WHAT is Presbyopia? That is a hard question to answer. The Medical Dictionary explains that it is not a disease, but that it is the physiology of vision due to advancing years, or to old age. It is also stated that the condition is dependent on diminution of the power of accommodation from loss of elasticity of the crystalline lens, causing the near-point of distant vision to be removed farther from the eye. Loss of elasticity of the crystalline lens means a hardening of the fluid content of which the lens is composed. This condition of old age of the lens is supposed to begin at about forty years. It is explained that it may begin prematurely, that is before forty years, and it is stated that in those cases the cause is unknown. These statements are very simple, but there are many questions which they do not answer. Although this is not an uncommon condition, it cannot be questioned that the great mass of people is not afflicted with presbyopia. All those that have no difficulty with their eyes, at sixty, and seventy, and eighty, and ninety years of age constitute very plain exceptions to that which is offered as a sort of law.
Those who have had the symptoms of presbyopia for a number of years, and then had a return of good normal vision, would seem to constitute some kind of a contradiction to the explanation that their lenses had degenerated into a hardened condition. There is no doubt that there are many such cases in evidence. In "The Autocrat of the Breakfast Table," Dr. Oliver Wendell Holmes refers to such a case in the following words:—"There is now living in New York State an old gentleman who, perceiving his sight to fail, immediately took to exercising it on the finest print, and in this way fairly bullied nature out of her foolish habit of taking liberties at five-and-forty, or thereabout. And now the old gentleman performs the most extraordinary feats with his pen, showing that his eyes must be a pair of microscopes. I should be afraid to say how much he writes in the compass of a half-dime—whether the Psalms or the Gospels, or the Psalms and the Gospels, I won't he positive."
Dr. Holmes had a fine sense of humor in his writings, but always a subtle keenness which was never trivial. Above all, he was a practicing physician, and it is unthinkable that he would publish a statement as full of vital human interest as that, and mean it only as a cheap and misleading joke.
In my own practice, Mr. Burns, previously referred to, for forty years had all the symptoms of what is called presbyopia—in brief, poor vision; he also had the symptoms of astigmatism, which are often indistinguishable; and certainly a positive near-sightedness. His sight was poor for distance, and he could not see to read without glasses. In a few weeks, his sight improved for distant vision, and he could accommodate to read quite small print a few inches from his eyes. This vision, which he recovered at eighty-five, he retained until his death at eighty-seven. Whatever was the condition of his lens, a wonderful improvement was secured by his own alert and enthusiastic attention. Mind over matter, if you like. But mind certainly—his eighty-five-year-old mind; and eighty-five-year-old eyes.
The common experience is that eyes gradually lose power in the later years of life. This is true of eyes as it is true of every human function. But there are those who retain their organic vitality until they have exceeded by many years, the "three score and ten" which was allowed them by that self-constituted authority in the Old Testament. We are told in the text books that some develop what is called presbyopia, pre maturely, and the reason cannot be explained. Likewise, for those who advance to the end of a long life without developing any presbyopia, no explanation is offered in the text books.
"Presbyopia", according to the text books, is a condition of physiology, but it omits to remark that it must be an abnormal physiology. It may develop "prematurely", in early life. It may develop with the onset of "old age", at forty. It may develop forty years later. It generally does not develop at all—according to accepted authorities, thousands of millions never have had it. It may be present for many years, and then disappear as it came, without any apparent reason. There are many who have very poor vision for reading, for example, but who take off their glasses, and accommodate perfectly even in threading a needle. If it was caused by a physiological and inevitable hardening of the lens, Helmholtz must have been wrong, because every aged lens which accommodates disproves his theory. That is what a standard international text book means when it says that the Helmholtz Theory does not explain all the phenomena of presbyopia. The text book first approves of the theory of Helmholtz—which was that the lens accommodated by changing its shape, and which he offered only as a theory—and then points out that either he was wrong, or the theory of presbyopia is wrong. The conduct of the eye, in these cases under discussion, is physiological, as is claimed. But the physiology is dominated by the psychology. That is wily the records are so different and so variable. For the same reason, the condition is not a hopeless prospect. The correction of presbyopia involves the same treatment as is indicated in the cure of other physiological dysfunctions.
Eyes grow old, as do hearts and livers. But when vision begins to falter before the body is twenty years old and every other function is normal, it is not "a normal result of growing old." It is a manifestation of the infinite variety of the moods of astigmatism. When the old gentleman whom Dr. Holmes reported, cured his presbyopia at an advanced age, he responded to some impulses which aroused his conscious mind into action, and that which he demanded of his eyes, the visual center granted. There is a change in the power of vision which is spoken of as second sight. That old gentleman secured it. Who can say that the possibility of such an accomplishment was not aroused in his mind by some positive knowledge of the occurrence of what be demanded for him. self? A simple denial that this happens, is not an answer. to the question, when it is known that it does. To offer a contradictory explanation of the situation is not a scientific reaction. The practical interest in the discussion is the answer to the question as to the possibility of the cure of presbyopia and the procedure to employ. The same laws apply as are concerned in other abnormal visual functions. Correct the physiological dysfunction. Order the mind to constrain the mechanism of vision to function in a normal manner. This book contains all the directions that are necessary. For different cases, various practices are suitable. The results will not always be the same. It was the spirit of the old gentleman, not the method, that produced the result in his case. Any case of presbyopia can be improved or cured. That is the law.