Vision Problems

Presbyopia

 

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Eventually, nearly everyone loses some of their ability to focus on near objects and fine details. When this happens, it’s called presbyopia.

Presbyopia is why most people eventually develop the need for reading glasses or bifocals. Presbyopia is often confused with farsightedness because the two conditions share the inability to clearly focus on near objects. But they are not the same.

Presbyopia (sometimes called age-related focus dysfunction) commonly occurs in a person’s mid-40s, when the lens thickens and hardens as part of the natural aging process. The muscles of the eye can no longer change the shape of the lens to focus on near objects. (Farsightedness, on the other hand, is caused by flatness of the cornea or by the shape of the eye itself.)

Most people who develop presbyopia wear reading glasses, bifocals or multifocal contact lenses to read or see other close objects clearly, but glasses and contact lenses are not always an ideal solution.

Patients with presbyopia often say:

• Reading glasses are inconvenient, expensive and easy to lose or break.
• Contacts make my eyes feel dry, irritated or painful.
• Taking care of my contact lenses is too time-consuming.
• As my vision changes, I feel less safe-especially at night.
• I want to look and feel younger.
• I wish I could see more clearly again with my own eyes.

Treating presbyopia today

Advanced techniques make it easier than ever to correct presbyopia permanently-often reducing or completely eliminating the need for glasses or contacts, including reading glasses. There are two major types of presbyopia-correcting surgery. Your specific medical needs and personal preferences will determine which is right for you:

Monovision or Presbyopia Laser Vision Correction corrects one eye to focus on far objects, while the other is corrected to focus on near objects. Your brain learns to coordinate between the two images, so you have both far and near vision. If you also have other refractive errors (like nearsightedness, farsightedness or astigmatism), they can be addressed at the same time.

Presbyopia Lens Replacement Surgery replaces the natural lens in your eye with an advanced artificial lens, called an intraocular lens or IOL. It corrects presbyopia and cataracts at the same time, so you won’t have to have another surgery later in life. You can usually also correct nearsightedness, farsightedness or astigmatism at the same time, as well, so that you will have excellent vision at all distances-even without glasses or contacts.

Finding the right presbyopia treatment for you

Here are a few special guidelines for choosing a presbyopia treatment:

• Patients over 50 years of age are generally better served by Lens Replacement Surgery because it spares you from ever getting cataracts, which cloud the vision and can start to develop as early as your mid-50s.
• Nearsighted patients under age 50 are generally better served by Presbyopia Laser Vision Correction (also called LASIK monovision).
• Astigmatic patients under age 50 may also be better served by Presbyopia Laser Vision Correction, depending on the degree of astigmatism.
• For patients who are over age 60 or who have already developed cataracts, cataract surgery may be a more appropriate option. Cataract surgery can also correct presbyopia with the right lens

Talk with your eye doctor about which procedure is right for you.

Why does the eye lose the ability to focus on near objects?

When light enters your eye, the cornea and the lens work together to focus light on the retina at the back of your eye. When the lens is relaxed, it is the right shape to focus light from distant objects. For close-up objects, the muscles of the eye push on the lens to change its shape to focus light for near distances-this process is called accommodation, and it happens naturally, without you even noticing.

Over time, the lens thickens and loses some of the flexibility needed for accommodation, making it much harder to clearly focus on close objects.

Presbyopia affects almost everyone, even if they are already nearsighted, farsighted or astigmatic. Presbyopia usually precedes the development of cataracts. With modern presbyopia treatments, all of these conditions can often be treated in one procedure.

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