Presbyopia

What is Presbyopia

Presbyopia is the inability of the eye

to focus well at a range of distances.

Ophthalmologists often refer to this

process as 'loss of accommodation'.

It is caused by the ageing process

and most people over the age of 45

will notice a degree of presbyopia.

The degree to which it effects individuals

varies.

What are the symptoms of Presbyopia

Most people read at a distance of approximately 33cm, shortsighted

people may read closer than this and longsighted people, further away.

Age causes the lens within the eye to stiffen which prevents it from changing shape reducing it's ability to see objects close up.

Initially you may notice that you need to hold reading material further away. If you have always worn spectacles for shortsightedness you may notice that you can read without spectacles, but still need them for a range of other activities. If you are longsighted you may notice changes earlier, and may find that your arms simply aren't long enough to be able to hold reading material at the distance required to focus at all.

What treatments are available for Presbyopia

Spectacle or contact lens correction are by far the most common treatment methods. in later life, many people find that single prescription corrections ( i.e. near or far) are no longer appropriate and need bi-focals or two pairs of specs.

Surgical treatments have become more common over the last five years, as outcomes have become more predicatable, technology has improved and the internet has led to increased patient awareness. Surgical treatments, namely PreLex, and C.L.E ( Clear lens exchange) are available at i4Vision™.

PreLex (or Refractive Lens exchange)

PreLex stands for Presbyopic Lens Exchange. Unlike other refractive disorders

( such as short sightedness), presbyopia is due to the lens within the eye's inability to focus. Other disorders are related to the shape of the eye and cornea in particular, which is why LASIK or LASEK ( laser treatments) are NOT SUITABLE for those with presbyopia.

PreLex involves removing the lens which can no longer focus properly and replacing it with a lens that can. The mechanism for focusing naturally is different to that used with an implant, but the outcome is similar. You will be offered an implant that is capable of accomodating ( called an accomodative implant). The benefits and risks would be discussed with you during your consultation.

The objective is to reduce the need for spectacles. You should be able to see to read and to play golf and drive for instance without wearing spectacles. There maybe situations where you feel more comfortable wearing spectacles and this is fine too.

Apart from offering good working vision, without having to rely on multiple pairs of spectacles, the procedure also means that cataracts can NEVER develop. This is because the natural lens, which can become cloudy in later life, has been removed.

The procedure is very similar to a normal CATARACT operation, with the exception of additional measurements ( which are painless) to ensure that the most appropriate lens is used.

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Clear Lens Exchange

Again, the procedure is very similar to a cataract or PreLex procedure. The differences being that the primary reason for removing the lens is either due to;

presbyopia where occasional use of specs is acceptable and the possible side effects of other lenses are not,

or a very high refractive error that cannot comfortably be corrected with spectacles.

The lens used would offer good vision at a single distance ( usually distance) and spectacles would be needed for reading. This type of lens is called a MONOFOCAL lens and is widely used in everyday cataract surgery.

There are less side effects with monofocal lenses ( particularly at night).

An in depth consultation is required during which time, the benefits and potential risks of all treatment options will be fully explained.

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