Presbyopia is a condition where a person develops the inability to focus on near objects that occurs as they get older and it is considered as a part of aging. In fact, the word Presbyopia literally mean “Old Eye” in Greek and it is due to the gradual loss of the lens’ ability to accommodate. Presbyopia usually becomes noticeable in your early to mid-40s and gradually worsen until around the age of 65. Most People will notice their problem when they start having trouble seeing small print clearly such as books or even text messages and need to hold their reading materials at a distance (usually at arm’s length) to be able to read them. Even in people who are myopic (near-sightedness) will experience blurring of vision as they age despite putting on their usual eyeglasses or contact lenses. While surgical implantation of corneal inlay and multifocal contact lenses are gaining popularity as attractive options of treatment, the usual treatment for Presbyopia is a prescription of a pair of reading eyeglasses with progressive lens to correct the underlying refractive error.
The Assumption Of Exclusivity
The focus and emphasis on reading, writing and typing has been a great determinant on how Presbyopia affects the quality of life, particularly in high-income countries as these tasks are commonly executed in daily life. This creates the assumption that it doesn’t affect the quality of life equally for rural people of middle and low income countries as the aforementioned tasks are not mastered or done in the same volume. Even studying the disease in these countries is difficult as as most studies on refractive error in these nations have been limited to distant vision.
Some studies with data includes one that is done in southern India, where a prevalence rate of 55 percent in people aged 30 years and older were identified. It was found that in this population, female sex, rural residence (as opposed to urban), myopia, and hyperopia were associated with presbyopia and only a third of subjects with presbyopia were currently using spectacles. In Brazil, it estimated that the prevalence of presbyopia in 3,000 adults of 30 years and older is also at 55 percent. Similarly, age and female sex were associated with higher prevalence in this population. A total of 58 percent of the sample reported requiring near vision for their routine daily tasks. In another example, studies on hospital patients conducted in Africa showed a younger onset of presbyopia and more severe presbyopia than studies conducted in Europe and North America. It was also observed that presbyopia affected women earlier than men.
In summary, the studies to date of presbyopia in low- and middle-income countries suggest the following:
- More than half of adults over the age of 30 have presbyopia
- Women have both a higher prevalence of, and more severe, presbyopia
- The majority of those with presbyopia do not have corrective spectacles.
Quality Of Life Among Presbyopic In Rural Areas In Middle to Low Income Countries
Presbyopia affects quality of life. This seems straightforward in high-income countries, where reading and writing are the main near vision tasks undertaken. However, it is a misconception to think that presbyopia has little or no impact on quality of life in populations where reading and writing are less of a part of daily life, for example in the rural populations of low- and middle-income countries.
Study in Tanzania showed that in rural communities, where near vision tasks other than reading and writing are predominant, uncorrected presbyopia had a substantial impact on quality of life as near vision is needed for winnowing grain, sorting rice, weeding, sewing, cooking food, dressing children, and lighting and adjusting lamps. Almost 80 per cent of people with presbyopia reported having problems with near vision and 71 per cent were dissatisfied with their ability to do near work.
Good near vision is needed in many work-related tasks. In India, presbyopic factory workers were less productive than their co-workers and that after correction, their productivity improved significantly, which made the investment in corrective spectacles very beneficial. Also, as more transactions are done in writing, adults with poor reading vision will be at an economic disadvantage.
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