Presbyopia and Treatment Options

Presbyopia is the name given to when men and women start to lose their ability to focus their eyes as they age. Seeing objects farther away remains easy, but close-up vision becomes blurry. The condition typically affects people in their 40s and older, and it is currently estimated that half of the American population has presbyopia (i.e. they are presbyopes). Although no one understands the exact mechanism that causes presbyopia, there are a number of possible treatments available for people.

Reading Glasses

Reading glasses, bifocals, and trifocals are the oldest, traditional method for treating presbyopia. They allow men and women to continue all the activities they did before they were affected by presbyopia, such as driving and reading. In recent years, special multifocal contact lenses have been used as well. However, many people find reading glasses to be a nuisance. Not only do they make a person look old, but they can get lost or not be handy when you need them. The prevalence of this condition and people's resistance to bifocals have led to the development of more corrective treatments.

Refractive Lens Exchange

Refractive lens exchange is now one of the most common treatment options. Lens exchange has long been used for the treatment of cataracts, but in the past only monofocal lenses were available, meaning that every person who underwent cataract surgery was permanently presbyopic. Now, though, the development of multifocal intraocular lenses (IOLs), means that lens exchange can actually be used as a treatment for presbyopia. There are several different options available, all giving a different range of vision, but giving consistent vision that does not degrade, generally obviating the need for reading glasses.

Monovision

Monovision is a relatively new option, approved by the FDA only recently (2007). Monovision is the use of LASIK to get around the eyes' inability to focus at different distances by refractively correcting one eye for focusing up close while the other eye is corrected for distance vision. After a period of adjustment, monovision treatment seems to work quite well.

CK

Conductive keratoplasty, or CK, uses radio waves to affect the collagen that makes up the lens. There are no incisions, no surgery, and no lasers, but the curvature of the cornea increases as the collagen tightens (similar to what happens during the Thermage skin-tightening treatment), which can lead to increased close up visual clarity.

Although all these presbyopia correction options are sufficient, which one is best for you in your life can only be determined through conversation with an ophthalmologist. The doctor will discuss lifestyle factors that may make one or the other treatment option better for you.