When we pass our 40th birthday, for most of us our eyes gives us the gift of needing reading glasses. The condition is called presbyopia and it almost universal after people turn 40.
At Papale Eye Center in Springfield, MA, we’re excited about the new multifocal lens and extended range of focus lens options available for cataract lens replacement. Not only do they present crystal clear vision to replace the former cataract-clouded view, but some of these lenses now also correct for presbyopia. That means you’ll also be able to ditch the readers that are usually required for up-close vision.
What is presbyopia?
You don’t think about them like you do your skin or your joints, but your eyes age, too. Presbyopia is a natural consequence of this. Presbyopia is a condition where the eye loses its ability to change its focus so that you can see objects that are near. In most people, it starts to occur at the age of 40.
When you’re young, the lens in your eye is soft and flexible, and it can change shape easily. This is how you focus on objects both up close and far away. After most people turn 40 the lens becomes less flexible, more rigid. It can’t change shape as easily as it did in your younger days, so it becomes much more difficult to see things up close, such as when you’re reading. But you’re in good company — presbyopia affects almost everyone.
What are the symptoms of presbyopia?
After we turn 40 presbyopia develops gradually. These are the symptoms you’ll start noticing:
- A tendency to hold reading material at arm’s length to make the letters come into better focus
- Blurred vision at normal reading distance
- Eyestrain or headaches after you read or do close-up work for a while
What multifocal intraocular lenses now correct for presbyopia?
Since cataracts affect about half of people over the age of 50, with those numbers increasing with age, many people now choose to replace their cataract with an intraocular lens (IOL) that also corrects for presbyopia. There are three main types of IOLs that also correct for presbyopia:
- Extended depth of focus IOLs (Symfony) — These are the newest technology. By combining a unique diffractive pattern with achromatic technology, these lenses deliver outstanding vision quality over a continuous range of distances, while maintaining high image contrast.
- Multifocal IOLs — Multifocal IOLs have focal zones, or rings, that allow you to see clearly at both near and far distances. While these IOLs may not completely remove your need for glasses at all times (such as extended periods of reading), they will dramatically reduce the need. Some studies have shown that multifocal IOLs provide better near vision than accommodating IOLs, but they are also more likely to cause glare or mildly blurred distance vision as a tradeoff.
- Accommodating IOLs — Like multifocal IOLs, accommodating IOLs expand the range of focus to both near and far, but they do this is a different fashion. Accommodating IOLs have what are called “haptics” on the ends. These supporting legs hold the IOL in place inside the eye. These haptics are flexible and they allow the accommodating IOL to move forward slightly when you look at near objects, which increases the focusing power of the eye enough to provide good near vision.
What results can I expect after having any of these IOLs placed during my cataract surgery?
The vast majority of our Papale Eye Center patients have reported high levels of satisfaction with these IOLs that also correct for presbyopia. Formerly, IOLs for cataract replacement usually were monofocal, meaning they delivered one focal range of distance. Most people selected distance vision, and they would correct for up-close vision with readers.
With these IOLs, most patients say they rarely, if ever, need any eyeglasses any longer. So, not only are their cataracts gone, but so are, for the most part, their reading glasses. People love the freedom this offers.
What are the risks of having these IOLs implanted?
These are the most common complications when these IOLs are implanted:
- Indistinct or “foggy” vision (far away, up close, or both)
- Reduced contrast around objects, making them appear less clearly defined
- Glare and halos around streetlights and vehicle headlights and taillights in low-light conditions
In many cases, the patient notices these problems less and less over time. For some patients, a follow-up refractive procedure, such as LASIK, can decrease these issues.
Are there other treatments?
Treatment for presbyopia needs to compensate for the inability of your eyes to focus on nearby objects. If you’ve had good uncorrected vision before developing presbyopia, readers, those over-the-counter reading glasses you can buy most anywhere, will usually allow you to read just fine. If you’ve had to correct your vision, there are other treatment options.
Here are various treatments for presbyopia:
- Readers — These “dime store” glasses range in power from +1.00 diopter to +3.00 diopter. When buying a pair of readers (or numerous pairs to have in various parts of the house) try different pairs until you find the magnification that allows you to read comfortably. Start with the lowest magnification and move up from there.
- Office progressives — These eyeglasses have corrections for computer-distance, such as for work, and for up-close vision. When the wearer is out and about, he or she doesn’t wear these.
- Bifocals — These eyeglasses have lenses with a visible horizontal line that separates your distance prescription, above the line, and your reading prescription, below the line.
- Trifocals — These eyeglasses have three zones: one for up-close work; one for middle vision, such as looking at a computer screen; and one for distance vision.
- Progressive multifocals — These implanted lenses have no visible lines, but they have multiple powers for distance, middle distance, and close-up correction. These are the newest form of available intraocular lenses used for cataract replacement.
- Contact lenses — These are also available to offer similar focal distances as mentioned above. For people with overall good vision who simply have presbyopia, contact lenses just for up-close work aren’t really realistic.