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Presbyopia Art

Orangutan Arms?

It happened overnight. You had no problem reading that book yesterday, yet today the arms of a orangutan wouldn't let you hold your reading material far enough away to see clearly.


Presbyopic Salute?

You have also tried many different approaches to solve this problem. You look like you are playing an imaginary slide trombone with that book you are trying to read. You have turned the light up bright enough to burn a hole in the page. You only read the newspaper under direct sunlight. You have your spouse either, hold the menu far away, lend you their "reading glasses" or, just read the menu for you. You may be saluting a thousand times a day by constantly putting on and taking off your glasses. You may have two dozen pair of those "flea market specials" in every imaginable place so that should you actually need to clearly see something in your hands, you will be prepared. Of course, you have lost or broken at least a dozen of these in the past year.


It Is A Monster

The monster has a name and it is called, Presbyopia.


No One Escapes

"... intermediate vision also suffers when Presbyopia rears its ugly head"

Presby what? Presbyopia affects everyone at some point, by creating the need for separate prescriptions to see far away activities like driving on the highway, and close activities like reading a book. (Working on the computer is an additional complex and separate issue). In addition to this, the mid-range or intermediate vision also suffers when Presbyopia rears its ugly head. The person you are talking to across the table in the restaurant, the papers on the top of your desk, men trying to shave in the mirror or women trying to apply makeup in the mirror are all blurred because this midrange vision is also affected. It does not matter if you are near-sighted, far-sighted, or have astigmatism, if you are a stockbroker, Realtor, or auto mechanic, live in Alaska or Australia, presbyopia happens to everyone.


It Isn't All Bad News

That's the bad news. The good news is that there are many ways to beat the "evil" Presbyopia. In order of my personal preferences, based on the best functional performance to the worst; Bifocal/Multifocal contact lenses, Monovision contact lenses, Progressive glasses, standard bifocal glasses, and two separate pairs of glasses. You will notice that contact lenses are in the top two performance categories. The contact lenses will out perform glasses for many reasons, but mainly are superior because the vision is more "natural."


Bifocal Contacts?

"Bifocal contacts have been around for more than fifty years."

Bifocal contact lenses seem to be one of the best kept secrets in the world. When I offer this option to the person with Presbyopia, the response I receive is always "I have never heard of bifocal contact lenses before - are they new?" Bifocal contacts have been around for more than fifty years. They are often not recommended because they are difficult to fit - it is a moving lens on a moving eye that still must be in the correct position so that the person can see clearly where they are looking. They are not however, difficult to "get used to", which is the most common concern when discussing bifocals. Since Bifocal contacts are the way to look your best while seeing your best I will always recommend this as my preferred choice.


Monovision Is Another Option

Monovision contacts is the next best option and although this concept sounds totally absurd - one eye set up to see more of the distance and the other eye more of the close, it is very effective and in my experience, approximately 95% successful. Both eyes are actually working at all distances. The Monovision balance that is achieved does not hurt or over work either eye. Even though the vision isn't quite the same as with bifocal contacts, the vision doesn't suffer from some of the limitations of glasses.


Progressives Are Progressive

Progressive lenses are the best option in glasses to address Presbyopia because they function as though there are an infinite number of prescriptions to keep everything clear from far away to close. I have heard complaints from people who've tried and failed in Progressive glasses. The failures when more closely examined are almost always because originally they were not properly measured, fitted, or manufactured. Progressive glasses are very technologically advanced and when properly fit, provide better vision and make you look better than standard bifocal glasses.


A Very Special Option - Orthokeratology


Ortho-Kera-What?! Orthokeratology is the word, and breaking it down from its origins, "Ortho" = straightening or correcting, such as in Orthodontics (straigtening the teeth) or Orthopedics (correcting the skeletal system). "Kerato" = cornea. "Ology" = the study of. So putting these parts together, we have "the study of straightening or correcting the cornea." Through the use of a very specially designed contact lens device, you would put this on just prior to sleep (it is not being used for the purpose of providing you clearer vision when worn), go to sleep, and upon awakening, remove this contact lens. Upon removal you will now have clear vision at all distances, far, close, and everything in between. This clear vision will last for your entire day so that you will not need to have any optical appliance to help you see for all of your waking hours. You can read much more about Orthokeratology by clicking the link below in the "Related Links for Presbyopia" section.


Stay Looking Young

"Presbyopia does not mean that you have to look old."

Whether Bifocal contacts, Monovision contacts, or Progressive glasses are used, Presbyopia does not mean that you have to look old. You can maintain your youthful appearance while maximizing your vision. One or more of these superior alternatives can be appropriate for you. They can be just for what your eyes have been looking.


Are The "Cheaters" Cheating You?

Like a thief in the night that lurks without warning, so too was your close vision robbed. You woke up from a restful sleep to find that you couldn’t read the morning paper because it was too blurry. You heard from your friend that they have these 'cheaters' at the drugstore and so you went and tried them out and lo and behold you could read again.


Are The Ready-Mades Junk?

Since you are able to read with these ready-made off-the-shelf devices, you might have wondered as to the differences between these and appropriately prescribed and properly manufactured prescription reading glasses. Although you might think that I, as a physician am going to tell you that the ready-mades are just junk, this does not give a balanced view of the problem nor clear the misconceptions of the 'magnifiers.'


Ready-Mades Have Prescription Lenses

Ready-mades are mass-produced, quickly-assembled optical devices, that are actually prescription lenses you may buy without a prescription. The instructions for selecting the proper power are as follows: "try me on; can you read this?; must be OK." Well, that may be a bit dramatic but that does essentially describe the procedure. No one will tell you that these "cheaters" will ruin your eyes, including myself, but there are several things to consider before you take that $2-$10 plunge.


Near Blur Isn't Always Presbyopia

"...several other conditions can simulate a need for reading glasses."

If your near vision is blurred there is the possibility that this is the result of a medical problem that requires more investigation than trying on a few 'cheaters.' Macular degeneration, central serous retinopathy, optic neuritis, diabetes, and several other conditions can simulate a need for reading glasses. Obviously, these are circumstances that demand a thorough eye examination.


Significant Limitations

Reserving comment on the quality of the frames that are used, the lenses are made with many assumptions. These 'cheaters' were made for the masses and therefore assume that your two eyes are exactly the same, which is rare. These 'cheaters' assume that you have no astigmatism, and nearly 60% of the population does. These 'cheaters' also assume that your eyes are over 65 millimeters apart when you read, but that only accounts for about 10% of you. The placement of the optical centers (the point in each lens that should be placed over each pupil) for the 'cheaters' seems to be random, and actually have a rather wide range. The misalignment of the optical centers with your pupils will cause a significant 'prismatic effect' that forces your eyes to turn excessively and can result in blurred vision, a pulling of the eyes, and general fatigue.


Your Eyes Deserve Better

"...there are better ways to save a dollar..."

Although none of these symptoms will destroy your eyesight, it seems to me that your eyes deserve better correction. They have served you well for many years, and this is not the best payback. Even more outrageous is when I hear from a patient that their last eye doctor told them to "just go buy some readers from the drugstore, that's all you need!" I think that is a disservice and there are better ways to save a dollar than to impart your vision to this advice.


The Right Tool For the Job

If you only need an occasional aid to read the stock quotes, or find a number in a phone book, or thread a needle, or read a medicine bottle, then a ten-dollar 'cheater' will probably do the trick. If, however, you work at a desk most of your day, spend time at a computer, or just like to read, then invest in a top quality, corrected curve reading prescription that is measured and made for you specifically, and purchase your glasses from a reputable optical retailer. Your eyes will be beholden.