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Presbyopia Tips
Tips for Performing Presbyopia Exercises
There are some who believe presbyopia exercises can help to delay or correct presbyopia if performed correctly. The theory behind this type of treatment option is that performing these exercises will help to delay or reverse the stiffening of the eye’s natural lens which causes difficulty focusing on objects which are nearby. The basic movements involved in these types of exercises involving crossing and uncrossing the eyes while focusing on targets. Some patients have difficulty with these exercises at first, but also report improved vision of objects which are near after performing the exercises regularly.
Patients who are interested in this type of treatment option for presbyopia should consult with their eye doctor for more information on these exercises and their effectiveness. Using this information the patient can make an informed decision about whether or not to pursue this type of treatment program.
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Understanding Crystalens
The-Lasik-Directory.com Tip: Crystalens involves removing the eyes natural lens and replacing it with a surgical implant to improve the patient’s vision. This implant is usually placed during cataract surgery to provide the patients with improved vision at near, middle and far distances. These implants work with the eye’s muscles to provide the ability to focus on near objects, as well as far objects.
The crystalens procedure is a relatively simple one which is typically completed in less than 20 minutes. At the start of the procedure, drops are placed in the eyes to numb them and then an ultrasonic probe is used to remove the eye’s natural lens. The lens is then replaced with the crystalens implant. There is no need for stitches in this procedure because the opening created in the eye is small enough to heal naturally. At the conclusion of the procedure more drops are placed in the eye to help to prevent infection.
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What is Presbyopia?
Presbyopia is sometimes jokingly called “short arm syndrome.” It's a problem common among people in their 40s and older, who have trouble focusing on near objects, and may complain that their arms are too short to hold a book at the right distance from their eyes! If you have to lean forward to reach your mouse, or need extra light to read a restaurant menu, you might already have it.
As we get older, our eyes become less flexible, and all of us are vulnerable to presbyopia, which occurs when the less-flexible lens can't adjust to focus on objects close at hand. If you're farsighted, you're likely to experience presbyopia's effects sooner than someone who is nearsighted. It also occurs earlier in women and in people whose jobs demand a lot of close vision.
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Presbyopia Explained
The-Lasik-Directory.com Tip: Presbyopia is a condition in which the lens of the eye becomes stiff and is no longer able to change shape to focus on near objects. With normal vision, the lens of the eye is able to change shape as necessary to enable the eye to focus on objects at different lengths. However, at approximately age 40, most people begin to experience stiffening of this lens and find they have difficulty seeing near objects.
Presbyopia usually occurs gradually and patients may not realize the source of the problem because they get accustomed to near vision which is less and less clear. However, symptoms such as the inability to focus on near objects, fatigue, eye strain and headaches after work requiring close vision and the inability to read clearly at night are all symptoms of presbyopia. Patients experiencing these symptoms should undergo an eye exam to determine if they require treatment for presbyopia.
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Types of Presbyopia Surgery
Doctors will sometimes use ordinary LASIK to create a "monovision" effect by correcting one eye (usually the dominant one) for distances and the other for reading. It is recommended that patients try this first with contact lenses before having the surgery. Some people take readily to the new way of seeing, but others find it difficult to tolerate.
In 2004 the FDA approved a new type of presbyopia surgery called conductive keratoplasty (CK). CK is a less invasive procedure that takes just three minutes to perform. Instead of cutting into the eye, the surgeon uses radio waves to shrink collagen in specific parts of the eye, making it more suitable for near vision. This is another monovision technique -- the second eye is left alone and corrected with a contact lens if need be for distances.
Several other treatments are in experimental phases and have not yet been approved.
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Laser Vision Correction and Presbyopia
The-Lasik-Directory.com Tip: Laser vision correction surgery is not currently approved for treatment of presbyopia in the U.S. Laser vision surgeries focus on reshaping the cornea to eliminate abnormalities which cause vision problems. However, difficulty viewing nearby objects is a result of the eye’s lens stiffening and inability to change shape as required to focus on near objects. This means the problem of presbyopia relates to the human lens as opposed to the cornea and is therefore not likely to be corrected through the use of laser vision correction surgery.
Although the use of laser vision correction surgery to treat presbyopia is not currently approved in the U.S., there are other countries which are experimenting with the use of lasers as a treatment option. Canada and Mexico are among the countries doing this type of experimentation and if they see success, there may be laser treatment options for presbyopia in the future.
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Monovision for Presbyopia
Monovision is an approach to presbyopia treatment that involves correcting one eye for distances and the other for close work. This can be done with glasses or contact lenses, or surgically with LASIK or CK.
Some people find they have trouble adjusting to monovision, which affects their depth perception. Those considering presybopia surgery are advised to try monovision with contact lenses first to see whether they can tolerate it. For those who cannot, the best option is probably keeping two pairs of glasses, one for reading and one for distances.
Monovision surgery is also not as accurate as corrective lenses, meaning the corrections between the two eyes may not be perfectly aligned.
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Signs of Presbyopia
Presbyopia is not a disease and cannot be prevented. It usually becomes noticeable after age 40, and tends to manifest at first as difficulty seeing close objects. Many people first notice it when they have trouble reading menus in dimly lit restaurants, or when it seems their arms aren't long enough to hold a book or magazine far enough away.
Many people also notice that they begin suffering from headaches when doing close work, or that their eyes get tired more quickly than they used to.
If these symptoms sound familiar, it may be time to see your optometrist to begin presbyopia treatment.
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Presbyopia Treatments
Presbyopia treatments start out very simply. Many people begin by buying a pair of “reading glasses” at a supermarket or drugstore. Others get bifocal or multifocal glasses or contact lenses to correct their vision for different distances, or keep different pairs of glasses for distance and close vision.
Sometimes, doctors “correct” presbyopia with a technique called “monovision” – engineering one eye for reading and close work, and the other for driving and other distance-related tasks.
Presbyopia surgery is increasingly becoming an option. Only one form of surgery, conductive keratoplasty, is currently approved by the FDA for treating presbyopia. CK is a type of monovision treatment, in which one eye is reshaped with radio waves for distance vision. It is a very brief and non-invasive procedure, but is not appropriate for everyone with presbyopia.
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What to Expect after Presbyopia Surgery
People who have presbyopia surgery will go through an adjustment period -- the length of time varies depending on the kind of surgery -- before reaching their final vision improvement.
Presbyopia surgery also may not eliminate the need for glasses or contact lenses. For one thing, their eyes will continue to lose focus, so that the correction that was right at age 42 will not be right five or 10 years later. This sometimes manifests as a loss of clarity in middle distances. The solution for this is a multifocal or bifocal contact lens in one eye, while correcting for distance vision in the other.
Side effects with monovision sometimes include "ghost images" visible at night and trouble with depth perception. Monovision treatments are not recommended for those who fly airplanes, do a lot of night driving or are required to maintain top athletic performance.
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Can Surgery Stop Presbyopia?
If you are middle-aged or older and have developed presbyopia, is eye surgery an option for you?
There is a surgery available that may benefit those with presbyopia. A treatment called conductive keratoplasty (CK) which uses radio waves to create a more bendable cornea, thus improving near vision.
This procedure was FDA approved in 2004 for the temporary reduction of presbyopia. However, it should be known that this procedure is not a life-long fix from presbyopia, it is only temporary. Your doctor should be able to supply you with more information and if this eye surgery is right for you.
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Is Crystalens Right for Me?
Crystalens is a treatment for cataracts, which often occur with presbyopia. While crystalens is not specifically approved to treat presbyopia alone, the Crystalens is designed to address the chief problem of presbyopic people -- the inability to change the focus of the eye at different distances.
Crystalens is different from other intraocular implants because, its makers say, it revives the eye's ability to focus at short, middle, and long distances.
If you are on Medicare, you should know that a 2005 ruling allows cataract patients to receive the Crystalens, but makes them pay the difference in cost between the Crystalens and more traditional treatment.
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Presbyopia: Lenses vs. Laser Surgery
Should you have intraocular lenses implanted or laser surgery to correct your presbyopia? Let's look at the facts.
-If you suffer from thin corneas or myopia and you are not a candidate for laser eye surgery, then lens implants may be your only other option.
-Intraocular lenses do not have the results that laser surgery would. This means that the results are even less permanent than laser surgery.
-However, if something goes wrong with an implanted lens as a person's eye ages, the lens can be removed and another put in. Laser eye surgery does not have this easy of a "fix-it" option.
-These types of implanted lenses for presbyopia are still very new. It is hard to know everything about the materials and the side effects of the procedures when there is still so much research to be completed.
-Implanted lenses can also cost more than laser eye surgery and like laser eye surgery, it typically isn't covered under insurance.
-Is one better than the other? That is up to you and your ophthalmologist to decide.
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A Closer Look at CK for Presbyopia
CK, conductive keratoplasty, is another option for the treatment of presbyopia. CK works for presbyopia patients in this manner:
A mild heat from a radio wave is used to shrink the collagen in the cornea's peripheral area. This causes the cornea to become steep, which improves near vision for the person with presbyopia.
In the past, studies have shown that CK allowed for eventual regression of the vision, which means that the outcome was not stable. However, there are new findings that are showing with new technology and better surgical procedures, the results are becoming more stable.
Because the outcome of CK is monovision, your surgeon may ask you to wear monovision contact lenses before the surgery. One eye would be corrected for near vision and the other for distance vision. This is to make sure that your eye for distance vision remains sharp and is able to counter balance for the other eye.
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Dealing with Presbyopia
There is no reason for presbyopia to cause patients to live with a great deal of discomfort or difficulty focusing on near objects. The treatment for this condition is as simple as wearing reading glasses or contact lenses with a prescription to correct the patient’s near vision. However, many patients delay having an eye examination because they feel as though there is nothing that can be done and presbyopia is merely a part of the aging process.
Presbyopia does begin to affect many people over the age of 40 and is a natural part of the aging process but this does not mean the patient should delay treatment. Eye strain, discomfort and headaches are just a few of the complications a patient can avoid by devising a treatment plan. Additionally, without treatment, patients may have to give up activities they previously enjoyed such as reading, sewing, painting or doing anything which requires the ability to see near objects. However, patients who undergo treatment can continue to participate in the activities they enjoy without difficulty.
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Insurance and Crystalens Cost
Crystalens cost will vary significantly based on the condition of the patient’s eyes and the extent of the damage. Additionally, the skill level and experience of the surgeon you select as well as the area in which you live and have the surgery performed can have an impact on the cost, as well. However, patients who require this procedure may have insurance coverage which makes the surgery more affordable.
Whether or not the cost of crystalens surgery is covered will vary depending on your insurance provider and the type of coverage you have. However, most patients will likely find their insurance covers the cataract portion of the surgery, as well as the anesthesia. Some policies may also cover part of or all of the crystalens implantation, as well. Determining the crystalens cost and the insurance allowances before undergoing the procedure will help the patient to determine whether or not they can afford this treatment option.
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Good Candidates for Crystalens Surgery
Patients who are considering crystalens surgery should consult their eye doctor to determine if they are a good candidate for the procedure. Most patients who are reasonably healthy will be good candidates for the procedure, but crystalens surgery is not right for everyone. Those who are not considered to be good candidates for crystalens surgery include patients who have uncontrolled diabetes or chronic infections.
Some patients who have had previous eye problems or surgeries may also not be good candidates for crystalens surgery. This includes patients who have previously had cataract surgery. However, patients who have had corneal refractive surgery may still be good candidates for the procedure as long as their eyes are currently in good health.
