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Monovision for Presbyopia

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Light rays enter the eye through the clear cornea, pupil and lens. ... Phakic Intraocular Lenses (IOLs) Refractive Lens Exchange (RLE) ... – PowerPoint PPT presentation

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Title: Monovision for Presbyopia


1
Monovision for Presbyopia
Insert name/ Practice name/ Logo here if desired
2
How the eye works
  • Light rays enter the eye through the clear
    cornea, pupil and lens.
  • These light rays are focused directly onto the
    retina, the light-sensitive tissue lining the
    back of the eye.
  • The retina converts light rays into impulses,
    sent through the optic nerve to your brain, where
    they are recognized as images.
  • 70 of the eye's focusing power comes from the
    cornea and 30 from the lens.

3
Refractive errors
  • Inability to see clearly is often caused by
    refractive error.
  • Four types of refractive error
  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Astigmatism
  • Presbyopia

4
Refractive errors myopia
  • The distance between the cornea and the retina
    may be too long or the power of the cornea and
    the lens may be too strong.
  • Light rays focus in front of the retina instead
    of on it.
  • Close objects will look clear, but distant
    objects will appear blurred.

Myopia, or nearsightedness
5
Refractive errors hyperopia
  • In hyperopia (farsightedness), there is too
    little optical power.
  • The distance between the cornea and the retina
    may be too short.
  • Light rays are focused behind the retina instead
    of on it.
  • In adults (but not children), distant objects
    will look clear, but close objects will appear
    blurred.

Hyperopia, or farsightedness
6
Refractive errors astigmatism
  • In astigmatism, the cornea is curved
    unevenlyshaped more like a football than a
    basketball.
  • Light passing through the uneven cornea is
    focused in two or more locations.
  • Distant and close objects may appear blurry.

Astigmatism occurs when light passes through
uneven cornea
7
Refractive errors presbyopia
  • Presbyopia is a normal condition in which your
    eyes gradually lose the ability to focus things
    up close.
  • When we are young, the lens in our eyes is
    flexible and is able to change focus easily
    between near and far objects, like an autofocus
    on a camera.
  • At around age 40, this flexibility naturally
    begins to gradually decrease, making it more
    difficult to see objects up close.

8
Non-surgical correction of presbyopia
  • Presbyopia is often corrected with reading
    glasses, bifocals or contact lenses.
  • People within the presbyopic age who have good
    vision at distance usually use reading glasses
    for close-up vision and remove them to see
    far-away objects.

9
What is refractive surgery?
  • A group of outpatient surgical procedures used to
    alter how your eye focuses light rays on the
    retina, thereby improving vision and reducing
    dependence on glasses and contact lenses.
  • In most cases, refractive surgery affects the
    shape of your cornea to redirect how light is
    focused onto the retina. Popular procedures
    include LASIK, LASEK, PRK and CK.

Refractive surgery procedure on the cornea
10
What is refractive surgery?
  • Most refractive surgery is performed on the
    cornea and affects only the front of your eye,
    while the rest of your eye will change naturally
    as you age.
  • In some cases, refractive surgery procedures
    dont reshape the cornea instead, the eyes
    natural lens is either replaced or enhanced by an
    implantable lens that helps correct vision.

11
Monovision for presbyopia surgery
  • Adjusting each eye for different focusing
    distances can reduce or eliminate the need for
    glasses or contacts.
  • Monovision, sometimes known as blended vision,
    allows for different focusing distances in each
    eye separately.

12
Monovision for presbyopia surgery
With monovision, one eye is corrected
surgically to allow clear distance vision
13
Monovision for presbyopia surgery
while the other eye is either not treated, or
is partially treated, to allow clear vision close
up.
14
Monovision for presbyopia surgery
  • Monovision for presbyopia yields clear vision,
    one eye for distance and one eye for near.

15
Types of surgery
  • Monovision can be achieved through these types of
    surgery
  • Laser In Situ Keratomileusis (LASIK)
  • Epithelial Laser In Situ Keratomileusis
    (Epi-LASIK)
  • Photorefractive Keratectomy (PRK)
  • Laser Epithelial Keratomileusis (LASEK)
  • Conductive Keratoplasty (CK)
  • Phakic Intraocular Lenses (IOLs)
  • Refractive Lens Exchange (RLE)
  • Intrastromal Corneal Ring Segments (INTACS)

16
Monovision for presbyopia surgery
  • While the brain does get used to seeing with
    monovision, it can take up to six to eight weeks
    for your eyes to adjust.
  • It may be useful to try monovision with contact
    lenses before having the monovision surgical
    procedure, as some patients may not be good
    candidates for the surgery.

17
Considerations for monovision for presbyopia
surgery
  • Reduce or eliminate the need for both reading and
    driving glasses.

18
Considerations against monovision for presbyopia
surgery
  • May not be recommended for people needing to see
    better than average and binocularly for certain
    activities at either distance or near (like
    pilots).
  • May not be recommended for people requiring rapid
    improvement in vision, as it may take up to two
    months for your eyes to adjust to monovision.
  • Night driving vision may be more difficult since
    there can be reduced depth perception.

19
To be a candidate for monovision surgery, you
should
  • Be over over 40 years of age.
  • Have an appropriate, stable refractive error
    within a correctable range.
  • Be free from eye disease.
  • Understand and accept risks, limitations and side
    effects of the procedure.

20
Risks and possible side effects of monovision for
presbyopia surgery
  • Infection.
  • Over-correction or under-correction (with a
    possible need for a re-treatment).
  • Visual aberrations, such as seeing halos around
    lights at night.
  • Lack of depth perception.
  • Inability to adapt to the monovision state,
    possibly requiring a re-treatment.

21
Is refractive surgery right for you?
  • Advanced surgical procedures, including
    monovision for presbyopia, are creating more
    opportunities for people who want to be less
    dependent on glasses or contacts.
  • Surgery may not entirely eliminate your need for
    corrective lenses. Glasses/contacts may still be
    needed for activities such as fine or detailed
    work, reading and perhaps night driving.
  • If an accommodating or multifocal IOL is used,
    then reading as well as distance vision may be
    improved.

22
Is refractive surgery right for you?
  • A large part of the success of any refractive
    surgery depends on your understanding of the
    procedure and your expectations.
  • Since refractive surgery is an elective
    procedure, you have the opportunity and
    responsibility to become fully informed about its
    risks and benefits.
  • Your ophthalmologist will explain the specific
    technique, its benefits, as well as possible
    risks and side effects associated with your case.

23
Discuss options and questions with your
ophthalmologist
  • With the help of your ophthalmologist, its
    ultimately your responsibility to weigh the risks
    and side effects of a procedure with the benefits
    it has to offer.
  • If you decide refractive surgery is right for
    you, you may join millions of people who have
    reduced their dependence on glasses or contacts.
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