I have trouble reading but otherwise see pretty well far away.
Presbyopia
refers
to the natural decrease in the eyes’ ability to see up close as
we get older. Even a patient with perfect vision (Emmetropia) all their
life will require glasses to help them read, usually at some point in
the early to mid forties.
Presbyopia starts to become noticeable usually at around age 40 and
it effects everyone. Nearsighted people (with Myopia) can usually remove
their glasses, hold the print up close, and read without glasses or
have bifocals put in their distance glasses. Slightly farsighted people
(with Hyperopia) will initially just need glasses to read but as they
get older, they will need them for near and far. Moderately or severely
farsighted people will already be wearing glasses for distance but will
now need either bifocals or two separate pairs of glasses. Normal sighted
people (called Emmetropia) who have never needed glasses will now need
them in order to read small print. Presbyopia gets worse as we get older
and thus patients require changes in reading power every few years.
If you are near age 40 or older, your laser eye surgeon should discuss
Presbyopia with you and explain your options to minimize this annoying
decrease in your near (reading) vision.
Surgical
Procedures to reduce the symptoms of Presbyopia
•
Conductive Keratoplasty (CK)*
• LASIK (monovision)*
• PRK
• LASEK
• EpiLasik
*Conductive
Keratoplasty or CK and monovision LASIK are the only two procedures
approved by the FDA for treating Presbyopia, although this does not
mean PRK cannot be utilized. Although not FDA approved, PRK is considered
an “off label” use of the FDA-approved lasers. In fact,
many refractive surgeons used PRK and LASIK (which has now approved
by the FDA) in both nearsighted and farsighted eyes to create monovision,
with one eye focused for distance and the other focused for near vision.
Although
neither Conductive Keratoplasty (CK) nor laser vision monovision (LASIK
or PRK) “cure” Presbyopia, both procedures can reduce the
need for reading glasses for every day activities like reading a menu
or looking at a cell phone. With “monovision” (or “blended
vision”) one eye is focused better for reading while the other
eye is focused primarily for distance. This is a common option for patients
over the age of 40 who are considering laser vision surgery to correct
their nearsightedness or farsightedness, with or without astigmatism.
Monovision is also an option for patients who have always had natural
excellent distance vision (Emmetropia) and desire to be able to read
without glasses. The only FDA-approved procedure for the correction
of Presbyopia in emmetropic eyes (normal eyes requiring no glasses)
is Conductive Keratoplasty (CK) where radio-frequency energy is applied
to 8 spots in the cornea to refocus one eye for a reading focus. The
CK procedure results in a milder form of monovision than the typical
laser procedure and it is often better tolerated by the patient because
the CK eye is not usually as blurred for distance as it would be with
laser induced monovision. However, not all patients are comfortable
with mono or blended vision and it is best to have this demonstrated
with either contact lenses or glasses before choosing this option