Presbyopia: the stigma of old age

The orthopaedic surgeon will only make the decision to operate after consensus… with the patient. Here is how to prepare for your consultation with your surgeon.

I always believed that there were two fair and inevitable things in life: death and presbyopia. But one day it was made clear to me that I was wrong. Death may be inevitable, but it is far from being fair to everyone. OK for death! However, let there be no mistake, presbyopia remains an insidious phenomenon that awaits us all around the age of fifty, whether we are beautiful or ugly, poor or rich, black, yellow or white, short-sighted or long-sighted.

The first signs of presbyopia can be seen in the difficulty in reading a text up close when the same text could be read a few months before. This is a classic testing situation at the beginning. In a restaurant, under dim lighting, one notices that one can no longer distinguish the words on the menu (or, more seriously, the prices!) even if one pushes it to the middle of the table to read it at arm’s length. To make it look like he is not presbyopic, the shortsighted will raise his glasses (not his glass) to his forehead. The day will come when we will see ourselves wearing “old age glasses” candidly called “reading glasses” which will ignominiously reveal our canonical age.

THE AGEING EYE
As we have said, presbyopia is inevitable and affects both eyes. It is, in fact, a progressive loss of the accommodation power of the crystalline lens which is due to a modification of its anatomical structures. Thus, the body and the ciliary muscles surrounding the lens gradually wear out and alter its flexibility. Whether we like it or not, age has gradually altered our ability to read.

Who invented spectacles, a word whose origin means circular lenses in the shape of “little moons”? All agree that a Franciscan monk, Roger Bacon (1214-1292), invented spectacles. He is said to have designed the first reading lens, the prototype of the magnifying glasses still in use today. They came into common use around the middle of the 14th century and took various forms over the following centuries, from “magnifying glasses”, to “lorgnons”, to “monocles”, to “rivet or nail spectacles”, to “face-glasses” and finally to “nose-clips”.

Who were the people who could benefit from this invention? Obviously, the clergy, philosophers, writers and especially in their austere monastery, a few old educated monks whose eyesight was failing with age and who still had manuscripts to copy, before Gutenberg invented the printing press, around 1450.

In 1784, the American Benjamin Franklin invented the bifocal lens, which will allow people to see up close with the lower part of the bifocals and at a distance with the upper part, without having to remove their glasses. Until recently, presbyopia was only solved by wearing optical lenses, including progressive lenses. Eventually, single or bifocal contact lenses will appear in clinics. At present, the use of implants inside the eyeball in front of the lens in the pupillary area is being considered. But this costs an arm and a leg…