Middle-aged people may experience substantial changes in their refractive power, thus affecting their visual acuity and quality.
A high proportion of people suffers from presbyopia from age 40: in patients with hyperopia it occurs sooner, and in patients with nearsightedness, it occurs later in life. Presbyopia is characterized by a failure of focusing near objects. This means the ability of focusing objects located at a 25-30 cm distance, which is the usual reading distance, is lost.
It is an age-related physiological change that occurs due to a progressive loss of the accommodation ability, as the crystalline lens, which modifies its power by means of the ciliary muscle force of contraction, progressively loses its performance.
In case it is not corrected, visual symptoms may arise. These symptoms may include: distancing the books from our eyes in order to read, feeling tiredness or eyestrain after carrying out tasks that require near vision efforts, eye redness, blurred vision and headaches. It may be corrected by means of eyeglasses (convergent lens), contact lenses, or, in case we want to avoid the use of optical correction, an intraocular refractive surgery with multifocal lens implantation may be performed (part of the optics focuses in near vision, and the other in distance vision).
The incidence of dry eye syndrome increases with age, usually having the onset in middle age. We can find differences in terms of gender. Women are usually more affected by presbyopia, mainly because of hormone changes. It may be exacerbated with menopause, but in some occasions it may also be related to systemic diseases, specially to rheumatic diseases such as rheumatoid arthritis.
It is a syndrome caused by a lubrication failure in the eye surface due to a bad quality of the tears that are supposed to moisture the cornea. Moreover, in most occasions, this is combined with a poor function of the eyelid glands, that produce the most thick (lipid and mucous) element of tears.
In case it is not corrected, visual symptoms may arise. These symptoms may include: irritation, eye redness, photophobia (abnormal sensitivity to light), sand or foreign body sensation, redness in the eyelids edge, decrease in visual quality and even a decrease in visual acuity in most severe cases.
Its treatment consists in improving the tears quality by following eyelid hygiene measures and topical treatments with eye lubricants such as tear drops or lubricating gels for the eye surface. In most severe cases, the administration of topical eye corticosteroids or topical immunomodulators may be needed, as well as the use of devices that reduce the tear drainage (tear duct plugs).
Contact lens users will need to be extremely cautious in case of dry eye syndrome. Moreover, in many cases this syndrome may even be directly associated to an excessive use of contact lenses. Rules of proper use for contact lenses must always be followed in order to avoid eye surface diseases that may have a major impact in vision. Furthermore, artificial eye drops may be used to protect the eye surface while using contact lenses. Sometimes, if eye surface is irritated or suffers from any condition (such as superficial corneal wounds due to bad hydration, inflammatory areas, etc.) it might be necessary to stop using contact lenses until your ophthalmologist tells you otherwise, once the process is resolved.
Health issues, and more specifically diseases that are considered a cardiovascular risk factor, such as arterial hypertension and diabetes mellitus, usually have their onset on this period of life.
Diabetic retinopathy is the most important cause of irreversible bilateral blindness among people younger than 65 in developed countries, the time of disease progression being the main factor that plays a role in its development (it usually affects between 50% and 60% of diabetic patients with 15 years of disease progression.
Therefore, it is of great importance to carry out an eye examination in case the patient has been diagnosed of such diseases, even if he does not experience visual symptoms, as this may allow to prevent irreversible complications affecting the eyes, as well as to assess whether there’s a proper systemic control of the disease. It is necessary not only to perform a single examination, but also a proper follow-up with long-term eye examinations with variable frequency depending on the signs found during the such examinations, as we are talking about chronic diseases.
In case of experiencing changes in vision, in spite of not having been diagnosed of a systemic disease, it is essential to go to the ophthalmologist for an eye examination, as in many cases, systemic diseases that do have a treatment are diagnosed following a visual alteration that appears as the first symptom of such disease.
In order to decrease the risk of suffering the above-mentioned diseases, it is important to have healthy habits in our daily life, such as doing physical exercise, eating healthy, sleeping properly and avoiding unhealthy habits (tobacco, alcohol, etc.).
It is important to perform a comprehensive eye exam at age 40 even if there are no signs of vision symptoms. On one hand, because some eye diseases have their onset at this life stage and go unnoticed during early stages (such as glaucoma, cataracts, diabetic retinopathy or age-related macular degeneration), although its prognosis may improve and irreversible complications may be avoided when diagnosed early, and, on the other hand, because some visual warning signs might be the starting point for the diagnosis of a systemic diseases requiring a treatment.
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