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|Source:||New York Times Digital|
EVERYTHING seems to stiffen up as people age, and our eyes are no exception. As the years go by, the lens of the eye becomes harder and less elastic. The result is a gradual worsening of the ability to focus on objects up close, called presbyopia.
There’s no escaping it. Diet and exercise, the baby boomers’ weapons of choice for warding off age-related health problems, have no effect. Presbyopia generally starts in the mid-40s, when people begin to notice that they have difficulty punching out a number on their mobile phone or reading a book. Over the next 20 years or so, the eyes continue to lose their ability to zoom in on things; by about age 65, it’s often impossible.
”It’s like having a camera with no multifocal option,” said Dr.
About four years ago,
She knew right away what her problem was. ”I was in denial,” she said.
Until then, Ms. Dallas generally wore regular contact lenses to correct her severe myopia, or nearsightedness. She knew that she did not want to switch to glasses with bifocal lenses. Once, during a Jazzercise class, her glasses had flown off and she could not find them without her classmates’ help. She needed an option that would stay put.
Her optometrist suggested multifocal contact lenses, which correct for both distance and near vision problems. Ms. Dallas tried them, and loved them. They’re more expensive than regular contacts or bifocal glasses because she has to replace them every two weeks at an out-of-pocket cost of about
But it’s worth it. ”They’re really comfortable, and I’m sold on them,” she said.
Like many people, when Ms. Dallas first noticed she was having trouble reading she tried to compensate by shining a brighter light on the page. Others try holding reading material at arm’s length. But at some point, even the longest-armed person can no longer read the fine print on a menu.
That’s when it is time to find some help. Both optometrists and ophthalmologists can perform eye exams and prescribe eyeglasses and contact lenses. Ophthalmologists are medical doctors who can also perform eye surgery, like Lasik, to correct refractive errors.
Here’s some advice on what to ask them about, and how to pay for it.
A VISION PLAN Many employers offer or provide vision insurance for their employees, but it can also be purchased as a stand-alone product. At Vision Service Plan, a large vision insurer, individual coverage costs between
A typical plan covers a comprehensive annual eye exam and provides a certain amount, often a few hundred dollars, toward the purchase of contact lenses or glasses. Like health insurance, prices may be cheaper if members use a practitioner in the insurer’s network.
For many types of corrective lenses, however, vision insurance coverage is inadequate, experts agree. The biggest advantage may be that the coverage encourages baby boomers to get annual eye exams, which can catch vision problems at an early stage.
Glaucoma, for example, damages the optic nerve and is the leading cause of irreversible blindness, yet half of people with glaucoma don’t know it, said Dr.
GLASSES The easiest and cheapest solution for presbyopia is to go to your local drug or discount store and buy a pair of
But for many patients, one-size-fits-all reading glasses cause eye fatigue, said Dr. Martinez. If that is the case, prescription glasses or contacts may be best.
The least expensive prescription option is bifocal or trifocal glasses with a visible line separating the top portion of the lens, which corrects for distance if necessary, from the bottom portion, which corrects for presbyopia. On trifocals, there is a middle section that corrects for intermediate distances. These lenses can be bought for under
Progressive eyeglass lenses — in which the lens power gradually increases from the top of the lens to the bottom — eliminate the unsightly focal lines and avoid the image jump that can occur with traditional lenses. The downside is that progressive lenses often are significantly more expensive than bifocals or trifocals, sometimes
CONTACT LENSES Bifocal and multifocal contact lenses have two or more prescriptions in the same lens, similar to eyeglasses. They come in a range of hard and soft materials with various disposable options.
In the past, some doctors told patients with presbyopia that they were not good candidates for multifocal lenses. Although fitting presbyopic patients with multifocal contacts is more complicated than fitting people without it, it’s a good option for many, said
Expect to pay a fitting fee of up to
Some patients do well with a different therapeutic approach called monovision. Rather than correcting both eyes for both distance and near vision problems, monovision corrects one eye for distance vision and one eye for near vision. ”Your brain learns to ignore the image that’s not in focus,” said Dr.
This can be accomplished with contact lenses or through Lasik surgery, which reshapes the cornea. If someone is considering an irreversible process like Lasik, however, it’s important to test monovision first with contact lenses, say experts. And insurance generally does not cover Lasik surgery, which typically costs up to
Research shows that about 70 percent of patients tolerate monovision, said
LENS REPLACEMENT As the eye ages, the lens may develop cataracts, or cloudiness. Eye surgeons correct the problem by replacing the lens. Now some of these intraocular lenses can also correct for presbyopia.
But be warned: health insurance will generally cover cataract surgery, but if you opt for one of the new lenses that correct presbyopia rather the standard single-focus lens, you’ll have to pay the difference — up to
Some ophthalmologists are now replacing people’s healthy lenses with presbyopia-correcting lenses. Because it is not medically necessary, insurance won’t cover the
And some doctors are wary of the practice. ”To correct just for presbyopia, I myself wouldn’t do that,” said Dr. Bishop. ”I don’t believe the risks are outweighed by the benefits.”