Eye Health

By Dr S.S. Gill

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about NEAR VISION PROBLEMS.

Presbyopia is a gradual loss of eye accommodation. The remarkable ability of the eye to accommodate allows the eyes to view objects at different distances. When our eyes lose the ability of the eye to see objects at near distances, it is called presbyopia. This slow deterioration in accommodation occurs gradually starting usually from the age of 40 years. It may start at an earlier age in some people or later in some others. Metabolic diseases like diabetes mellitus may accelerate presbyopia to start earlier.


The inability to read near print is the first to occur which means one will have difficulty in reading the newspapers, books or magazines. When it first starts, most people unknowingly hold the reading material at arm’s length in comparison to the usual 14-16 cms. Those who thread needles often notice the onset of presbyopia early for obvious reasons.


The commonest correction is a pair of readers or near reading glasses. It is not uncommon for people to purchase the readers at a pharmacy or a store without a prescription. This is fine in most cases. If you are short-sighted to start with, and if you do not mind having to remove your short-sighted correcting spectacles to read near print, that is fine too. However, if you do not fancy the hassle of having to keep removing your short-sighted correcting spectacles to read near print, then you would need to get bifocals or multifocal spectacles.

Short-sighted individuals comfortable with contact lenses may consider multifocal contact lenses. There is also the option of Monovision correction where only one is given a prescription for distance and the other eye under-corrected so that it is used for near reading. The preference is usually personal. While some individuals adapt to this well, others are unable to tolerate it.

Surgical options include a procedure called Conductive Keratoplasty which uses radio waves to treat the cornea. Here again, the procedure is only on one eye. However, the procedure often compromises distant vision. Presbylasik using the excimer laser is the other option to create a multifocal surface on the cornea, but this has limitations and has not been perfected fully. LASIK is the other option but again here, the option is to create monovision. One eye is corrected fully for distance while the other eye is under-corrected to allow for near vision reading. Cataract patients undergoing eye surgery can opt for either multifocal intraocular lenses or opt for the same principle as a monovision correction where one intraocular lens implant is corrected for distance and the other under-corrected for near reading.

Under-correction in all of the above descriptions, mean that distance vision is partly compromised to allow for the eye to see near clearly. The visual expectations and requirements vary from individual to individual and so whatever decisions taken to get your presbyopia treated are personal.

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