I Am Over 40 And Have Astigmatism

I Have Astigmatism

  • The cornea (front of the eye) is not perfectly round, but has more of a curved shape.
  • Objects may appear to have a shadow or ghosted image without glasses and/or contact lenses.
  • Your distance vision and near vision are probably both blurry, and you probably require extra help at near (bifocals, trifocals, progressives, etc.).
  • It is common to have a combination of astigmatism and nearsightedness or farsightedness.
  • If you wear soft contact lenses, the prescription probably has several numbers listed for the power. Example: -4.50 -1.25 x 180 soft contact lens power. If you wear gas permeable contact lenses, you probably have astigmatism.
  • Astigmatism occurs because the curved shape of the cornea (front of the eye) causes images to be bent as they pass through. This causes two focal points near the retina (but not focused on the retina), leading to distortion and ghosting.
  • Refractive eye surgery can correct the focus of your eye, helping light rays focus on the retina.
  • As you age, the lens inside your eye loses its ability to focus as well at near – this usually becomes evident around the age of 40. This is when many people begin using reading glasses or bifocals. The correct term for this condition is presbyopia (see below).

I Have Presbyopia

  • If you are over the age of 40, you have probably begun to experience presbyopia.
  • This is a normal age-related vision problem which usually becomes evident around the age of 40.
  • You have difficulty focusing at near without extra help (reading glasses, bifocals, trifocals, progressives, etc.).
  • Presbyopia occurs as the eye’s natural lens hardens and loses its ability to flex and focus with age. The focusing muscles within the eye also become weak with age, contributing to presbyopia.
  • This leads to difficulty in focusing from far to near, and is usually when many people begin to require the use of reading glasses or bifocals.

Thinking About Your Vision Options

  • There are several options available to help reduce or eliminate your need for glasses or contact lenses. Your Free Evaluation will allow us to determine which of these options are best suited for your unique visual needs. Here are some potential options to think about and discuss with the doctor when deciding on your visual goals:

    • Full distance vision correction for both eyes This would provide you with great distance vision, but you would still require reading glasses for near and midrange (computer) vision. This is a good option for patients who have an active outdoor lifestyle and don’t mind wearing reading glasses.
    • Monovision With this option, the dominant eye is corrected for full distance vision, while the non-dominant eye is corrected to see well at near. While this concept may sound strange, most patients actually adapt well. The brain learns to depend more on the distance eye when viewing distance objects, and depend more on the near eye when using a computer or reading. The use of reading glasses may still be needed on occasion (mostly for detailed near work), but patients are not typically dependent on them. Monovision is a good option for patients who multi-task and are willing to accept a slight compromise in distance vision in order to gain near vision.

Here Are Your Potential Surgical Options

  • Your Free Evaluation will allow us to determine which of these options are best suited for your unique visual needs. Use the links below to learn more about each procedure:

    • iLASIK This is the newest version of LASIK (Laser Assisted In Situ Keratomileusis), combining the most advanced technology:
      • iDesign Scanning System This is a mapping system used to create a “fingerprint” of your eye and its individual characteristics. This data is then plugged into your laser program, creating a laser treatment customized for your eye.
      • IntraLase “Blade-free” Laser This laser creates a thin flap in the outermost layer of the cornea, the epithelium. Blades are no longer used! The flap is then folded out of the way in preparation for the excimer laser.
      • VISX Star S4 Excimer Laser This laser permanently sculpts the patient’s visual correction into the deeper tissue of the cornea (beneath the flap). This laser utilizes 2 types of eye tracking to ensure accuracy:
      • Iris Registration
      • 3-D Autotracking
    • PRK (Photo-Refractive Keratectomy) This procedure is similar to LASIK, except a corneal flap is not created. Instead, the corneal epithelium (outermost layer) is removed and the Excimer laser treatment is then applied. The epithelium slowly grows back as the eye heals, and ultimately the visual outcomes are similar to LASIK. The procedure does cause discomfort during the initial healing process, and the vision is typically slow to settle, therefore PRK is typically reserved for special circumstances. Cases in which PRK may be utilized include:
      • Patients whose corneas are too thin to safely have LASIK
      • Patients who have previously had refractive eye surgery
      • Patients who have problems with the corneal surface
    • PRELEX (Presbyopic Lens Exchange) Similar to cataract surgery, this procedure surgically removes the natural lens of your eye and replaces it with an artificial lens implant. Newer technology now provides premium multifocal lens implants, which enables a wide range of vision – including distance, intermediate, and near. As the brain adapts to the new optical system, haloes may be noticeable after surgery, and should diminish over time as vision settles. PRELEX is usually best suited for patients age 45 or older, although younger patients may be considered in certain circumstances. There are different premium lens options available for implantation, and our staff can help advise which choice is best for you. We currently offer the following premium lenses as part of our refractive package service:
      • ReSTOR® This lens implant uses revolutionary apodized diffractive technology – a series of concentric circular rings which focuses images on the retina and enables a full range of vision. Patients with ReSTOR® lenses usually report great distance vision and great near vision, with adequate intermediate (computer) vision. The vast majority of patients with ReSTOR® lenses will no longer need glasses, but some patients may still need glasses on occasion for certain tasks.
      • Tecnis® This lens has the ability to consistently offer patients improved vision at a range of distances, from near to middle to far. The Tecnis® Lens is the only wavefront-designed lens with FDA-approved claims for improved functional vision and improved night-driving simulator performance. The vast majority of patients with Tecnis® lenses will no longer need glasses, but some patients may still need glasses on occasion for certain tasks.
      • Single Vision Intraocular Lenses This lens implant provides one focal point (distance OR near), and is the same type of lens used for standard cataract surgeries. This would be an option for a patient who may not be tolerant of haloes (as are sometimes reported with multifocal lens implants), and who is not a good candidate for iLASIK or PRK. Vision may be set for monovision (one eye set for distance vision and the other eye set for near vision) or for distance vision with both eyes (which would still require the use of reading glasses for intermediate and near work).

Am I a Good Candidate?

Several factors such as age, visual demands, eye health, and general health all play a part in determining whether or not you are a proper candidate for refractive surgery. Candidates must have stable vision, be at least eighteen years old, and should not be pregnant or nursing. Let’s evaluate your vision and determine the best possible vision correction procedure to meet your unique visual needs…

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