Dr Lee Mun Toong
Presbyopia is the medical word used to describe the increasing difficulty with near vision as people age, like most of us will be struggling to read this without glasses if over the age of 42. Therefore Presbyopia is the irreversible loss of the accommodative ability of the eye that occurs due to aging. Accommodation refers to the ability of the eye to increase its refractive power of the crystalline lens in order to focus near objects on the retina.
The classical theory of accommodation proposed by Helmholtz over 150 years ago states that the lens under resting tension is held relatively flat when viewing objects at a distance. During accommodation, the ciliary muscle contracts and moves both anteriorly and inwardly. This decreases tension on zonular fibers and, in turn, causes increased curvature in the elastic lens resulting in increased focusing power. According to Helmholtz, age-related hardening of lens tissue results in decreased elasticity and thus, decreased distortion of the lens during accommodation.
Many patients hate wearing reading glasses or bifocals, or hate that they keep having to switch between glasses for different tasks. They often don’t like the fact that reading glasses make them look older than they feel! We are more active, youthful, and affluent than generations before, and have a strong desire to remain as active as possible. Unfortunately, we live in an increasingly near sighted world, where smart phones, computers and Kindles make near visual tasks increasingly common.
Technological advances in eye surgery now offer a number of effective options for people who want to be less dependent on reading glasses. There are 3 effective options for people seeking less dependence on reading glasses
1. Laser vision correction with mono-vision (Laser blended vision)
2. ICL Implant with Presbyopia lens
3. Refractive lens exchange surgery with multifocal intraocular lenses
