Question

Presbyopic correction in an old patient is:

• A. +1 D
• B. +2 D
• C. +3 D
• D. +4 D

Hint:

Near add rises with age and tops out around this plus value in the elderly.

Answer 1

The Correct Option is C

Step 1: Presbyopia is the age-related loss of accommodation, so the patient needs a near-add convex (plus) lens for reading.
Step 2: The amount of add increases with age as accommodative amplitude falls. By the time a person is elderly the residual accommodation is essentially gone and the maximum add is reached.
Step 3: The standard near add ceiling in an old patient is about \(+3.0\,D\), which is the value used for the oldest age group.
Step 4: Smaller adds of \(+1\,D\) or \(+2\,D\) are used in younger presbyopes (around 40-50 years), and \(+4\,D\) is not a routine near add. Hence the correction in an old patient is \(+3\,D\).