Presbyopia (The need for reading glasses around 42 – 45 yrs of age)
As the natural lens inside the eye ages, so it becomes less flexible. This results in difficulty focussing up near (e.g. reading) in the early to mid-forties. People with normal distance vision now need reading glasses for near work. Those who wear contact lenses now need reading glasses over the contact lenses and those that have always worn glasses now need bifocals or progressive or multifocal / varifocal glasses. So presbyopia is something that affects everyone.
Surgical procedures for presbyopia
There are a number of treatment options that we can offer to overcome the effects of presbyopia:
1a) Monovision with laser vision correction (LASIK or LASEK)
This has been used at the clinic for the past 10 years or more with great success. More than 6000 patients have enjoyed the benefits of monovision here at the Wellington Eye Clinic. It is a concept based on a principle used by contact lens practitioners for more than 40 years already. The one eye (usually the dominant one) is corrected for distance vision while the non-dominant eye is corrected for near vision. With this combination you find that you are now able to see far and near without the use of glasses and 80% of presbyopes find that monovision provides a good solution for them. If one finds that the monovision is not satisfactory, then the reading eye can be re-treated in order to make it good for distance vision.
1b) Advanced monovision is a new concept and the only clinic in Ireland that can offer this is the Wellington Clinic. The principle is similar to Monovision described above except for a single difference that results in a better quality distance vision in the reading eye. With normal monovision, the reading eye cannot see well in the distance and this difference between the two eyes can be a reason why monovision does not work for everyone. With advanced monovision, the reading eye is corrected for near but with the use of a laser profile called "Custom-Q" the asphericity of the cornea can be changed in such a way that even though the eye has been modified for reading vision, it still retains good distance vision. This results in less "difference between the 2 eyes" and less of a compromise in terms of visual quality.
2. Conductive Keratoplasty (Read more...) is a technique of advanced monovision that is performed without the use of a laser. Radio frequency is used to modify the shape of the cornea in order to improve reading. This procedure is typically used for the person with perfectly normal eyesight who has suddenly found that their reading vision is becoming less good. This would normally be around the mid-forties. The non-dominant eye is treated with CK by applying 8 or 16 spots of radio-frequency energy to the peripheral cornea under topical anaesthesia. The procedure is incredibly safe and effective and the improved reading visionis usually noticed as soon as the following day. Like with advanced monovision described above, the distance vision (in the reading eye) remains good even though reading has been improved. With both eyes open the patient finds that they now can read while the distance vision is still good.
3a) Intra-ocular lens surgery with monovision lens implants
Here the natural lens is removed and replaced with artificial lens implants. In the one eye the vision is corrected for distance vision and the other eye is corrected for near. This has been used for more than 10 years at the clinic with great success.
3b) Intra-ocular surgery with multifocal lens implants
Here the natural lens is replaced with multifocal lens implants. That means that each lens / eye has both distance and near vision. This sounds ideal and better than monovision but the reality is that the multifocal lenses only work well for perfect candidates. If you have astigmatism or any intra-ocular pathology the results are less good.
As you can see from the choices above, there is a solution for presbyopia now that is likely to suit you. Your consultant can guide you in this choice once your examination has been completed and your visual requirements established.
Before presbyopia surgery is performed, a contact lens trial simulating the expected outcome of surgery can be done to show the patient first hand what the effect of surgery will be. This way a truly informed decision can be made to assess suitability for a particular procedure. Contact lens trials cannot be performed on patients that are contact lens intolerant or those who have refractive errors that contact lenses cannot adequately correct.
Presbyopia (The need for reading glasses around 42 – 45 yrs of age)
The car park for the clinic is shared with the Beacon Hotel and Beacon Hospital Car Parks
