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Presbyopia: What You Need to Know

What is presbyopia?
Presbyopia is an extremely common condition that affects the eyes with age. Even if it hasn’t affected you yet, you have surely seen people who hold their newspaper or menu out at arms length in order to read it. This is a classic symptom of presbyopia, the inability to focus up close that develops with age. Presbyopia is impossible to avoid, but it is easy to treat when it does occur.

Presbyopia definition
By definition, presbyopia is an age-related vision disorder that affects the ability to focus on close up objects, due to the aging and hardening of the eye’s lens. The lens thickens with age and loses the ability to focus in the same ways that it was able to when it was younger. The muscle fibers surrounding the lens also lose flexibility, and this is thought to contribute to the loss of vision as well.

Presbyopia symptoms include:

  • The need to hold objects, such as reading material, at an arms length to read clearly. In more advanced cases, an arms length may not even be far enough to allow for clear vision
  • Trouble focusing on close up objects, when this was never a problem in the past
  • Eye strain may occur in sufferers of presbyopia
  • Headaches may also occur is presbyopia sufferers

Presbyopia cure
While there is no one size fits all cure for presbyopia, there are several treatment options available. It is important to discuss all options with your eye care professional to select the option that is best for your eyes. Everyone is different. Treatment options include reading glasses, eyeglasses for all day wear, contact lenses, and surgery.

Presbyopia treatment

  • Reading glasses: Reading glasses can be purchased at a drug store or recommended by your eye care professional. These glasses are worn only when up close vision is needed, such as for reading or hobby work. They provide a “quick fix” by allowing you to focus up close only when you need to.
  • Standard eyeglasses: Bifocal, multifocal, and progressive lens eyeglasses are all options for those who suffer from presbyopia. These eyeglasses have several points of focus, allowing the wearer to focus on objects both close up and far away with increased accuracy.
  • Contact lenses: Contact lenses also come in multifocal options, allowing the wearer to focus on both up close and far away objects.
  • Monovision: Another option is monovision, in which the eyes wear different prescriptions, one for up close and another for distance. The brain adapts to this difference in vision strengths and learns which eye to favor for distance and close up vision. This is an option for eyeglasses and contact lenses.
  • Surgery: There are several surgical options to correct presbyopia. Refractive lens exchange surgery replaces the eye’s lens with an artificial lens, much like cataract surgery. Monovision LASIK, on the other hand, corrects the vision in one eye to allow for improved distance vision while the weaker eye is left to focus on close up vision. There is also the Kamra corneal inlay, which is implanted in the cornea and sharpens vision with a pinhole effect, much like looking through a telescope.

If you think that you may be suffering from presbyopia, your eye doctor can discuss the best options for you moving forward. Whether it be reading glasses, multifocal eyeglasses, contact lenses, or surgery, there are plenty of options to treat presbyopia.

Myopia Control at BayState Eye Center

What is myopia?

Myopia, also known as nearsightedness, causes vision to be blurry far away without glasses. Typically, the eye is too long, resulting in blurry vision. Other factors like the shape of the lens or cornea can contribute to myopia. Traditionally, myopia has been corrected with glasses or contact lenses.

 

Why does my child need stronger glasses every year?

            Myopia typically develops around age 8 and progresses for 10-15 years. Risk factors that increase the risk of developing myopia and rate of progression include:

-parents with myopia

-young age when myopia first diagnosed

-higher degree of myopia when first diagnosed

-certain types of focusing or eye coordination weakness

-race (Asian and Hispanic higher risk than Caucasian and African American)

-more hours of near work and holding work too close

-decreased time spent outdoors

 

Why should we try to slow down the progression?

High myopia increases risk for glaucoma, cataracts, retinal detachments and atrophy. The goal is to decrease the progression of myopia for a better visual outcome, and to hopefully decrease the risk of these sight-threatening complications.

 

What are some treatments that can help decrease the rate of progression?

 

Orthokeratology (Ortho-K)

These are contact lenses worn during sleep that gently reshape the cornea to correct vision. This temporary reshaping provides clear vision all day, which eliminates the need for glasses or contact lenses. This treatment corrects vision in a way that has been shown to slow the progression of myopia by about 50%. Some patients do not progress once this treatment is started.

 

Soft Multifocal Contact Lenses

Soft contact lenses are worn during the day to correct vision and to help slow the progression of myopia by approximately 50%. This type of contact lens is traditionally worn by adults to help them read clearly and see far away. In kids and teenagers, they correct vision in a way that helps to slow the growth of the eye.

 

Are these treatments FDA approved?

Studies have shown that Ortho-K and soft multifocal contact lenses can slow the progression of myopia in some children. However, the FDA has not approved the use of these lenses for this specific purpose. All contact lenses we use have been approved by the FDA, just not specifically to control myopia.

 

How do I find out if my child is a candidate?

            You can schedule a free myopia evaluation with Dr. Lambert. A detailed evaluation will allow Dr. Lambert to decide which of these options would minimize progression as much as possible.

 

For the evaluation, please bring:

  1. Your child’s current glasses
  2. Records from any previous eye doctors (unless all exams were done here)
  3. A detailed family history including glasses or contact lens prescriptions for parents and siblings
  4. We will be using a dilating drop that will make the eyes sensitive to light for approximately 24 hours. Vision may also be blurry up close while dilated during this time period.

 

If you have any questions or would like more information, please feel free  to call us at 508-339-7600.

 

Orthokeratology

Orthokeratology (Ortho-K) is a non-surgical procedure using specially designed contact lenses to gently reshape the eye to correct vision. The custom contacts are worn during sleep and removed in the morning, providing clear vision during the day. This eliminates the need for glasses and contacts.

Ortho-K is most commonly used to correct myopia (nearsightedness), but can also correct hyperopia, astigmatism and presbyopia. This is also a good option for current soft contact lens wearers who have discomfort with their contacts due to allergy, dry eyes or dusty work environment. Many people who are active in sports or other activities love the freedom from glasses, contact lenses and sports goggles.

One big advantage is that Ortho-K has been shown to slow myopia progression in children and teenagers. Between the ages of 8 and 15, myopia can increase rapidly. This increase in nearsightedness increases the risk of sight-threatening conditions such as retinal detachments, cataracts and glaucoma. Studies show that using Ortho-K can dramatically slow down progression of myopia and even arrest it in certain patients.

When first starting Ortho-K, vision will dramatically improve after one night of wear. It can take up to a couple weeks of wearing the lenses to get to the full correction. We will see you for follow-up visits during this process. Once stable, most people need to wear the contact lenses nightly to retain the benefits. The doctor can determine if you are a good candidate for Ortho-K with a thorough eye exam.

We use Paragon CRT (Corneal Refractive Therapy) lenses, which are a type of Ortho-K.

 

www.paragonvision.com

BayState Eye Center now offers Myopia Control Treatment!

Dr. Meghan Lambert tells her story on having myopia:

In third grade, I noticed I couldn’t see the board in school very well unless I was in the front of the classroom. When I went to my optometrist, he broke the news that I needed my first pair of glasses. I only had to wear them to see far away, so I only wore them in school. No big deal.

When my vision worsened the next year, I needed to wear glasses all the time. I already had braces and was not excited to have to wear glasses full time. Each year when I went back to see my optometrist, my vision got worse. I felt helpless and so frustrated that it kept worsening. By junior high, I felt like I couldn’t see anything without my glasses. I started wearing contacts which were great for sports and my self-confidence. Contacts worked well most of the time. But they would rip, I’d lose one or my eyes would get irritated since I wanted to wear them constantly. When I was old enough, I considered LASIK surgery but wasn’t a candidate.

My vision didn’t stabilize until I was in my early 30’s. By this point, I was practicing optometry myself. Due to my high prescription, I am at a much higher risk of having a retinal detachment and developing other eye diseases. I treat many patients with eyes like mine for these conditions, and it’s scary seeing what they go through knowing my own risks.

I want to do everything in my power to help patients not end up with vision as poor as mine and decrease their risk of eye disease. Until recently, I had no tools to help slow the progression of nearsightedness.  New research shows there are ways to slow down progression in nearsighted kids, which is very exciting.  They’ll not only see better, but also hopefully have a lower risk of eye disease. I am hoping by employing these methods, I can prevent kids from having eyes like mine once they’re adults. Having had this experience in my life will hopefully help me to give the best care possible making myopia control treatment a valuable addition to how I practice optometry.

Myopia, or nearsightedness, is a refractive error that causes far away objects to appear blurry while nearby objects remain clear. Myopia affects nearly 40 percent of the United States population. For years, myopia symptoms could be treated but not controlled. Myopia control studies now offer promising results on slowing the progression of nearsightedness with impressive new treatments. BayState Eye Center’s Dr. Lambert is excited to offer myopia control treatments with orthokeratology hard contact lenses and soft bifocal contact lenses. BayState Eye Center is accepting all regional patients for this opportunity.

Anyone with myopia will agree that they wish there had been a way to slow down the progression of myopia when they were younger. These treatments offer a revolutionary way to slow the progression of myopia in children. Following an evaluation, Dr. Lambert will determine which lenses are the best option for each patient. Although these treatments are not covered by insurance, setting a child up for a lifetime of better vision is priceless.

If you would like more information on our myopia control treatments, please contact us at 508-339-7600.

Purchasing Glasses: A Comprehensive Guide

Closeup of a female's hands pulling glasses from display rack

Barbara, our licensed optician, has worked in our Mansfield office for 10 years and receives a lot of questions on what are the options for lenses and why do the prices in lenses vary so much.  Like all things in life, there are many options and some have added benefits to provide improved vision and comfort. This article goes over features you should consider on your next pair of glasses.  These added benefits can add costs to the lenses but provide a clearer, sharper image and lighter glasses.  Those who wear glasses full time should consider those options since they need to wear them from morning to night.  While those who take them on and off and tend to lose glasses may suffice with a basic pair of glasses.  If you are going to wear them full time, the additional benefits are worth their expense.  Some binoculars are $10 and others are $300 and they are both called binoculars but the difference is the optical quality.  How well do you want to see?

It is important to be well-informed while purchasing eyeglasses – they give you sight after all! There are so many ways to customize your glasses, it is helpful to have every resource available to custom fit your prescription to your life style.  There are several different lens options to take into consideration when making an investment in your visual needs.

 

Lens Material

Choosing the right lens material for your needs is the first step in purchasing eyeglasses. The lens material provides the basic building block for your glasses. The most common lens materials are CR39, polycarbonate, and high index.

CR93 is a basic plastic that has been a popular lens material since its introduction in 1947. It is the most affordable option for eyeglasses.

Polycarbonate lenses are lighter and thinner than CR93.  These lenses were initially introduced for use in safety glasses, but are extremely popular for regular eyeglasses today.

High Index lenses are the thinnest and lightest lenses and offer the best cosmetic appearance for a higher lens power.  These lenses are ideal for those with a high level of refractive error who do not want extremely heavy eye glasses.

 

Progressive lenses 

What are progressive lenses? Progressive eyeglass lenses are an alternative to bifocal and trifocal lenses. These lenses allow you to see at all distances, without the obvious indication of a visible line like traditional bifocals or trifocals. The progression between lens powers is seamless and invisible to anyone not wearing the lenses.

Our lifestyle today requires us to see at all distances (reading glasses, distance glasses, computer glasses, etc.), progressive lenses are the simplifying solution that you are looking for.  Selecting the best progressive lenses will ensure that your glasses meet all your visual needs.

Varilux lenses were the very first progressive lenses, invented in 1959. They are still a leading progressive lens option and specialize in providing clear vision that does not leave you feeling off balance or unsettled when moving your vision between lens powers. These lenses have the various lens powers in fixed, predetermined locations on the lens.

Digital progressive lenses and digital freeform progressive lenses are even more advanced options for those who need multifocal lenses. While traditional progressive lenses have their various powers at set locations on the lens, digital progressive lenses allow you to customize where the powers lie on your lenses. This allows a deeper level of personalization if you find traditional progressive lenses do not fully meet your needs. The lenses are completely custom made to your eyes and offer the maximum amount of high definition, throughout the lens.

There are different lenses designed for specific tasks – your lifestyle will play a big part in finding the lenses that best fit your visual needs. Some lenses have wider channels for easier adaptations. Other lenses have a larger reading area for those who spend a lot of time focusing on close up tasks. An optician, an eyeglass fitting specialist, can help to determine what lens would be the best option for you, as there are many different brands of progressive lenses.

 

Anti-Glare Lenses

When selecting the multiple lens coatings available, on the top of your list should be anti-glare lenses. Why would you need anti-glare? Anti-glare lenses eliminate reflections in your glasses. Anti-glare and anti-reflective (AR) are two different terms for the same coating. This coating makes the glasses appear more transparent, and minimizes glare from light that can obstruct your vision. This is especially important for those with a high degree of refractive error. The higher the lens power of your glasses is, the more prone you will be to struggle with glare in the lenses.  Anti-glare lenses give you 8% better vision because you do not have to fight through the glare.

Anti-glare glasses allow others to see your eyes more clearly and allow you to see the world around you more clearly as well. The difference is particularly pronounced when looking at a screen for an extended period of time or while driving at night. Anti-glare lenses are a portable alternative to anti-glare screen protectors for cell phones and computers, and are proven to reduce eye strain and discomfort. AR lenses also allow for improved night vision by letting the maximum amount of light into the eye. This minimizes glare from other sources, like headlights while driving.

There are several different types of AR coatings that vary in quality. Generic AR coatings minimize glare at an affordable price tag. These coatings are often applied to large quantities of glasses in batches. High end AR coatings, such as Crizal, allow the maximum amount of light through the lens. This provides the best resistance to glare and often comes with a diamond coat, which also prevents scratches and other damage to the lenses themselves. High end AR coatings, like Crizal, are more expensive but they provide the highest quality anti glare technology.

 

Computer Glasses 

Computer glasses are a great option for those who do not need to wear glasses all the time, but experience eye strain and irritation from prolonged exposure to a computer screen, cell phone, or television screen. These screens are all lit by blue light, which has been proven to cause eye fatigue and to disrupt normal sleeping patterns.

Glasses for computer use are offered in prescription or over the counter powers, depending upon your need. They are even available with no power at all, to protect your eyes from harmful blue light even if you have perfect vision. Computer reading glasses are becoming more and more of a necessity as we spend an increasing amount of time in front of screens every single day.  The best computer glasses will improve your vision in the intermediate zone, farther than reading but closer than driving – this is where the computer lies.

Computer glasses can also be incorporated into progressive lenses. Particularly in an office environment, it is common to spend a lot of time alternating focus between a computer screen and small text on paper. A progressive lens with computer distance towards the top of the lens, and a magnifying bottom portion for small text provides a solution to make office work less strenuous on the eyes.

 

Coating Options

There are several different coatings that can be applied to your eyeglasses. These coatings include AR, as discussed above, UV, tints, and scratch protection coatings. Depending upon your lifestyle, these coatings can be great tools to make your glasses work better for you.

UV coatings protect the eyes from the sun’s harmful rays. While you may associate UV protection with sunglasses, regular eye glasses can be coated with a UV protection agent as well. This is perfect for those who spend a lot of leisure time, or work, in the outdoors.

Tints can be applied to lenses and will change the color of the lens. This is can be beneficial for improving vision in certain environments.  For example, those who often work outside may prefer a pair of tinted eyeglasses to wear while working.  There are lots of tint colors to choose from.

Scratch resistant coating is available to prolong the life of your eyeglasses. For anyone who is prone to dropping their glasses, scratch resistant coating is the best investment to be made to extend the life and quality of your eyeglasses.

 

Photochromatic Lenses

Photochromatic lenses, often referred to as “transition” lenses, change their tint based on the amount of UV that they are exposed to. These lenses protect the eyes from UV damage. UV rays also cause the lenses to darken for increased comfort.  Photochromatic lenses are available in all lens materials and are good options for those who do not want their glasses to be clear while indoors, but prefer a darker lens when exposed to UV rays.

No matter what type of glasses you need, our licensed opticians are happy to help you on your path to finding the perfect pair by sharing their knowledge. While you know your lifestyle best, licensed opticians know glasses best. For some, one pair of glasses can do it all. For others, the best optical option is multiple pairs of glasses. Talk to one of our licensed opticians today to determine which qualities are the most important for your glasses.