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I heard an interesting presentation last week about a new way to describe the changes that occur in our eyes as we age. Shareef Mahdavi is a well known marketing consultant in ophthalmology. He recently discussed something I have believed in for a long time: how the aging eye is related to a dysfunction in its natural lens and new methods in its treatment.
As one ages, our natural lens loses its ability to flex or focus.When we approach our mid 40’s, our arms “become too short”, this manifests itself with our sudden need for reading glasses or bifocals. The term for this condition is presbyopia.
As we continue to age, our natural lens begins to lose its clarity and become opaque. This causes a blurring of vision which ultimately cannot be corrected with glasses. This is called a Cataract.
We can consider lens dysfunction as a continuum, first it loses its ability to change shape, than it loses its clarity. In the past, treatment for presbyopia consisted of reading glasses, bifocals, monovision contact lenses (1 eye near and 1 eye far), or bifocal contact lenses. Surgically a procedure called Conductive Keratoplasty (CK) can provide a temporary fix similar to monovision. Cataracts were treated surgically when vision deteriorated to the point where it interfered with one’s lifestyle. Following cataract surgery glasses were still required for reading, and distance if there was astigmatism.
By changing the way we view lens dysfunction, we change the way we can surgically correct the problem. At OCLI we address lens dysfunction as follows:
- Presbyopia can now be treated by Refractive Lens Exchange (RLE), replacing the lens that has lost its ability to focus with an artificial multifocal lens. If astigmatism is present, this can also be treated with LASIK following the RLE.
- Cataracts can also be removed and a multifocal implant can replace the cataract. Again, astigmatism can be addressed with LASIK following the cataract surgery.
In conclusion, by changing our view of the aging eye and lens dysfunction, it is now possible to surgically minimize one’s need for reading glasses and bifocals. Results are excellent. Patients are able to wake up, see the alarm clock, watch TV, drive, and read without glasses!
