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If you are one of the lucky people born with 20/20 eyes, you probably take your excellent vision for granted. You can engage in any type of sport or outdoor activity and never have to worry about losing glasses or contact lenses. You can immediately read print of almost any size and probably never think about your vision from one year to the next. Typically, when we reach the age of about 40, near vision starts to look a little blurry. This is the onset of presbyopia, an age-related and progressive loss of near vision. At first, you can just stretch your arm a little to hold the print further away. At some point, you may find yourself looking at the generic reading glasses sold in drug stores everywhere, and trying one or two on for size. For someone who has enjoyed 40 or more years of 20/20 vision, it can be an unpleasant shock to need reading glasses. On the other hand, perhaps you have always been a bit nearsighted and needed glasses for distance vision, or perhaps you have been severely nearsighted and needed glasses for all distances. In that case, you may not immediately notice presbyopia creeping up. You may need a change in presciption for reading but you are accustomed to wearing glasses. Or perhaps you have been farsighted and needed eyewear for near vision, in which case you also just need a new prescription. Then again, perhaps you were nearsighted or farsighted but had it corrected with LASIK. LASIK creates near-miraculous vision improvement for nearsightedness, farsightedness, and astigmatism, but it cannot prevent presbyopia. What is Presbyopia? Presbyopia is an age-related problem with the eye's lens and its causes are not fully understood. It is not caused by anything you did or did not do and it cannot be prevented by excellent nutrition or good eye health or eye exercises. The lens is a curved, transparent structure suspended behind the iris and its degree of curvature is controlled by two muscles that encircle it. In a young eye, the lens becomes flatter for far vision and steeper for near vision. This happens automatically and we have no conscious control over it. The presbyopia causation theory currently accepted says that with age, the lens becomes gradually stiffer and cannot change its curvature so easily. It stays relatively flat, retaining clear distance vision; but as near vision becomes more blurry over the mid-life years, the problem starts to extend to intermediate vision and you may then need computer glasses as well as reading glasses. Presbyopia Treatments Presbyopia is progressive, meaning that it cannot be cured but only managed. If you live to an advanced age it will eventually affect even your distance vision, but by that time, you will probably have cataracts anyway, which are also age-related and progressive and create blurry vision. There is a procedure that can correct both presbyopia and cataracts. When it is done to correct presbyopia, it is called PRELEX for Presbyopia Lens Exchange. When it is done to correct cataracts, it is simply called Cataract Surgery. In either case, it replaces the eye's natural lens with an artificial lens, an IOL (intraocular lens). You can have PRELEX done before any cataracts dim your vision and this will prevent you from ever getting cataracts, since the IOL cannot develop them. Presbyopia can also be corrected with LASIK Monovision, where one eye is corrected for near vision and the other is left as it is for distance vision. It can also be treated with CK (Conductive Keratoplasty), a procedure that uses radio waves to make the cornea more steep, giving clear near vision. However, bear in mind that presbyopia is progressive so repeat treatments will be needed as the years pass. Only PRELEX will need no repeat treatment. If you would like to learn more about presbyopia and how it might be best treated in your case, please contact Dr. Rajesh Khanna in Los Angeles, California, who has vast experience with treating presbyopia and other vision problems.
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