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LASIK for presbyopians?
Old 11-07-2006, 09:45 AM   #1
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LASIK for presbyopians?

I split this off from the hypercompetitive ERs thread:
Quote:
Originally Posted by Cut-Throat
• Had Lasik surgery and threw my nearsighted glasses away after 40 years.
Cut-Throat, how did presbyopia affect your LASIK surgery? Are your eye's lenses still changing their focus? Anyone else dealing with this combination?

Although I'm still pretty squeamish about the surgery I can appreciate its convenience. But I've heard that presbyopians may not benefit from LASIK or its brethren until well after their eyes have stopped shifting. Mine made a "great leap forward" to 2.0 a year ago and paused but it's starting to happen again...
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Re: LASIK for presbyopians?
Old 11-07-2006, 09:54 AM   #2
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Re: LASIK for presbyopians?

Hey Nords, I saw that post too and was going to start a thread.

I am interested in the Lasik and also wonder about the presbyopia. The people I know that have had the procedure use reading glasses to read.
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Re: LASIK for presbyopians?
Old 11-07-2006, 10:15 AM   #3
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Martha
I am interested in the Lasik and also wonder about the presbyopia. The people I know that have had the procedure use reading glasses to read.
Old neighbors of ours both had LASIK the same week and both had the same procedure from the same opthamologist-- one eye distant and the other eye for reading.

She came through fine and adapted to the different applications with no problem. He had issues with one eye-- I think it was the reading eye-- and so had a second operation where both eyes ended up focused on the distance. But he's a typical middle-aged guy about 50 pounds overweight, probably with incipient BP & circulation problems. I don't know how that affected his recovery (if at all). Unfortunately they both moved a year ago and we don't see them often enough to ask "Hey, how's the eyes?"

My father's cataract surgery inserted a 20/20 lens corrected for distance and he wears reading glasses. My FIL did the same. He's not sure what to do about his other eye; the cataract is still pretty small.
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Re: LASIK for presbyopians?
Old 11-07-2006, 11:09 AM   #4
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Nords
Old neighbors of ours both had LASIK the same week and both had the same procedure from the same opthamologist-- one eye distant and the other eye for reading.

I think that's called "monovision"; I had that done about 6-7 yrs ago. Right eye for distance, left for reading. It took a week or two for my brain to sort things out, but I'm loving it now. Can read the paper & watch tv at the same time w/out reaching for the specs. And man is it nice to play golf w/out wiping the sweat from my glasses! There is a very narrow problem distance around 3 ft , for instance looking at things in the grocery I might have to move closer to read the fine print on labels, but it's not a big deal.

I was told that presbyopia might be a problem as I aged (now 58), but so far so good. Can always go for another correction if needed. i hear that they can now deal with degrees of astigmatism that they couldn't before.

The procedure itself is not bad at all; no reason to fear it. A little scratchy feeling afterward, but you tend to sleep through the night & be ok the next day. It was a neat feeling waking up the day after & looking out the window w/out glasses.
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Re: LASIK for presbyopians?
Old 11-07-2006, 11:22 AM   #5
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Re: LASIK for presbyopians?

Here is a link from the FDA on monovision:

http://www.fda.gov/cdrh/LASIK/risks.htm

From the site:

Since one eye is corrected for distance viewing and the other eye is corrected for near viewing, the two eyes no longer work together. This results in poorer quality vision and a decrease in depth perception. These effects of monovision are most noticeable in low lighting conditions and when performing tasks requiring very sharp vision. Therefore, you may need to wear glasses or contact lenses to fully correct both eyes for distance or near when performing visually demanding tasks, such as driving at night, operating dangerous equipment, or performing occupational tasks requiring very sharp close vision (e.g., reading small print for long periods of time).

Many patients cannot get used to having one eye blurred at all times. Therefore, if you are considering monovision with LASIK, make sure you go through a trial period with contact lenses to see if you can tolerate monovision, before having the surgery performed on your eyes. Find out if you pass your state's driver's license requirements with monovision.

In addition, you should consider how much your presbyopia is expected to increase in the future. Ask your doctor when you should expect the results of your monovision surgery to no longer be enough for you to see near-by objects clearly without the aid of glasses or contacts, or when a second surgery might be required to further correct your near vision.



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Re: LASIK for presbyopians?
Old 11-07-2006, 11:35 AM   #6
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Martha
Here is a link from the FDA on monovision:

http://www.fda.gov/cdrh/LASIK/risks.htm

From the site:

Since one eye is corrected for distance viewing and the other eye is corrected for near viewing, the two eyes no longer work together. This results in poorer quality vision and a decrease in depth perception. These effects of monovision are most noticeable in low lighting conditions and when performing tasks requiring very sharp vision. Therefore, you may need to wear glasses or contact lenses to fully correct both eyes for distance or near when performing visually demanding tasks, such as driving at night, operating dangerous equipment, or performing occupational tasks requiring very sharp close vision (e.g., reading small print for long periods of time).

Many patients cannot get used to having one eye blurred at all times. Therefore, if you are considering monovision with LASIK, make sure you go through a trial period with contact lenses to see if you can tolerate monovision, before having the surgery performed on your eyes. Find out if you pass your state's driver's license requirements with monovision.

In addition, you should consider how much your presbyopia is expected to increase in the future. Ask your doctor when you should expect the results of your monovision surgery to no longer be enough for you to see near-by objects clearly without the aid of glasses or contacts, or when a second surgery might be required to further correct your near vision.



Maybe I'm fooling myself, but I really haven't experienced these problems to a degree to which they hinder me. A good caveat to others, though.
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Re: LASIK for presbyopians?
Old 11-07-2006, 12:53 PM   #7
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Bobot
Maybe I'm fooling myself, but I really haven't experienced these problems to a degree to which they hinder me. A good caveat to others, though.
Can you thread a needle?

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Re: LASIK for presbyopians?
Old 11-07-2006, 12:57 PM   #8
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Re: LASIK for presbyopians?

Local doc specializing in all the lastest eye surgeries has been including something called "restore" No explanation what it is, but it is for "patients over 50 who want to see well at near, medium and far distances" I'm not 50 yet, but I was planning on investigating it as I have astigmatism and presbyopia is starting to be an issue.

Edited to add: Never mind - the RESTOR is a lens used for people with cataracts.

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Re: LASIK for presbyopians?
Old 11-07-2006, 03:06 PM   #9
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Martha
Can you thread a needle?

Yes, but I've always had trouble with that anyway (motor skills, I guess, or no patience). The test for me is reading - no trouble at "normal" reading distance,even with small type.
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Re: LASIK for presbyopians?
Old 11-07-2006, 03:22 PM   #10
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Re: LASIK for presbyopians?

I've been around long enough that no subject on this forum should surprise me, but a religious discussion on eye surgery? Sheesh...!

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Re: LASIK for presbyopians?
Old 11-07-2006, 03:34 PM   #11
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Leonidas
Local doc specializing in all the lastest eye surgeries has been including something called "restore" No explanation what it is, but it is for "patients over 50 who want to see well at near, medium and far distances" I'm not 50 yet, but I was planning on investigating it as I have astigmatism and presbyopia is starting to be an issue.

Edited to add: Never mind - the RESTOR is a lens used for people with cataracts.

I googled around looking at other than Lasik options. ReStor is a lens used for people with cataracts, but it also is used for people who want to correct both near and far vision. One site I read did say it is not for people with "unrealistic expectations." But what is?

Wahoo, are you saying you haven't received the call to worship at the Prebyopian church?
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Re: LASIK for presbyopians?
Old 11-07-2006, 03:46 PM   #12
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Martha
Wahoo, are you saying you haven't received the call to worship at the Prebyopian church?
No, I haven't. You think maybe it could be because we did away with our land line?

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Re: LASIK for presbyopians?
Old 11-07-2006, 05:24 PM   #13
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Martha
Here is a link from the FDA on monovision:

http://www.fda.gov/cdrh/LASIK/risks.htm

From the site:

Since one eye is corrected for distance viewing and the other eye is corrected for near viewing, the two eyes no longer work together. This results in poorer quality vision and a decrease in depth perception. These effects of monovision are most noticeable in low lighting conditions and when performing tasks requiring very sharp vision. Therefore, you may need to wear glasses or contact lenses to fully correct both eyes for distance or near when performing visually demanding tasks, such as driving at night, operating dangerous equipment, or performing occupational tasks requiring very sharp close vision (e.g., reading small print for long periods of time).

I have been wearing a single contact (+2.0) for reading for a couple of years. I definitely notice a slight problem in low light (e.g. movies, driving at night). When I first started using the lens I would take it out to drive at night or at movies. But I have gotten used to it now and don't frequently bother. I also used to take it out when playing golf to make it easier to follow the ball. But the improvement in tracking was not enough to compensate for the lack of reading vision - I can't read squat without the contact or reading glasses. So I just lose a ball now and then. :

As to the lasik surgery, I have thought about it for the convenience but it would really be a bummer to find out that it bothers me at night or at movies. I have also heard that some people end up with generally blurry vision -- I have had no problem with that using the lens. I tried corrective glasses while wearing the lens a few times driving at night (the glasses return the "reading" eye to normal vision). I hated that and would not want to be stuck with corrective glasses. A couple of times at movies when I noticed a problem I just plucked the lens out and threw it away. Problem solved.

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Re: LASIK for presbyopians?
Old 11-07-2006, 05:28 PM   #14
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Re: LASIK for presbyopians?

Near-sighted, presbyopic, astigmatized...

Has anyone else noticed that light is darker than it used to be... :P

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Re: LASIK for presbyopians?
Old 11-07-2006, 07:52 PM   #15
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Re: LASIK for presbyopians?

I has customvue intralase (bladeless custom cornea mapping procedure) 3 months ago and my eyes are doing great. Reading is not a problem. My eyes still get a little dry at night and I do have some starbursts/halos at night due my my extremely large dilated pupils, but otherwise it was money well spent. My vision was -6.5 diopers in both eyes prior to the surgery and now it's very close to 20/20.

Took me many years to finally get up the nerve to get it done. The bladeless, all computer controlled procedure was the clincher for me.
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Re: LASIK for presbyopians?
Old 11-07-2006, 08:53 PM   #16
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Re: LASIK for presbyopians?

Quote:
Originally Posted by HFWR
Near-sighted, presbyopic, astigmatized...
Has anyone else noticed that light is darker than it used to be... :P
I think my problem is coming to terms with the sense of bodily betrayal. I started wearing glasses when I was three years old (amblyopia? esotropia? astigmatism? Dad, why the heck were glasses prescribed for me?) and wore them until I was about 30. At that age I noticed that I was going farsighted enough to read print and still see distant vision so I crowed "Yahoo!" and donated all my glasses to charity.

My euphoria crashed a couple years ago when I noticed that the lights WERE on and the print was still too dim to read.

I use those little thread-the-needle tools all the time now.

Quote:
Originally Posted by Cut-Throat
As far as night vision, there are some 'halo' effects a few months after the procedure, but this goes away totally after 6 months. My vision is 20/20 is sharp as a Hawk after 5 years. Blurry vision would be a rare occurance and would probably happen to someone that was advised not to get it in the first place.
Quote:
Originally Posted by kjpliny
I has customvue intralase (bladeless custom cornea mapping procedure) 3 months ago and my eyes are doing great. Reading is not a problem. My eyes still get a little dry at night and I do have some starbursts/halos at night due my my extremely large dilated pupils, but otherwise it was money well spent. My vision was -6.5 diopers in both eyes prior to the surgery and now it's very close to 20/20.
Took me many years to finally get up the nerve to get it done. The bladeless, all computer controlled procedure was the clincher for me.
I've read that halos come from the pupil dilating past the cornea/lens correction. My FIL has that problem with his cataract lens and he no longer drives at night.

I never thought about monovision meaning that one eye will always be blurry. I'm strongly left-eye dominant and I don't know how that would change if I had monovision surgery. I still have excellent night vision and a high squeamish factor.

I guess that juggling glasses in every room of the house (and the glove compartments of both cars, and in my surfing backpack, and in my pocket, and on my head) is going to continue for a while...
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Re: LASIK for presbyopians?
Old 11-07-2006, 09:25 PM   #17
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Re: LASIK for presbyopians?

I'll tell you a vision story you might find hard to believe. 4 years ago I was fairly myopic, in addition to the presbyopia being discussed here. My correction for myopia was L eye -2.50; R eye -2.00 diopters, with no appreciable astigmatism. With my glasses I could see at distance, but not close. Without my glasses I could read comfortably but couldn’t see at distance. I hated bifocals, so it was on and off with glasses all day long.

I read about some pilots in WW2 who avoided being grounded by wearing + lenses for all close work, and when reading, wearing plus lenses that were a bit too plus - i.e. they caused anti-accommodation.

So I started doing this. I never read without really strong + lenses 2.75 or so. I push the book out until the print is slightly blurry, and that is where I read.

I came back today form my eye exam-- -0.25 L, and -0.25 R. In other words, 20/25. I read the second line from the bottom of the chart, with no correction. I can legally drive without glasses- though this little bit of correction does make it sharper for me at distance, so I use them. But I don't use glasses for anything else- not sports, not dancing, not anything. I sit about 4 feet from my computer screen.

It used to be hard for me at dances- if I didn't wear my contacts, I couldn't see who was across the room; if I did wear them I couldn't see who was dancing with me!

This has been so much more successful than any do it yourself health project that I have ever tried. I recommend it to anyone.

Ha
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Re: LASIK for presbyopians?
Old 11-07-2006, 10:10 PM   #18
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Re: LASIK for presbyopians?

Quote:
Originally Posted by kjpliny
My vision was -6.5 diopers in both eyes . . .
Holy $h!#! How thick were your glasses? How much did they weigh? I thought 4 diopters was bad. Damn! Congratulations on your successful surgery.
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Re: LASIK for presbyopians?
Old 11-07-2006, 11:37 PM   #19
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Re: LASIK for presbyopians?

Quote:
Originally Posted by Leonidas
Local doc specializing in all the lastest eye surgeries has been including something called "restore" No explanation what it is, but it is for "patients over 50 who want to see well at near, medium and far distances" I'm not 50 yet, but I was planning on investigating it as I have astigmatism and presbyopia is starting to be an issue.

Edited to add: Never mind - the RESTOR is a lens used for people with cataracts.


Don't know if someone else wrote about this as I am now reading this thread....

BUT, I went to a very reputable doctor (who teaches at a college and wrote some books on Lasik)... I am NOT a candidate for the procedure as my eyes open up to much in the dark... dang....

But one of the'suggestionsl' was something similar... a different kind of lens... it is used for cataracts, but gives you the ability to focus.... SO, they said I could have the cataract surgury now... called 'clear lens replacement'... can fix you right up to 20 - 20...

NOW, I don't want someone cutting my eye when it does not need it yet... so I declined for now... but if I do get cataracts I will probably do that kind of lens...
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Re: LASIK for presbyopians?
Old 11-08-2006, 05:12 AM   #20
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Re: LASIK for presbyopians?

Quote:
Originally Posted by kjpliny
6.5 diopers in both eyes prior to the surgery and now it's very close to 20/20.

Who threw them (diopers) at you? I think you could sue and recover the cost of the surgery. Johnnie Cochran is gone but Jackie Chiles is still
available.

JG
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