Lecture on Presbyopia For 4th Year MBBS Undergraduate Students By Prof. Dr. Hussain Ahmad Khaqan

1. Presbyopia
Prof. Dr. Hussain Ahmad Khaqan
 MD
 FRCS(Glasgow)
 FCPS(Ophth.)
 FCPS(Vitreo Retina)
 MHPE (KMU)
 CICO(UK)
 CMT(UOL)
 Fellowship in Medical Retina (LMU, Munich)
 Fellowship in Vitreo Retinal Surgery (LMU, Munich)
 Consultant Ophthalmologist & Retinal Surgeon
Professor of Ophthalmology
Lahore General Hospital, Lahore
Ameer Ud Din Medical College, Lahore
Post Graduate Medical Institute, Lahore
Shaukat Khanum Memorial Cancer Hospital & Research Centre ,Lahore

2. DEFINITION
• Progressive age related inadequacy of
accommodation.

3. SYMPTOMS
• Difficulty in near work
• Eye strain
• Fatigue
• Headache

4. ETIOLOGY Continue
 Lenticular changes
 Lenticular sclerosis
 Changes in capsular elasticity
 Change in zonular insertion angle

5.  Extralenticular changes
 Neuromuscular changes
 Ciliary muscle changes
ETIOLOGY

6. AMPLITUDE OF ACCOMMODATION & AGE
(TABLE)
Age (years) Amplitude Age (years) Amplitude
10 14.00 45 3.50
15 12.00 50 2.50
20 10.00 55 1.75
25 8.50 60 1.00
30 7.00 65 0.50
35 5.50 70 0.25
40 5.50 75 0.00

7. TREATMENT Continue
1. Spectacles:
 Single vision reading glasses
 Multifocal lenses containing near add
• Bifocal lenses
• Trifocal lenses
• Progressive addition lenses

8. 2. Contact lens:
 Single vision contact lenses with glasses
 Monovision contact lenses
 Bifocal and multifocal contact lenses
 Modified monovision contact lenses
TREATMENT Continue

9. 3. Surgery:
 Laser in-situ keratomileusis(LASIK)
• More for presbyopic hyperopia
 Multifocal intraocular lens (IOL)
TREATMENT

10. THANK YOU