All About Presbyopia

Presbyopia is a condition that occurs in our 40s and onwards.  Presbyopia is a common and inevitable progression of aging.  With age, the lens inside the eye becomes more rigid and less accommodating in shape resulting in the reduced ability to focus on nearby objects.  As a result, we move objects further out at arm’s length to sharpen focus.  Think of when you struggle to read the fine print of an article on your smartphone and expand the font size or move your hand further out to enhance the clarity.  Can you relate to struggling to read menu items in a dim-lit restaurant?  If you are in your 40’s, presbyopia could be the culprit.   In addition to squinting, and eye strain, some may experience headaches.  Seeing an optometrist or ophthalmologist for an eye exam is encouraged to rule out any other issues and offer presbyopic solutions.

Correcting Presbyopia 

A common recommendation for presbyopia may be non-prescription readers or cheaters purchased from various stores at a nominal cost.  You will simply try various glasses and read print until you get the desired vision to help you see clearly.  You may also get prescription progressive glasses after seeing an optometrist or ophthalmologist, a customized prescription will help you get the desired glass frames you want indoors versus outdoors.  Contact lenses may also be prescribed by an eye specialist.  These are nonsurgical options. 

Presbyopia Treatment Via Surgery

Surgical interventions may also remedy presbyopia.  LASIK and PRK are surgical options for presbyopes using blended vision or monovision when the dominant eye is set to distance vision and the non-dominant eye is set to near vision.

Refractive Lens Exchange (RLE) also known as Clear Lens Extraction (CLE) is the removal of the natural eye lens and replacing it with a synthetic intraocular lens (IOL) before cataracts form.  Having an RLE prevents cataracts from forming as you age into your 50s and older thereby eliminating the need for cataract removal surgery down the road.  The recommended synthetic IOL varies according to the patient’s lifestyle and vision requirements.  Patients with astigmatism would benefit from toric lenses.  Patients wanting to see near, intermediate and distance vision without the use of glasses would benefit from multifocal lenses.  Light Adjustable Lenses (LAL) have been an exciting revolutionary technology that allows the modification and fine-tuning of lenses after surgery is completed.  The IOL is made of a special photosensitive material that changes the shape and power of the inserted lens in response to exposure to a special UV light in the office, called a Light Delivery Device (LDD).  The beauty of LAL is that it minimizes human error in calculating lens powers and allows patients to achieve their desired vision according to their lifestyle with light treatments lasting a  couple of minutes with a total of 3 to 5 treatments for optimization of vision.

Based on the patient’s age and refractive error, the EVO ICL is another exciting surgical option for treating presbyopia.  It is recommended for myopic patients up to age 45 and with prescriptions ranging from -3.00 to -16.00, treating up to 4 diopters of astigmatism. This lens is versatile in that it sits behind the iris and does not remove the natural eye lens.  Furthermore, it is reversible and the lens can be removed when cataract surgery is needed.  These are exciting advancements in ophthalmology to help presbyopic patients enjoy visual freedom that suits their active lifestyles.

These refractive surgical interventions are not covered by insurance and are considered elective procedures.  At San Antonio Eye Specialists, LASIK and PRK all-laser procedures are performed in our state-of-the-art laser suite.  RLE, LAL, and EVO ICL are also performed in our AAAASF-certified surgical suite onsite.

Choose San Antonio Eye Specialists for 

Consult with Dr. Iskander, our board-certified ophthalmologist, and fellowship-trained refractive surgeon spanning over 20 years of surgical skill and expertise about your presbyopic options.  For your eyes…don’t compromise! 

Learn more about our treatment options on the San Antonio Eye Specialists website