notably improving intermediate and near vision. When we look, we see with both eyes. However, one eye (the dominant one) is more specialized in seeing from afar while the other (reading eye) is more specialized in seeing closely. This combined Vision-Laser treatment enhances this specialization without altering the awareness of near and remote binocular vision.