WHAT IS PRESBYOPIA?
During childhood, people with normal vision have the ability to focus on near objects as well as on objects that are far away. They can switch focus from near to far vision allowing a continuous range of vision. This is called accommodation.
With increasing age, that ability to focus and to switch focus decreases. By the time most people reach their forties, they need an aid, such as reading glasses or bifocals, to focus on close up objects . This condition is called presbyopia.
As you age, the lens inside your eye will lose its ability to focus as well at near – this usually becomes evident around the age of 40. This is when many people begin using reading glasses or bifocals.
- – If you are nearsighted, farsighted or have astigmatism, refractive eye surgery will not prevent this age-related event, known as presbyopia, from occurring.
- – Refractive eye surgery will correct the focus of your eye, which should enable you to see well at distance following your surgery but will not help you with near tasks . You will eventually need reading glasses to see well at near.
POTENTIAL OPTIONS FOR CORRECTION OF READING PROBLEMS AFTER 40
There are several options available to help reduce or eliminate your need for glasses or contact lenses for reading or near work. Your complimentry examination will allow Dr. Abbas to evaluate your needs and chose the best procedure for your unique visual needs:
Spectacles or Eyeglasses
Eyeglasses are an easy and less costly way of resolving reading vision problems. However, if the patient desires freedom from reading glasses, this is not a good solution.
With this option, the dominant eye is corrected for full distance vision, while the non-dominant eye is corrected to see well at near. The use of reading glasses may still be needed on occasion (mostly for detailed near work), but patients are not typically dependent on them.
Monovision can be achieved using soft contact lenses with the dominant eye being corrected for distance vision and the non-dominant eye for near work. Alternatively, once it has been established that the patient can tolerate monovision, laser vision correction can be used to achieve the same result.
PRELEX- Multifocal Lens Correction (Presbyopic Lens Exchange)
Traditional IOLs are monofocal, meaning they offer vision at one distance only (far, intermediate or near). They definitely are an improvement over the cataractous lens that is replaced during surgery, which provides only cloudy, blurred vision at any distance. But traditional IOLs mean that you must wear eyeglasses or contact lenses in order to read, use a computer or view objects at arm’s length.
The new multifocal and accomodating IOLs such as the Crystalens offer the possibility of seeing well at more than one distance, without glasses or contacts. Examples of multifocal IOLs are different versions of Alcon’s AcrySof IQ ReSTOR. Abbott Medical Optics also offers the Tecnis Multifocal Lenses.
Presbyopia correcting IOL s are considered “premium” lenses, which means that you must pay any associated extra cataract surgery costs yourself. Medicare and most health care plans will not cover these extra costs, because the additional benefits of these IOLs are considered a luxury and not a medical necessity.
This is a great option for many presbyopic patients, and is usually best suited for patients age 45 or older who do not have significant cataracts. New technology lens implants can provide a wide range of vision, including distance, intermediate, and near. Patients who consider this option must have good eye health, and must have the right attitude in order to achieve good results.
This procedure involves removal of the natural crystalline lens of the eye using cataract surgical techniques and replacing it with a multifocal intraocular lens which allows patients to be able to see far, intermediate and at near without the help of glasses. PRELEX is usually best suited for patients age 45 or older, although younger patients may be considered in certain circumstances. There are different premium lens options available for implantation, and our staff can help advise which choice is best for you. We currently offer the following premium lenses as part of our refractive package service:
This lens implant uses revolutionary apodized diffractive technology – a series of concentric circular rings which focuses images on the retina and enables a full range of vision. Patients with ReSTOR® lenses usually report great distance vision and great near vision, with adequate intermediate (computer) vision. The vast majority of patients with ReSTOR® lenses will no longer need glasses, but some patients may still need glasses on occasion for certain tasks.
This lens has the ability to offer patients improved vision at a range of distances, from near to middle to far. The vast majority of patients with Tecnis® lMultifocal lenses will no longer need glasses, but some patients may still need glasses on occasion for certain tasks.
Toric IOLs for Astigmatism
Toric IOLs designed to correct astigmatism also are considered “premium” lenses, and like multifocal and accommodating IOLs they too will cost you extra because of benefits that are unavailable in conventional IOLs.
The aspheric version of Alcon’s AcrySof IQ Toric IOL is an astigmatism-correcting “premium” intraocular lens. TheStaar Surgical Intraocular Lens was the first toric IOL available in the United States. The Staar Toric IOL comes in a full range of distance vision pThe FDA also approved the AcrySof IQ Toric IOL (Alcon) in September 2005. Different models of this toric IOL can correct 1.50 to 3.00 D of astigmatism. This lens also is available in aspheric versions for crisper vision. Different models also can filter potentially damaging UV or blue light. Most surgeons who treat astigmatism in their cataract patients tend to use astigmatic keratotomy (AK) or limbal relaxing Acrysof Toric IOL incisions, which involve making incisions in the cornea to decrease corneal astigmatism. This can now be corrected with a toric IOL. Technology that has been etched into the IOL allows neutralization of astigmatism. by aligning the IOL with astigmatism. Risks include poor vision due to the lens rotating out of position, with the possibility of further surgery to reposition or replace the IOL.
Cataract Extraction With Lens (IOL) Implantation
When cataracts are present, cataract surgery with IOL implantation is usually the best option for correcting your vision. There are several options available to help reduce or eliminate your need for glasses or contact lenses after your cataract surgery. The type and power of these replacement IOLs can be manipulated to provide solutions for near and distance vision problems. The solutions include:
Cataract surgery with Single Vision intraocular lenses:
This is the standard option utilized for cataract surgery and is usually covered by Medicare or medical insurance. A standard, single vision intraocular lens implant provides one focal point (distance OR near). Vision may be set to the desired outcome based on your lifestyle and visual demands, so you may consider:
– Full distance vision correction for both eyes
- – Good distance vision
- – Still need glasses for intermediate (computer) and near vision
- – Good for people who do not mind wearing eyeglasses
- – Dominanat eye fixed for good distance vision
- – Non-dominant eye fixed for near vision
- – With both eyes open the brain uses both eyes simultaneously to be clear both at near and at distance
- – Glasses might still be needed for detailed and fine near work
– Cataract surgery with multifocal intraocular lenses:
- – New technology premium multifocal lens implants enables a wide range of vision – including distance, intermediate, and near.There are different premium lens options available for implantation.
If you would like to find out more about this exciting, once in a lifetime opportunity of turning back the clock on your vision, please contact us to see how we can restore your near vision to what it used to be when you were younger. Call us at 281-420-(EYES)3937 or Schedule Online