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Home » What's New » Trouble Seeing the Fine Print? Here are Your Options…

Trouble Seeing the Fine Print? Here are Your Options…

Every good pair of eyes eventually gets old and with age comes a condition called presbyopia. Presbyopia, which usually begins to set in some time around 40, occurs when the lens of the eye begins to stiffen, making near vision (such as reading books, menus, and computer screens) blurry. You may have this age-related farsightedness if you notice yourself holding the newspaper further and further away in order to make out the words, and you may begin to experience headaches or eyestrain as well. 

The good news is, presbyopia is very common. It happens to most of us eventually and these days there are a number of good options to correct it. First of all, let’s take a look at what causes the condition.

What Causes Presbyopia?

As the eye ages, the natural lens begins to lose its elasticity as the focusing muscles (the ciliary muscles) surrounding the lens have difficulty changing the shape of the lens. The lens is responsible for focusing light that comes into the eye onto the retina for clear vision. The hardened or less flexible lens causes the light which used to focus on the retina to shift its focal point behind the retina when looking at close objects. This causes blurred vision. 

Presbyopia is a progressive condition that gets worse with time. It is a refractive error just like myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. 

Signs of presbyopia include:

  • Blurred near vision
  • Difficulty focusing on small print or close objects
  • Eyestrain, headaches or fatigue, especially when reading or doing close work
  • Holding reading material at a distance to see properly
  • Needing brighter light to see close objects

Presbyopia can be diagnosed through an eye exam. 

Treatments for Presbyopia

There are a number of options for presbyopia treatment which include glasses, contact lenses or surgery. 

Glasses

The most common form of correction is eyeglasses. Reading glasses adjust the focal point of the target to reduce the focusing demand on the eyes. A side effect of the convex lenses is that they also magnify the target. For some, reading glasses are sufficient to improve close vision. Others, especially those with another refractive error, require more complex lenses. 

Bifocal or multifocal lenses, including progressive addition lenses (PALs), offer a solution for those with nearsightedness or farsightedness. These lenses have two or more prescriptions within the same lens, usually in different areas, to allow correction for distance vision and near vision within the same lens. While bifocals and standard multifocals typically divide the lenses into two hemispheres (or more), requiring the patient to look in the proper hemisphere depending on where they are focusing, with an unattractive contour calling attention to the presbyopia portion of the lens, progressive lenses provide a progressive transition of lens power creating a smooth, gradual change. Some people prefer progressive lenses for aesthetic reasons as they don’t have a visible line dividing the hemispheres.

Contact Lenses

Like glasses, contact lenses are also available in bifocal and multifocal lenses. Alternatively, some eye doctors will prescribe monovision contact lens wear, which divides the vision between your eyes. Typically it fits your dominant eye with a single vision lens for distance vision and your weaker eye with a single vision lens for near vision. Sometimes your eye doctor will prescribe modified monovision which uses a multifocal lens in the weaker eye to cover intermediate and near vision. Newer contact lens technology is making both lenses multifocal, and therefore doctors are becoming less dependent on monovision. Sometimes monovision takes a while to adjust to.

Based on your prescription, your eye doctor will help you decide which option is best for you and assist you through the adjustment period to determine whether this is a feasible option. Since there are so many baby boomers with presbyopia nowadays, the contact lens choices have expanded a lot within recent years.

Surgery

There are a few surgical treatments available for presbyopia. These include monovision LASIK surgery (which is a refractive surgery that works similar to monovision glasses or contact lenses), corneal inlays or onlays (implants placed on the cornea), refractive lens exchange (similar to cataract surgery, this replaces the old, rigid lens with a manufactured intraocular lens), and conductive keratoplasty (which uses radio waves to reshape the cornea in a noninvasive procedure). 

Medication - On the Horizon

There are currently clinical trials with promising early results that are testing eye drops that restore the flexibility of the human lens. It could be possible that in the near future eye drop prescriptions could be used to reduce the amount of time that people have to use reading glasses or contact lenses. 

These procedures vary in cost, recovery and outcome. If you are interested in surgery, schedule a consultation with a knowledgeable doctor to learn all of the details of the different options. 

As people are living longer, presbyopia is affecting a greater percentage of the population and more research is being done into treatments for the condition. So if your arm is getting tired from holding books so far away, see your eye doctor to discuss the best option for you. 

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Dear Northwood Vision patient,

Here is what we are asking you to do to make a smaller exposure footprint:

  1. If you have any symptoms of loss of taste or smell, upset stomach/diarrhea coughing, fever, difficulty breathing, running nose please reschedule your appointment in 30 days or more.
  2. Wash your hands or use sanitizer immediately upon entering.
  3. Try not to touch any surfaces in the office you do not have to touch (you can push our door open with your foot! Try not to touch your face!)
  4. If you are trying on glasses, we will collect them from you for proper cleaning.
  5. Contact lenses can be shipped to you at no cost with an active rx (minimum 2 boxes)
  6. We will ask that if possible you come alone to the appointment. Guests can wait outside or in the car unless they need to be with you..
  7. If you have been exposed please wear a mask or reschedule in case you are an asymptomatic carrier, masks are encouraged to be worn by each patient if you have one.
  8. We will extend Contact lens prescriptions up to 6 months if recently expired and can direct ship an order to you if you see clearly and your eyes are feeling healthy.
  9. For a fee, we can ship your glasses to you if desired and you can have them adjusted after the shelter in place order is lifted.

Thank you for your patience and understanding during this stressful and trying time. May God bless each of you and keep you well.

Dr. Christopher K. Keats, OD

What is an Eye Emergency? Read more

Routine Care: “I see pretty well in my glasses or contact lenses. I just want to update my frame and / or get some new lenses to optimize my vision. I don’t have any pain or headaches and my eyes feel good and look normal in the mirror to me. I have never been told I have a disease in my eye that needs to be managed. I should definitely wait to come in until the “Shelter at Home” mandate is over. If I am a contact lens wearer, I understand Dr. Keats will allow me to get 3-6 months of contact lenses mailed to me even if my contact lenses are recently expired or close to expiring.”

Emergent Care: “I see poorly and am having difficulty functioning to drive, read, or see my computer. It is affecting my work. Waiting to be seen in 2 months would be very difficult for me to conduct my life.” Another form of emergent care… “I have other symptoms like headaches, red eyes, discharge, or I might have a disease that threatens my sight like diabetes, macular degeneration, glaucoma, a recent onset of flashes and floaters in my vision and so on.” A final type of emergent care would be a patient who realizes, “I am a patient who has a previously scheduled appointment for a medical condition Dr. Keats is managing to protect my sight, so I should plan on coming in for my visit. However, if my overall health is poor and the benefit to risk ratio says I should push this appointment off until the “Shelter at Home” mandate is lifted, it may be wise for me to reschedule for a later date.” In summary, emergent care means it is important that you be seen quickly for the protection of your visual health and current discomfort, or medical health, so you can function to do your work efficiently now and in the future.