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Between Church and Wellington on Queen St.

Between Church and Wellington on Queen St.

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Presbyopia Diagnosis and Treatment

As we reach middle age, particularly after age 40, it is common to start to experience difficulty with reading and performing other tasks that require near vision. This is because with age, the lens of our eye becomes increasingly inflexible, making it harder to focus on close objects. This condition is called presbyopia and eventually it happens to everyone who reaches old age to some extent.

To avoid eyestrain, people with untreated presbyopia tend to hold books, magazines, newspapers, and menus at arm's length in order to focus properly. Trying to performing tasks at close range can sometimes cause headaches, eye strain or fatigue in individuals who have developed this condition.

Causes of Presbyopia

During our youth, the lens of our eye and the muscles that control it are flexible and soft, allowing us to focus on close objects and shift focus from close to distant objects without difficulty.  As the eye ages however, both the lens and the muscle fibers begin to harden, making near vision a greater challenge.

Presbyopia is a natural result of the aging process and not much can be done to prevent it.  Its onset has nothing to do with whether you already have another vision impairment such as nearsightedness, farsightedness or astigmatism.  Everyone will notice some degree of loss of near vision focusing power as they age, although for some it will be more significant than others.

Symptoms and Signs of Presbyopia

Presbyopia is characterized by:

  • Difficulty focusing on small print
  • Blurred near vision
  • Experiencing eyestrain, fatigue or headaches when doing close work or reading
  • Needing to hold reading material or small objects at a distance to focus properly
  • Requiring brighter lighting when focusing on near objects

Presbyopia can be diagnosed in a comprehensive eye exam.

Treatment for Presbyopia

There are a number of options available for treating presbyopia including corrective eyewear, contact lenses or surgery.

Eyeglasses

Reading glasses or “readers” are basically magnifying glasses that are worn when reading or doing close work that allow you focus on close objects.

Eyeglasses with bifocal or multifocal lenses such as progressive addition lenses or PALs are a common solution for those with presbyopia that also have refractive error (nearsightedness, farsightedness or astigmatism). Bifocals have lenses with two lens prescriptions; one area (usually the upper portion) for distance vision and the second area for near vision. Progressive addition lenses or PALs similarly provide lens power for both near and distance vision but rather than being divided into two hemispheres, they are made with a gradual transition of lens powers for viewing at different distances.  Many individuals prefer PALs because unlike bifocals, they do not have a visible division line on the lens.

Bifocal and Multifocal Contact Lenses

For individuals that prefer contact lenses to glasses, bifocal and multifocal lenses are also available in contact lenses in both soft and Rigid Gas Permeable (RGP) varieties.

Multifocal contact lenses give you added freedom over glasses and they allow you to be able to view any direction - up, down and to the sides - with similar vision. People wearing progressive lenses in glasses on the other hand have to look over their glasses if they want to view upwards or into the distance.

Another option for those that prefer contact lenses is monovision. Monovision splits your distance and near vision between your eyes, using your dominant eye for distance vision and your non-dominant  eye for near vision. Typically you will use single vision lenses in each eye however sometimes the dominant eye will use a single vision lens while a multifocal lens will be used in the other eye for intermediate and near vision. This is called modified monovision.  Your St. Marys eye doctor will perform a test to determine which type of lens is best suited for each eye and optimal vision.

Surgery

There are surgical procedures also available for treatment of presbyhopia including monovision LASIK eye surgery, conductive keratoplasty (CK), corneal inlays or onlays or a refractive lens exchange (RLE) which replaces the hardened lens in the eye with an intraocular lens (IOL) similar to cataract surgery.

Since it affects so much of the older population, much researc and development is going into   creating more and better options for presbyopes.  Speak to your eye doctor about the options that will work best for you.

LASIK & Refractive Surgery Co-Management

eye with laserThe doctors at St. Marys Optometry have extensive experience in the pre-operative evaluation and post-operative care of LASIK and other vision correction procedures.

We will evaluate your eyes and discuss your visual goals to help determine if you are an appropriate candidate for LASIK, PRK or Cataract Refractive Technology. If you have appropriate goals and there are no contraindications for the procedure, we will recommend a pre-operative evaluation to determine suitability for refractive surgery. This evaluation includes:

  • Counseling on refractive surgery options
  • Eye dominancy testing
  • Review of eye history and refractive stability
  • Medical evaluation of the cornea and eye
  • Current refraction status

If after the pre-operative evaluation, the decision is made to proceed with surgery, your information will be forwarded to the surgeon, a pre-surgery consult with a surgeon will be scheduled. Post-operative management will be provided by our St. Marys eye doctors, and includes multiple visits over a period from the date of surgery to include medical evaluation and management of the vision and corneal healing. Evaluation of any additional needs such as reading glasses, sunglasses, treatments or enhancement laser procedures is also included.

LASIK is currently the most popular vision-correcting or "refractive" surgery available. But there are other options as well. We will help you find the ideal solution for your problem and partner with the best surgeon to perform your procedure.

Introduction to LASIK

LASIK is the most commonly performed refractive surgery procedure. You may hear people calling it "LASIX," but the correct name is LASIK, which is short for "laser-assisted in situ keratomileusis."

Why is it so popular? LASIK has advantages over other vision correction procedures, including a relative lack of pain afterward and the fact that good vision usually is achieved by the very next day.

An instrument called a microkeratome is used in LASIK eye surgery to create a thin, circular flap in the cornea. Another, newer way of making the flap is with a laser.

The surgeon folds the hinged flap back out of the way, then removes some corneal tissue underneath using an excimer laser. The excimer laser uses a cool ultraviolet light beam to precisely remove ("ablate") very tiny bits of tissue from the cornea to reshape it.

When the cornea is reshaped in the right way, it works better to focus light into the eye and onto the retina, providing clearer vision than before. The flap is then laid back in place, covering the area where the corneal tissue was removed.

Both nearsighted and farsighted people can benefit from the LASIK procedure. With nearsighted people, the goal is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. Excimer lasers also can correct astigmatism by smoothing an irregular cornea into a more normal shape.

Learn more about Vision Surgery including LASIK, PRK, Corneal Transplants and more.

Our Eye Care Clinic

Welcome to our online Practice! Our team of eye doctors and eye care staff are here to care for all of your vision needs. We handle everything from adult and children’s eye exams and hard-to-fit contact lenses, to eye emergencies, treatment of eye diseases and co-management of eye surgery such as LASIK.

Great Vision, Advice, Technology and Fit

By staying current with the latest developments in eye care, prescription lenses and advances in contact lens technology, our vision centre can provide you with the best vision, advice and fit today—and in the years to come. We take pride in building lasting relationships with our patients, which is why we take the time to get to know you, your vision requirements and your lifestyle needs. Contact our eye care clinic today to find out how we can help.

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