Freedom from Bifocals
Click here to download a chapter "Freedom From Bifocals" from Dr. Epstein's book Seeing After 45.
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By middle age the ability to change focus from far to near diminishes greatly. At first, people get tired eyes while reading and must hold the paper out further. Later in life, people need reading glasses. Those who wear glasses to see far may be able to take off glasses to read, but gradually, to see both far and near without taking off glasses a bifocal glass is needed.
Dr. Epstein has been performing procedures for freedom from bifocals and readers since 1997. There are several procedures done at the center to reverse symptoms of presbyopia. For people who have cataracts and for certain others, there are lens implants that give vision for both far away and more up close. Also, there are procedures that actually make the muscles that flex the natural lens work better.
Technology Brings Freedom from Bifocals
By Robert L. Epstein, MD
With middle age comes eye trouble. Often for the first time a person who has never before had to wear glasses finds the need to wear glasses to read and perhaps for full time wear. This condition is called presbyopia (from the Greek “presby” =old and “opia” =eyes). Now, the baby boomer generation can take some comfort in that surgical technology has provided a way out of reading glasses and bifocals.
What are the ways to allow people to see far and near with just one’s own eyes? One way is to take advantage of the monovision effect. One eye sees slightly better at distance, the other sees better up close. Lasik laser vision correction can be used to cause the eyes to work this way. Less often, conductive keratoplasty using radio waves pulses can produce the desired effect. Monovision works best when the person is in the early to mid-forties. If both eyes already see in the distance perfectly, then probably only one eye needs treatment so as to produce close-up vision.
People over about 50 years old often have too much trouble seeing up close for the monovision approach to be highly effective for the patient so see for close reading, intermediate distance and long distance. Multifocal lasik produces a more comprehensive visual treatment for presbyopia than monovision. Multifocal Lasik R produces vision not only for reading and for far distance but also for middle distances such at from 3 feet to 6 feet by producing more than one optical curve on the eye. With multifocal lasik people can be out of glasses even past age 65 or as long as the eyes are healthy without medical problems like cataract. To further improve depth of focus with Multifocal Lasik , it is combined with a small amount of monovision. Like regular lasik, multifocal lasik has the safety of taking place merely on the exterior of the eye.
The ultimate form of correction of presbyopia is at the source of the problem. The source of the problem is the inner lens of the eye. That lens is supposed to change shape under the action of the focusing muscles. But with age, the lens enlarges and the muscles have no room to pull the lens.
One new form of presbyopia correction is the CrystalensR lens implant. Basically, the lens of the eye is removed and replaced with the Crystalens. The Crystalens procedure is as safe as cataract surgery, the commonest operating room surgical procedure done in the United States today. Afterward, when the brain wills the eyes to focus up close, the muscles of focusing cause the Crystalens to move slightly forward. With focus at distance the lens moves backward. The sharpest and most binocular vision can be achieved this way.
More recently, a lens implant called the ReSTOR has been shown to be even more effective than the Crystalens in allowing vision with the need for glasses either for distance vision or for close up vision. Each lens implant type has its particular characteristic, and if you have cataracts, then our decision about which lens is best can be best determined after you have been examined.