Eye corrections help people look toward old age

Letbetter Enlargephoto


If you’re over 40 and finding yourself holding newspapers, books, and magazines farther and farther away from your face with each passing year in order to read the fine print, you’re in the majority. Cortez ophthalmologist David Letbetter, MD, said that while everyone’s eyesight changes and progressively worsens throughout life, the inability to see small print and other objects at close range doesn’t become noticeable until middle age. But, by then, it’s an almost universal reality.

“Once you get to the magical age of about 40, you start having trouble reading,” Letbetter said.

If you’ve already been wearing glasses or contact lenses to improve your distance vision at that point, bifocal vision correction of some sort is in order.

“Traditional bifocal glasses have a lens on the top for distance vision, and another one on the bottom for close up vision,” Letbetter said.

While many patients are now opting for “progressive” bifocals that don’t have a visible line across the lens, the type with the line are often easier to see with.

“Some people still prefer those because the field of vision is larger,” Letbetter said.

If you find wearing glasses uncomfortable or just don’t like the look, ask your eye doctor about multi-focal contact lenses. These relatively new contacts work like bifocal eye glasses. They typically take from several days to a couple of weeks to adjust to, so if you try these, give yourself a chance to adjust to wearing them.

“Some people are successful in adapting to mono vision for correction” Letbetter said.

Mono vision involves wearing a contact lens in one eye to achieve good distance vision, and one in the other eye for close vision. It takes a little while, but the brain eventually learns to “switch” between eyes, depending on what needs to be seen.

Yet another option is to wear contact lenses for distance vision and keep reading glasses handy for reading, working at the computer, and other activities that require good close vision such as sewing or sorting through your tackle box to find the perfect fishing lure.

Today’s contact lenses are very comfortable for most patients.

“About 99 percent of people who wear contacts use soft lenses,” Letbetter said.

A few patients still require rigid gas permeable lenses to achieve optimal vision correction.

Most soft contact lenses manufactured today are disposable.

“Daily wear lenses are designed to be worn during the day, taken out at night for cleaning, and then replaced with a new pair after about three to four weeks,” Letbetter said.

There are also “daily disposables” that are worn for only one day and then replaced. The advantage of the daily disposables is that you don’t have to fiddle with cleaning solutions each night, and they may be associated with a lower risk of developing eye infections.

If you’ve been lucky enough to reach middle age without needing glasses or contact lenses to improve your distance vision, then simple reading glasses are all you’ll need when the day comes that your arms are not long enough to allow you to read a restaurant menu. You can pick up a pair of magnifying reading glasses (sometimes called “cheaters”) at your local drugstore, but you may get a better result with prescription lenses from your eye doctor.

Patients who want vision correction without having to wear glasses or contact lenses may opt for laser surgery, the most common type being LASIK. This procedure has been around for a couple of decades now and is very common, but not everyone is a candidate for the operation.

“We have to do a careful screening to make sure the eye is fit to have LASIK done,” Letbetter said.

The shape of the eye is the main determining factor for success.

Patients who undergo LASIK, usually done in an eye surgeon’s office using topical anesthetic eye drops, experience improved vision almost immediately and have very little discomfort. Significant complications are rare, and the most common minor complication is dry eyes, which Letbetter said can usually be managed well with artificial tears.

Another laser surgery vision correction procedure is photorefractive keratectomy, or PRK for short. Also done in a physician’s office or clinic, this procedure is somewhat more painful than LASIK because the laser is applied to the eye in a different way, but for patients who have thin or steep corneas, it may be a better option. Potential complications are the same as they are with LASIK, but may actually occur less frequently.

The most common vision problem among people over about the age of 60 is cataracts.

“If you live long enough, you’ll eventually develop cataracts,” Letbetter said, adding that not everyone develops cataract disease that is severe enough to require surgery. “My rule of thumb is that if cataracts are negatively affecting a patient’s quality of life, I’ll do the surgery.”

Cataract surgery is the most commonly performed operation in the United States. The surgery is done at the hospital, does not generally require an overnight stay, and complications from the procedure are rare.

“Patient preparation is so thorough and careful now that the risk of infection or other complications is extremely low,” Letbetter said.

Patients recover fully after cataract surgery within a few weeks, but vision is usually dramatically better the day after the procedure.

No matter your age, if you’re having trouble seeing, make an appointment with an ophthalmologist (MD or DO) or optometrist (OD) for an evaluation. Most vision problems can be easily corrected, and being able to clearly see the world around you is worth investigating.

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal health care provider.

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