Tuesday, January 4, 2022

How can I say Goodbye to my Reading Glasses Forever?

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In today's article, I will review the treatment for presbyopia AKA the need for reading glasses that starts for many people in their early 40s. I will go over the cause of presbyopia and the latest FDA-approved eye drop as well as surgical treatment options that are currently available in the United States.

What is Presbyopia?

Presbyopia is the decrease in close-up reading vision that occurs in our eyes as we age. As you age you may start to notice that reading the small or fine print becomes more and more difficult over time and you may find yourself holding your reading material further and further away.

Eventually, you may need over-the-counter reading glasses, prescription bifocal glasses, or multifocal contact lenses in order to be able to read the small print. If you are affected by presbyopia, you are not alone. Presbyopia affects 128 million Americans and the number continues to grow.


So What Causes Presbyopia?

The lens in our eye is flexible and is designed to change shape when muscles in our eye called the ciliary body contract. It is this ability of the lens to change shape that enables us to see objects clearly at different distances by changing the focus.

When the lens shape is more curved, the eye becomes more nearsighted. Thus enabling us to clearly see objects that are close to us. The reverse happens when we look at objects further away. As we age, our lenses gradually lose their flexibility and no longer change shape when our eye muscles contract causing presbyopia. 

Although, there is no available treatment to restore the elasticity of our natural lens. There are several effective presbyopia treatments to get around this limitation. I have no financial interest in any of the treatments that I mention in this article. all of the treatment options I review for you in this post are based on my own clinical experience and study.

Eye Drop for Presbyopia

Vuity eye drop is a new FDA-approved and prescription eye drop that is used to treat presbyopia. Vuity contains a 1.25% pilocarpine active ingredient that improves near vision temporarily or short-term period.

It starts to show his result to improve vision after 15 minutes after putting in the eyes and the result lasts for 6 to 9 hours.

Long-Term Surgical Treatment for Presbyopia

One option for long-term presbyopia is LASIK surgery. A lot of us are familiar with LASIK as a treatment for nearsightedness. But did you know that LASIK can also be used to treat presbyopia? for my LASIK patients with presbyopia, I plan two different customized treatments, one for each eye.

This means that each eye sees a little differently, with one eye slightly more nearsighted than the other while the other eye sees distant objects more clearly. This technique allows the patient to see both distant and near objects clearly when both eyes are open.

Having Slightly differently corrected vision in each eye is called monovision. You may hear of or even wear contact lenses for monovision yourself. Having LASIK surgery to create monovision is like having the prescription correction from contact lenses permanently on your eyes.

I perform femtosecond laser wavefront-guided all-laser LASIK surgery using two different lasers. During the surgery the first laser, the femtosecond laser will create a very thin flap on the cornea then the flap is lifted, and the second laser, the excimer laser reshapes the cornea to the targeted prescription to create monovision.

A possible limitation of monovision is a slightly decreased depth perception because one eye is more nearsighted than the other. The exact amount of difference between the two eyes for monovision needs to be carefully chosen by you and your eye surgeon, and this is not for monovision needs to be carefully chosen by you and your eye surgeon, and this is not always as simple as it sounds.

It is important to balance depth perception, distance vision, and near vision to obtain the best visual outcome that is possible for your eyes. In my practice, I have very patient who is considering monovision LASIK surgery for presbyopia wear contact lenses for a time to stimulate the visual outcome of monovision and we only proceed with the surgery if they like the simulated vision.

Permanent Surgical Treatment for Presbyopia

Presbyopia available by your eye surgeon is called Refractive lens exchange. it is essentially the same surgery like cataract surgery for cataract removal.

Replacing the crystalline lens not only treats cataracts but can also treat presbyopia by removing the old stiff lens and replacing it with an advanced multifocal or extended depth of focus intraocular lens implant for IOL.

These special implantable lenses bend the light rays entering your eyes at different focal points, enabling us to have clear distance vision for objects that are far away, clear intermediate vision such as using a laptop, and clear near vision for reading cellphones or books.

I perform femtosecond laser-assisted refractive lens exchange surgery for my presbyopic patients. To learn about the differences between laser-assisted cataract surgery and conventional manual cataract surgery. Click here

Both monovision LASIK surgery and refractive lens exchange surgery are surgical options. Any surgical procedure has many potential risks. So be sure to have an individualized eye exam and consultation with your eye surgeon to find which treatment option is best for you.

There are other treatments available internationally such as different types of cornea inlays, and laser cornea surgery. I hope through this article you have learned anything new so don't forget to share this post with others. 

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