Latest methods of tackling presbyopia

CORPORATE professional CL Tan is not the only person to proclaim with dismay that the day she turned 40 was also the very day when she had to squint at her reading material and move it farther from her nose to be able to read the print.

"It's like clockwork - you turn 40 and your eyes find it harder to focus!" she laments.

Presbyopia is as inevitable as income tax, some say. With new advancements in medical treatments, however, having presbyopia need not be as dreaded as, well, death taxes.

The presbyopic condition sets in when the lens in the eyes loses its elasticity and therefore its ability to focus. "Presbyopia is an ageing process and not a disease.

Two factors happen - the lens gets harder and can't change its shape as easily while the internal eye muscles also lose their function and can't control the elasticity of the lens well," explains Dr Lee Hung Ming, Medical Director and Senior Consultant at Parkway Eye Centre, Gleneagles Hospital.

In the old days, one would just have to reluctantly put on reading glasses or bifocals, but there are now more advanced options in the market. One of the newest ways to treat presbyopia is through IntraCor, an all-laser treatment with no cuts to the cornea.

"The Technolas femtosecond laser is used to create concentric rings around the cornea, changing its shape. So it's minimally invasive as there's no flap created," explains Dr Lee, who was the first eye surgeon to use Intracor in South-east Asia.

The laser adjusts the central shape of the cornea, the front of the eye, to bring near objects into focus. The result is a minor alteration to the corneal curvature to correct the presbyopia, and the actual laser procedure is over in only 20 seconds. There's no downtime at all after the procedure as well.

Intracor is suitable for those who could see well without glasses before - those who didn't have short-sightedness.

Unfortunately, Intracor isn't advised for those who have had Lasik and those who've had glaucoma. People with too-thin corneas are also not suitable for IntraCor.

"Intracor may however cause patients to see halos and glare at night", says Dr Lee.

Meanwhile, for senior folk who are suffering from short-sightedness, astigmatism and presbyopia, the development of multi-focal toric lens for cataract sufferers means that all three conditions can be dealt with in the Cataract operation with Toric Multi-focal lens implantation.

"This is only for senior folks who suffer from cataracts - which is when the lens get cloudy.

Cataracts are also inevitable, and when this happens, they will have to replace their lens anyway.

The advent of multi-focal lens implant will render patients spectacle-free both for distance as well as near work," explains Dr Lee.

The lens in the eye is like camera lenses - when they get scratched or get dirty, they need to be replaced. The multifocal lens allows the patient to see far and read without glasses. And now, astigmatism is also dealt with. The best thing is, it's permanent.

"There are different methods of tackling presbyopia for different groups," concludes Dr Lee, adding that the condition has been the ultimate challenge in ophthamology given that it's taken this long to find more permanent solutions beyond multifocal glasses.

The ultimate solution is still some time off - where myopia and presbyopia can be corrected in both eyes instead of the current practice of correcting them in one eye each - but one reckons that the moment that technology is possible, Dr Lee will be the first to offer it.

uihoon@sph.com.sg

This article was first published in The Business Times.

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