As we age, the eye goes through some predictable changes. Not accounting for ocular disease, which may affect a percentage of those over 40 years of age, there are expected age related changes to the eye that cause refractive error. The most common is presbyopia, a loss of the flexibility and accommodative power of the crystalline lens of the eye. This is what allows us to focus up close and relaxes when we want to see distance objects. Between 40 to 45 years old most patients’ crystalline lenses becomes rigid enough where it will no longer flex and give them good near vision without some form of refractive help. Most people utilize spectacle correction to help with reading and intermediate or computer work.


Many people don’t realize there are a multitude of contact lens options which will help alleviate the need for reading glasses. One solution involves under correcting the non-dominant eye, thus giving some nearsightedness for the patient to be able to see near and distance at the same time. This is referred to as mono-vision and has some drawbacks. These include reduced depth perception and lack of binocular vision, which can affect certain activities such as night driving and 3-D movies. Other contact lenses employee multifocality in the lens design which gives simultaneous distance and near focus. The brain is able to select the clear image for the desired task. This allows more binocular already and less side effects compared to mono-vision. Although it is often difficult to get a good fit and may take many contact lens follow-ups and different trials for the right multifocal brand and performance.


There have been some significant advancements in surgical correction for this problem as well. We are able to utilize laser refractive surgery to employee mono-vision just like in contact lenses, but this has the same type of drawbacks. A much more effective surgical procedure involves replacing the natural crystalline lens with a multifocal intraocular lens implant which will allow the patient to see distance and near in both eyes similar to multifocal contact lenses. Lens implants often give better results with better patient toleration. This also alleviates the future need of cataract surgery, as it replaces the lens which will no longer be able to become opacified with age. Newer surgical advancements look to create near vision by inserting devices into the eye which will create near focus and several have just been approved by the FDA. There still much more time needing to evaluate the long-term effects and success of these devices. Future surgical options are likely to involve restoring the lens flexibility or replacing it with a lens that has more natural focusing ability like our lens has prior to the onset of presbyopia.


At South Beach Vision we are experts in correction of age related eye changes and ocular disease. Schedule a consultation today during your comprehensive eye exam and we will be able to find the best solution for your specific needs. We are the go to eye doctors and optical dispensary of Miami Beach.  We cater to all of your visual and spectacle needs and carry a vast array of contact lenses, eyeglasses and sunglasses. Call us today and make an appointment with our optometrist.

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