Gender differences in presbyopia

is the loss of lens accommodation with age that results in an inability to focus at near distances. It is receiving growing attention because of the recognition that good near vision is needed to accomplish a broad range of tasks, not only reading and writing. Research shows that there are differences between men and women in the prevalence, age of onset, and severity of presbyopia, 1 in the types of tasks for which men and women use near vision, 2 and in the ability of men and women to afford spectacles for correction of presbyopia. The prevalence of presbyopia in low-and middle-income countries is not well known, but several studies have indicated that the prevalence is higher among women: • Morny, using hospital chart reviews, found a prevalence of 65 per cent in Ghanaian women. 4 • In southern India, Nirmalan et al. found a prevalence of 55 per cent in subjects aged 30 years and older. 5 The prevalence of presbyopia increased with increasing age and women had 40 per cent higher odds of being presbyopic. • Duarte et al. in Brazil estimated the prevalence of presbyopia in 3,000 adults 30 years and older at 55 per cent. 6 Once again, age and female sex were associated with higher prevalence. • Age-adjusted data collected during the authors' study of 1,709 people aged 40 and above in rural Tanzania showed higher prevalence among women than men (Figure 1). In multivariate analysis, women had 46 per cent higher odds of being presbyopic (defined as the ability to read N8 at 40 cm using a logMar E chart). 1 Pointer, in his clinic-based study, observed that presbyopia affected women earlier than men. 7 Our study showed that women also had more severe presbyopia than men across all age groups. The authors' 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. 2 We found that women used near vision for lighting and adjusting lamps, winnowing grain, sorting rice, weeding, sewing, cooking food, and dressing children. Men reported using near vision for lighting and adjusting lamps, reading, writing, harvesting, and weeding. Nearly 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. Women were just as likely …