Home > 45-55

Distance Prescriptions Easily Corrected

Over 45, Reading Clarity Becomes the New Challenge

Correcting fixed-focus imperfections of the eye is now straight-forward, whether caused by nearsightedness, farsightedness or astigmatism.  LASIK does a terrific job with these optical imperfections.

If you're over 45 and have perfect distance vision, or wear correction for distance (glasses or contacts), you have probably noticed that reading clarity is not what it used to be.  If you are now having difficulty seeing your cell phone, computer monitor, restaurant menu or newspaper, you’re not alone; everyone will eventually experience presbyopia,  the loss of close-focusing adjustability that leads to reading glasses.

Presbyopia is caused by a slow, progressive change within the natural lens of the eye.  The human lens is made of protein; it's transparent and very flexible when we're young.  The natural lens is surrounded by a circular muscle and when this muscle contracts, the lens changes its shape, enabling focus adjustment in much the same way as the lens in an auto-focus camera.  Through life, though, layers of protein are laid down on the outside surface of the lens like the rings on a tree trunk.  As we mature into our mid-40s, these extra layers cause the lens to become bigger, stiffer, more dense and less flexible.   The muscle pull on an increasingly stiff lens is not enough to effect shape change and focus adjustment, hence the need for reading glasses or bifocals.  Since it is a condition of the lens and a natural part of the aging process, it affects everyone, usually at about 45 years of age.  Normal glasses and contact wearers, people with perfect vision, and even people who received laser vision correction will all develop presbyopia at some point in their lifetime.

 Presbyopia:  How the lens of the young eye adjusts for close focusing

Since Ben Franklin invented bifocals, their existence has been both a blessing and a curse for the people that wear them.  For most people this problem introduces itself to us in our mid-40's, when we find that "our arms are not long enough" to see clearly when we read. At first, it is easily solved by using brighter light, or holding things further away. Then it becomes necessary to use readers, which are small magnifying lenses.  At age 44 or so, one might only need magnifiers of power +1.25, but every few years the strength of the lens power needs to increase, to keep up with the progressive decline in close focus capability of the eyes. Finally, at about age 56 or so, we are wearing +2.50 cheaters, and this is where our eyes remain for the foreseeable future.

You can read easily if looking down through the "reading" portion of bifocals, but not if looking straight ahead at a computer monitor. And when you are walking down a flight of stairs or lining up a putt, your feet and the ground are blurry because you are looking through the reading portion of the lenses. The optical industry offers many choices: you can have "flat-top" bifocals with a line in the lenses, or you can have progressive, blended, or Varilux lenses, for a premium price; all because they afford a range of focus and hide the unsightly line in the lens.

But there is hope.  Recent advances in surgical and artificial lens technology have made it possible to significantly reduce or eliminate bifocals, progressive lenses and reading glasses. 

If you’re age 45 to 55 and want to see clearly without glasses, here are the options:

This corrects both eyes for optimized distance viewing, affording the best night vision and binocular (stereo) vision with depth perception.  Above age 45 or so, use of inexpensive magnifiers (reading glasses) will be necessary at close ranges, typically within about 26" or so. 

Most patients who receive traditional LASIK will be glasses-free until their mid forties, when presbyopia sets in.  But LASIK can help correct both distance and reading vision.  Called Monovision, this adjusts one eye to see things close up, while the other eye sees things at a distance.   Many people adapt to this so that with both eyes open, clear vision is appreciated at near and far.

Clear Lens Replacement is essentially the same exact procedure as cataract surgery, but it can be performed before a cataract is detected.  This is done to remove the presbyopic natural lens and replace it with an artificial lens (called an Intra-Ocular Lens or "IOL") that has a different prescription (thus eliminating nearsightedness, farsightedness, astigmatism) and enhanced range of clear vision. 

With CLR, the natural lens of the eye can be replaced with a multifocal or accommodating lens.  These 'Lifestyle' lenses are designed to provide the patient with a full range of vision, acting like a permanent contact lens in the eye, and therefore reducing the need for glasses.  Another advantage:  Once your natural lens is removed, there is no future risk of cataract.  There are several very good options available now, and we expect to see significant evolution in lens implant technology, laser methods, and treatment options for presbyopia.

Have you reached a point where you want to just ditch the glasses and see clearly?  Then take the first step and call or email to arrange a comprehensive consultation.