With presbyopia, the natural lens of the eye begins to harden and becomes less flexible. This diminishes the eye’s ability to switch its focus from one object to another at different distances. Over time while distance vision may be very good near vision gets progressively worse. Presbyopia usually occurs before cataracts and affects almost everyone over 50. Eventually reading glasses or bifocals become necessary for reading, and frequent changes in eyeglass prescriptions are common.
While traditional cataract surgery with conventional monofocal lens implants is successful, it is limited because it provides good vision at a single focal point, either at distance or at near. But we live in a world where we need to see near, far, and everything in between. And that’s where the advanced multifocal lenses come in. Multifocal lenses are designed to provide a wide range of vision and greater independence from glasses. In fact, most people who have had this procedure no longer have to depend on their glasses all the time.
These lenses are designed with special visual zones. As light enters the eye, these special zones focus that light for both near vision and far vision. This advancement in lens design means that many patients may be able to read a label, see a computer screen, cook or shop or even drive a car without depending on glasses at any time. Studies show that after implanting the multifocal lenses in both eyes about 85% of patients never need to use glasses for any activity. In addition, 94% of those polled agreed that they would have the lens implanted in their eyes again if given the choice.
It is important to remember that there are still a small percentage of people that may need glasses for some activities after having multifocal lenses, however this is dramatically different from monofocal lenses. With a standard monofocal lens you are virtually guaranteed to need glasses after surgery. If you are interested in learning more about multifocal lenses ask your eye doctor. During your exam your doctor will conduct a series of tests to determine the health of your eye and whether you are a good candidate for multifocal lenses. At that time your doctor will discuss your treatment options and review all important safety information including potential risk and side effects of the lens and the procedure. Halos and some glare around bright lights during the first few months after the procedure are common and in most cases diminish in time. In addition, some patients with other eye conditions such as macular degeneration, sever glycoma, or diabetes may not be ideal candidates for this lens. Your doctor will explain this and answer all of your questions.
The lenses used in cataract surgery come in a wide range of powers. By taking special measurements of the eye we can determine what power is required so that you are less dependent on your glasses after surgery. If you have cataracts your options fall into two basic categories, monofocal or multifocal. Monofocal lenses can give you clear vision at a single point without glasses. Patients having a monofocal lens will have to choose between seeing well without glasses at distance, or up close, and they will need to use glasses for the other activity.
If you have astigmatism your doctor may recommend a special type of a monofocal lens called a toric intraocular lens. It works to correct the abnormal curvature of your cornea to correct astigmatism and cataracts in a single step. By addressing your astigmatism with this toric lens, a patient’s distance vision can be much clearer without glasses. However glasses will still be needed for reading.
If your eyes are healthy your decision to choose between a monofocal or a multifocal lens will be based on your lifestyle. What activities are most important to you? Are you active and motivated to be independent of glasses and contacts in most situations? Would you like to read without needing glasses all the time? These are a few key questions your doctor and their team will discuss with you, and together you can determine if a multifocal lens might be right for you.
Cataracts are another problem affecting our vision as we age. Having cataracts and presbyopia can significantly affect your vision and affect every aspect of your life, from reading and using the computer to cooking, watching TV, and driving, particularly at night. To understand presbyopia and cataracts and how these conditions affect your vision it is important to understand how your eye works.
Your eye works much like a camera. Light passes through the lens of the camera and is focused on the film. Our eye also has a lens. Normally this lens is transparent and lets light pass freely and is focused on the back of the eye called the retina. A cataract is a change to the natural crystalline lens of the eye. As we age the natural lens of the eye can become clouded and light rays become scattered and no longer pass clearly through to the retina. At first, this cloudiness may affect only a small part of the lens, but over time the cataract becomes harder and darker and vision decreases significantly. As cataracts develop, all objects whether near or far become blurred, and vision usually worsens. One of the first signs of cataracts is the inability to see in low light situations or at night. Other indicators include hazy or blurred vision, faded colors, or sensitivity to light.
The cataract surgeons at Eye Doctors of Washington are Board-certified ophthalmologists who are acknowledged leaders in their field. They have performed thousands of cataract procedures and are naturally and internally-recognized surgeons. They were the first surgeons in the Washington DC area to implant the Restore Bifocal lens, and have been featured on the ABC news. We created this short movie to help our patients better understand cataract surgery and their options. We hope you find this video both educational and informative.
The only treatment for cataracts is to remove the cloudy natural lens and replace it with an artificial lens implant. Today this procedure is very common and over 14 million are performed every year worldwide. Cataract surgery is a brief and painless procedure. The average time for surgery is less than 20 minutes. We bring you to the operating room and give you some sedation through an intravenous line so you feel calm and relaxed. A tiny incision is made through the cornea. Through this incision we are able to remove the cloudy lens with an ultrasound device. We then can place a new clear lens inside of your eye. Because the incision is so small there is usually not a need for stitches.
Most patients see well right after cataract surgery, but there is a convalescence of several weeks. During this time you’ll be asked to use both an anti-inflammatory and an antibiotic drop. Complete instructions regarding your post operative regimen will be provided.
Not all patients are good candidates for Lasik. Some people have too thin of a cornea to have the Lasik procedure. Other individuals have an irregular shape to their cornea called karatoconus. In caritokonis the cornea is weaker than normal and the Lasik procedure can make the cornea buckle or become unstable. It’s critical to have a very thorough, comprehensive evaluation prior to the Lasik procedure. In our office we measure and map the cornea looking for any disorders which would make you a poor candidate.