People with normal eyes can see well for distance as well as near . Presbyopia is the state of our eyes , when it becomes increasingly difficult for us to see things up close when we approach the age of 40 years.
Cause of presbyopia is yet to be understood conclusively as is our limited understanding of how the eye focusses for near.
Treatment of Presbyopia
In order to function with our near vision, the easiest treatment is to start wearing glasses for near vision. The number of these glasses usually starts with +0.5 to +1.0 Diopter and gradually increases as we advance in age. It may go to a maximum of +2.5 to +3.0 Diopter .
Near vision glasses may be worn as and when required or may be worn all the time in the form of Bifocal or progressive glasses , when the distance vision spectacle number is combined with near vision number . This helps avoid putting on and taking off glasses innumerable times during the day.
Use of glasses does allow us to see near without any problem at a very nominal cost but wearing of glasses is not a very convenient proposition and we would definitely like to shed this appendage if given a chance.
Many surgical treatments have been proposed for presbyopia in the past but most of them have been dismal failures. The latest to hit the market are :
a) Kamra Ring : This is a small black ,opaque disc with a 1.6 mm hole in the center and an overall size of 3.8 mm. This works on the principle of a pin hole camera and is implanted in the cornea of the non dominant eye. A Femtosecond laser is used to create a pocket in the cornea and this ring is slid into the pocket. Since there is no lens inside this ring , this ring stays in the eye forever and does not need to be changed. Many patients are benefitting from this technique .
b) Raindrop hydrogel implant : Unlike the Kamra implant, which is opaque , the raindrop implant is a transparent disc shaped implant , which also is implanted in the layers of the cornea after creating a flap or pocket with the femtosecond cornea laser. This implant too has no dioptric power. It helps in enabling us to read by changing the power of the cornea in the centre since it's implantation raises the centre of the cornea.
We are eagerly looking forward to evaluating the longterm results of theses devices which have the potential to help a lot many of us in attaining freedom from glasses.
Other treatments which have been tried in the recent past with limited success and being tested these days are :
Intracor Femto laser technique
Supracor laser technique
Laser Blended vision
Surgical scleral expansion .
Being able to treat Presbyopia successfully would be the most exciting time for Ophthalmologists around the world.
Till then glasses remain the mainstay of Presbyopia treatment.
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