What Is Presbyopia?

It is a constant struggle with near vision for most middle-aged and older adults, due to presbyopia and it can be awkward for those with myopia . The ageing lens loses its ability to focus light on the retina when looking up closely, thus resulting in blurred vision. It is a natural part of aging and affects everyone during middle age. Presbyopia can be treated through various methods depending on individual’s requirement.

Some of the signs of presbyopia are:

  • Difficulty focusing on nearby objects
  • Having to hold books and newspapers further to read.
  • Tired eyes
  • Headache

Treatment Options for Presbyopia

Over-the-counter reading glasses

For most people, reading glasses are the best and easiest way to deal with presbyopia. These items are commonly sold at convenience stores, gas stations, and pharmacies. Typically, these have magnifications between +1.00 and +3.00. They are useful for overcoming the early stages of presbyopia and are often used only when close work is required.

Pros

  • Affordable and easy to purchase in stores
  • Easy to replace if lost or broken

Cons

  • Most people with astigmatism or who need a specific magnification or different refraction for each eye will not get good results from using standard, store-bought reading glasses.
  • The vision may not be corrected accurately

Contact lenses

People with presbyopia can opt for contact lenses with choices between multifocal and monovision designs. Akin to bifocal/multifocal glasses, multifocal contact lenses allow for sharp vision at both near and far distances. The contact lenses are available in both soft and rigid gas permeable lens materials & patients together with optometrists can discuss on the best suitability.

Pros

  • Contact lenses are a good option if you are someone who doesn't enjoy wearing glasses, does certain sports or prefers it for cosmetic reasons

Cons

  • It's not always convenient to have a supply of contact lenses and solutions on hand, especially when you are on the go
  • Many people need some time to become used to putting in and removing their contact lenses, especially for first time wearers

Monovision LASIK

Monovision LASIK is a type of laser eye surgery in which the cornea of the dominant eye is reshaped to improve myopia/short-sightedness, and the cornea of the non-dominant eye is reshaped to help with near vision. The brain and the eyes will then coordinate and adjust to this correction to see clearly at different distances.

Pros

  • Don't need corrective lenses.
  • The cornea, found on the outer surface of the eye, is surgically altered with a laser in LASIK. Compared to other, more intrusive procedures, this one is quick, painless, and has a shorter recovery time.

Cons

  • As with any change, some people handle monovision well while others struggle.
  • Some professions or athletic activities, where depth perception is crucial, may disqualify a patient from receiving treatment with monovision.

 

Refractive Lens Exchange

Since presbyopia originates in the eye's natural lens, a refractive lens exchange (RLE) involves replacing the natural lens through surgical implantation of an artificial intraocular lens (IOL) without the actual presence of cataract. When implanted with a multifocal IOL , it will enable focusing at multiple distances with clear vision and no glasses will be required after the surgery.

Pros

  • The majority of people (90%) can achieve a 20/20 vision.
  • Generally a safe
  • Reduce the risk of getting cataract

Cons

  • It's an invasive procedure.
  • It's usually more expensive than LASIK

Lenticule Implantation

Corneal lenticules are a relatively new treatment option for presbyopia. In today’s ophthalmology field, the use of biological lenticules is found to be a possible method to address the problems related to the tissue reaction resulting from the insertion of synthetic inlays when treating presbyopia.

Small incision lenticule extraction (SMILE) is a laser refractive lenticule extraction procedure, which is an alternative to LASIK for the correction of myopia and myopic astigmatism. In the SMILE procedure, the lenticule is cut by a femtosecond laser, and is extracted through a small incision. Instead of the previously discussed RLE method, this thin, extracted stromal lenticule may be used for other purposes such as treating presbyopia.

Pros

  • Biologically-safe
  • No scarring of cornea
  • Reversible
  • No rejection
  • Reduce risk of corneal inflammation and hazing

Cons

  • Require the SMILE procedure to be done first before the lenticule can be collected
  • An invasive procedure

The purpose of treatment is to help you adapt to the fact that your eyes can't see up close. Glasses, contact lens, refractive surgery, and even LASIK are all viable choices for correcting vision. Following a thorough eye examination, your doctor and optometrist can recommend a tailor-made treatment best suited according to your lifestyle and needs.