Separate and combined solutions to presbyopia
People with presbyopia from their middle ages may experience vision difficulty in certain distances. A single pair of eyeglasses may be no longer enough to provide satisfying vision correction. Separate solutions to presbyopic people include multifocal eyeglasses or contact lenses, presbyopia surgery, and intraocular lenses implantation. However, a combination of certain of these solutions is also feasible.
Presbyopic patients who have also developed myopia can still manage close reading properly without eyeglasses. Mild myopia between -1.50 and -2.00 requires a reading distance of 14 to 16 inches. And higher nearsightedness above -5.00 needs a much closer distance.
Although many presbyopic people choose multifocal lenses for convenience, multiple pairs of single vision eyeglasses also have their own advantages and are favored by certain people. In most cases, these people keep a pair of single vision glasses for distance vision such as driving and watching TV and another pair of eyeglasses for intermediate vision during computer work or near vision such as reading.
Single vision glasses either for distance vision or near vision are more professional in dealing with specific tasks. For example, watching TC requires concentrating distance vision. Single vision eyeglasses for distance vision are more competent, because they eliminate the interference of the near vision part from multifocal lenses. Similarly, single vision lenses with a nearsighted prescription are more helpful during close-up activities such as car repairs.
Single vision eyeglasses provide more peripheral vision than multifocal eyeglasses, which is quite important for people in their 60s and 70s. Multifocal lenses may even increase peripheral vision loss. In addition, single vision lenses provide a wider area of clear vision than multifocal lenses.
Single vision computer eyeglasses can be customized to meet your personal needs of certain working distance. Sustained computer tasks require more precise intermediate vision, which is beyond bifocal or multifocal lenses.
A combination of contact lenses for distance vision and reading glasses for close vision is suitable for people can not adjust to multifocal contact lenses. Taking use of contact lenses, there are also other combinations.
Monovision or modified monovision combines contact lenses with different vision effects. Standard monovision uses two single vision contact lenses for your eyes, one lens for distance vision and the other for close vision. Modified versions of monovision apply a near-emphasized or distance-emphasized multifocal lens to one eye or both eyes. However, monovision is not suitable for some people.
Among the various choices of contact lenses for presbyopia, none of them is “one size fit all”. The best solution is to wear different types of contact lenses under different scenarios and situations. For example, full distance contact lenses on both eyes perform well during golf rounds and monovision or modified monovision lenses favor evening dinners at restaurants.
In addition to separate presbyopic solutions, combinations of surgical and non-surgical solutions are more effective for severe presbyopia. The most widely accepted combination is LASIK and reading glasses but it is inconvenient. Another combination is LASIK with a single contact lens for close vision. One of LASIK-corrected eyes performs distance vision and the other eye wears a single vision lens for near vision, creating monovision.
Wavefront lenses can manage high-order aberrations, which are beyond LASIK and regular contact lenses. A combination of LASIK and wavefront lenses reduces night glare and halos around headlights and street lights, sharpening night-driving vision. This combination eliminates the need for a second LASIK.
Monovision LASIK combined with single vision eyeglasses for near vision enhancement is another solution that favors near vision. The single vision lenses can also be customized for computer work. You can take measurements of your exact computer vision distance to your doctor for a precise prescription.
If you have received a LASIK at an earlier age, a second PRK or CK on one eye that creates monovision may be more effective in improving near vision. A refractive surgery after cataract surgery can also be conducted to enhance both near and distance vision and reduce astigmatism remains. Intraocular refractive lenses implanted into your eyes during a cataract surgery can restore your vision at all distances.
It is important to keep proper expectations since no presbyopic solution is perfect. Dynamic focusing flexibility of your eyes won’t come back completely.
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