| gospa68@aol.com 2005-05-18, 11:45 am |
| Take a look at new options for presbyopia
Surgical choices are limited, but monovision contacts may help
KAREN SHIDELER
Knight Ridder
WICHITA, Kan. - -- Sooner or later, you'll find yourself holding the
phone book at arm's length when you look up a number.
Stock listings in the newspaper will be blurry.
You'll wonder when the restaurant started using smaller type on its
menu.
And then you'll acknowledge an inevitability: Like death and taxes,
presbyopia is something you can't escape.
For most people, presbyopia -- "old eyes" -- starts showing up in the
early to mid 40s, says Wichita ophthalmologist Mark Wellemeyer.
Tiny muscles in the eye, called the ciliary muscles, move the lens to
change its focus. But The lens in the eye becomes increasingly rigid
with aging, and the muscles in the eye can't move it as well.
Eventually, they give up. The result: an inability to focus on nearby
objects.
No, you can't go to the eye gym to keep those little muscles in shape,
despite infomercials' claims.
Genetics play a big role in when presbyopia begins, he says. By the
time most people are in their mid- to late 50s, their presbyopia is as
bad as it's going to get.
If you're nearsighted, taking your glasses off for close-up work may
get you by for a time. But sooner or later, your arm won't stretch
enough to get objects out where you can focus.
What are your choices when that day comes? You have several:
Reading glasses: For people who have otherwise normal vision, these
"Wal-Mart glasses," as Wellemeyer calls them, work just fine.
Readers are available in a range of strengths, from 1.0 to 3.25 or so.
You can buy them on your own or your eye doctor can prescribe them.
They are inexpensive, which means you can keep a pair in every room.
Bifocals: People who wear glasses to correct vision usually move to
these prescription lenses. Two options are available: traditional
bifocals, in which a visible horizontal line separates the part of the
lens for close-up vision from the part for distance vision, and
progressive bifocals, in which the parts gradually blend into each
other.
Trifocals, which include a middle distance area for computer work, for
example, also are available in traditional and no-line versions.
Contacts: There is a bifocal contact lens, Wellemeyer says, but only
about 50 percent of those who try it can wear it successfully. More
common is the "monovision" approach, in which the dominant eye wears a
lens to correct distance vision and the other eye wears a lens for
close-up vision.
Vision-correcting surgery: "There really are not a lot of surgical
options for treating presbyopia," Wellemeyer says, though it can be
done with the same procedures, such as LASIK surgery, used to correct
other vision problems.
But because presbyopia can worsen and because a monovision approach has
to be used, surgery isn't a common approach.
Lens replacement surgery: Traditional cataract surgery, in which an
artificial lens replaces the natural one, doesn't correct close-up
vision.
The crystalens replacement, which became available a year ago, has tiny
hinges that allow the lens to move, as a natural lens does. And the
tiny ciliary muscles seem to start doing their job again, gently moving
the crystalens.
But after implantation, the patient must do eye exercises to strengthen
the muscles, a process that can take a year. "You have to be pretty
motivated," Wellemeyer says. "And you have to do the exercises."
|