Presbyopia is the normal age-related loss of near focusing ability. If you are over 40 years old and need to move reading material away from you to be able to focus on it then you are starting to experience presbyopia.
Nearly everyone has this condition as they age, even people who have had a LASIK surgery in your 20s or 30s, you will still have this reading vision problems from presbyopia in your 40s, 50s and over.
As people in Northern Colorado age they usually find that reading glasses or bifocal or progressive lenses help. But if you want greater freedom visually from glasses after age 40, there are some surgical options available for the correction of presbyopia:
Monovision is a presbyopia-correcting technique where your eye doctor prescribes lens powers for one eye to see clearly across the room (leaving it slightly blurred up close) and the other eye to see well up close (making it slightly blurry far away). In this way your eyes continue to work together just in a different way and this works surprisingly well.
Even though this method may sound unusual to some, monovision contact lens fittings have been in practice for years, and most presbyopes who try monovision adapt to it quite well. Some people find that reading glasses are still needed for very small print or prolonged reading sessions, but a person can usually be glasses-free for most of the day with monovision.
In Fort Collins, Loveland and Greeley, LASIK surgeons have begun using this monovision technique, and success rates are expected to be as good as or better than monovision with contact lenses. It is wise to try monovision contact lenses before you decide to permanently alter your eyes with LASIK surgery. If you like the way that monovision contact lenses work then you can continue on with monovision LASIK with greater assurance that you will be happy with the outcome (provided you meet the other criteria of a good candidate for LASIK).
Monovision CK (NearVision CK)
CK (conductive keratoplasty) is a procedure that uses a hand-held probe to deliver controlled radio-frequency energy to specific areas in the periphery of the cornea of the eye. This area specific energy shrinks the corneal tissue in these spots and steepens the central cornea, thus making the eye have a greater nearsightedness.
NearVision CK, the version of CK for presbyopia, does this proceedure for monovision and so it is performed only on one eye. NearVision CK is a less invasive option and is also less expensive than LASIK. It is a good option for someone who only needs reading glasses – that is, someone who is presbyopic but has no nearsightedness, farsightedness or astigmatism.
The effects of CK do become reduced over time, so much that at some point, additional procedures may be needed to keep the effects of the NearVision CK. Just as with monovision LASIK, it is wise to first try monovision with contact lenses to make sure you’re comfortable with it before proceeding with NearVision CK surgery.
Multifocal IOLs and RLE
There are a couple of options available in this category. The first is multifocal intraocular lenses (IOLs) which are a new take on the lens implants that eye surgeons have been doing for years in cataract surgery. In this case though, the lenses have the ability to correct vision at all distances instead of having just one lens power to correct nearsightedness or farsightedness.
Multifocal IOLs have successfully been used in cataract surgery to correct cloudy vision, or they can be used to correct a clear natural lens that has just lost its ability to change shape for reading related to aging due to presbyopia. This second procedure is called refractive lens exchange (RLE).
Both cataract surgery and RLE are intraocular procedures; this being the case they have more side effects associated with them than other, less invasive procedures do. Some of these risks include but are not limited to: glaucoma and retinal detachment.
Accommodating IOL (Crystalens®)
Here in Fort Collins, Loveland and Greeley, another type of IOL that is available is the “accommodating” IOL. While this intraocular lens has only one lens power, the center of the device has structures called haptics which allow the lens to have more natural movement forward and backward inside the eye thus giving it the ability for a more natural type of response to the eye’s focusing muscles. Because of this movement, an accommodating IOL can give back some of the eye’s ability to change focus as needed.
The accommodating IOL is an approved procedure in the United States as part of cataract surgery, and it has the same risks associated with it as with other intraocular lens surgeries.
Multifocal LASIK (PresbyLASIK)
During PresbyLASIK, the excimer laser creates concentric rings of different powers of correction on the cornea (much like the different corrective powers of a multifocal soft contact lens) to provide corrected vision at all distances for the patient.
Today in Northern Colorado, some studies now reveal that presbyopic patients are happy with the lasting result of PresbyLASIK, many of them do continue to wear eyeglasses for during a few activities. Although near vision after PresbyLASIK is usually good in bright light, many patients find that reading glasses help provide better vision in low-light situations. PresbyLASIK is a multifocal variation of LASIK that is available in Europe and Canada, but is not yet FDA approved in the U.S.A.
Corneal inlays are yet another surgical optical solution for presbyopia which is still being developed and is not yet FDA-approved for use in the U.S.A. In this procedure, a small circular device is put inside the cornea to improve a patient’s visual clarity for near objects and reading. Corneal inlays will one day be a lot like multifocal contact lenses, except that they would never need removal or maintenance.
For additional information or to schedule an appointment, please call 970-204-4020 or click on the link on the side of the page.