Alamo Optometry Blog

November 1, 2008

Presbyopia

Filed under: Educational — Tags: — admin @ 11:18 pm

(As appeared in Alamo Today Nov 2008 edition, pg.28)

Presbyopia, or the short-arm syndrome, eventually affects everyone. Your lens, which is in the inside of the eye, continues to grow throughout life. As it becomes thicker and denser, it becomes less flexible, and this is what causes a decrease in your near focusing ability. Overall, your focusing ability is best when you are born, and decreases from that point on. Usually the symptoms of presbyopia include pushing reading material farther away, the need for good lighting, eyestrain, and fatigue, begins in your low-to-mid 40’s. As you age, your ability to focus decreases. As your accommodation decreases, which will happen regardless if you wear glasses full-time, part-time, or never, you will need more power to make up the difference. This process will cease in your upper 50’s to around 60 years of age. After that point, you might need some fine-tuning in your glasses or contacts, but the constant change will stop. Even though this is a completely normal process, there are several methods to help.

Progressive Lenses: These lenses have the advantage of 1 pair of glasses giving you clear vision at distance, intermediate, and close. Another advantage is that they have no lines; cosmetically they look like single-vision lenses. There will be adaptation necessary for this type of lens because you have a smaller area to use for near compared to a single vision lens. In addition, for heavy computer users, computer progressives are available. These lenses do not correct for distance vision, but allows a wider field of view compared to regular progressive out to about 7 feet. With the proper frame size and motivation, well over 90% of patients do very well with all types of progressives.

Bifocal Lenses: This lens will allow you to see well at distance and near. However, intermediate vision eventually will become compromised. These lenses don’t require the adaptation that progressives do, but the “line” will be evident.

Single Vision Glasses for Near Work: Some people choose to have separate glasses for distance (if needed) and near. The nice thing is that there is no adaptation required; you can use any part of the lenses to see. However, the compromise is that you will need to remove or slide them down your nose to see clearly outside of a few feet.

Contacts: Some people are still under the impression that once presbyopia hits, you can no longer wear contacts. These days, that could not be farther from the truth. Assuming you can comfortably wear contacts, there are basically 3 options:

Multifocal contacts allow you to see distance and near with each eye. All of the power is centered in the middle of the lens, and you just pay attention to the object in focus. These require very little adaptation and care of the lenses is no different than any other type.

Monovision allows you to see distance out of one eye and reading out of the other. Your need for reading glasses is minimal; they usually are only required for small print like reading medicine bottles. This modality does require some getting used to, since you are artificially changing the power of one eye to read. Greater than 75% of patients get comfortable with monovision after the initial week or so. If you are happy with the comfort of your current contacts, this allows you to remain in them and just change the power in one eye.

Distance contact with reading glasses is also the choice for many people. This allows clear distance vision out of both eyes, and clear reading through the glasses. Even though you still need glasses for near work, the contacts still give you the flexibility for sports, recreation, and other activities where detail near work is not needed.

As you can see, all is not lost when your accommodation (focusing ability) decreases. It is a completely normal process; but the advantage we have now is that we have several tools to help solve the problem. Depending on your personality, activities, and prescription, we will determine what will work best for you and help guide and assist you in the process.

Dr. K. at Alamo Optometry is your hometown eye doctor for outstanding service, vision care, and designer eyewear. He can be reached at 925-820-6622 or visit his office at 3201 Danville Blvd., Suite 165 in Alamo.

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