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Title	Presbyopia : ‘Not always obvious, not always simple …’
Abstract Nr.	3030

Purpose	If a patient of 40 years or older presents with difficulties to focus on small near objects or fine print, or with ocular fatigue, eyestrain or difficulty seeing in dim light, the obvious working hypothesis will be presbyopia. More often than not this will prove to be correct. However, presbyopia can also be less obvious. Patients of various ages may present with atypical complaints varying from blurred distance vision to hyperventilation and “seeing dots” at near fixation. In other patients the first sign can be the gradual increase of a previously stable, longstanding micro-esotropia, without any asthenopia.
Methods	Presbyopia can be corrected by a refractive correction for reading distance. Usually, uni-, bi- or multifocal glasses or contact lenses ( bi-/multifocal or ‘monovision’) are prescribed, taking into account the patient’s activities and preferences and the physical possibilities (eg does the patient support contact lenses?). However, in a number of patients correction of presbyopia is not simple. Factors like ocular dominance, hyperopia, heterotropia, incomitancies and nystagmus may have to be taken into account.
Results	This presentation focuses on the examination and management of presbyopia, especially on the not so obvious and not so simple.

Authors 1