In the past, people fitted with glasses simply switched to bi-focals to correct reading and distance vision. These days, those who opt for glasses also have the choice of a graduated or progressive lens, which gives them both. (Doug Wells/Associated Press)
In Depth
Health
Eye care
Now you see it
Last Updated July 13, 2007
By Georgie Binks, CBC News
About a month ago, the Toronto Star newspaper increased the point size of its font from 9.9 to 10.25, coming not a minute too soon for the baby boomers, many of whom are finding it challenging to read tiny (and even normal-sized) print these days.
Take Nancy Collier, 43, from Murray Harbour North, P.E.I., who grapples daily with the tiny print on spice bottles.
"Less than a year ago, my doctor said my next prescription would be graduated glasses. I'm wishing she gave me them this time," she complained. "I'm really having a hard time reading the fine print in the grocery store."
Collier, and just about anyone in their mid-40s, is grappling with presbyopia or loss of reading vision.
North Vancouver optometrist Dr. Katherine McKay explained, "Forty-plus is typically when patients start to complain their arms are too short, the print is getting smaller — but they think there's nothing wrong with their vision."
What's happening, explained Toronto optometrist Dr. Upen Kawale, is that the eye is aging.
Some people suffering from presbyopia opt for eye surgery. (Charles Rex Arbogast/Associated Press)
"There's an auto focus mechanism inside the eye, which is the crystalline lens and a muscle system that allows us to focus on things up close. This lens hardens between the ages of 39 and 45. It creates a functional problem — you need to see far but you need to read."
In the past, people fitted with glasses simply switched to bi-focals to correct reading and distance vision. These days, those who opt for glasses also have the choice of a graduated or progressive lens, which gives them both.
However, many baby boomers who have worn contact lenses successfully want to have their cake and see it too — but not through spectacles.
"The baby boom [generation] is more demanding in this area," Toronto ophthalmologist Dr. Sheldon Herzig says.
"Our lives have been better than our parents, we've had all these conveniences and we're not as accepting of age as our parents were. So doctors need to go a little further to find solutions through surgery or contact lenses."
Looking over the options
There are three basic options for those who don't want to wear glasses — a combination of contact lenses and reading glasses, multifocal contact lenses or surgery to correct both near and far sightedness.
Some doctors such as Kawale prefer to use a mix of contact lenses and glasses.
"Most people have three prescriptions [for eyeglasses] after the age of 50. You might be corrected for distance, wear glasses for the computer and another pair, slightly stronger, for reading."
Dr. Upen Kawale, optometrist
However, if you opt solely for contact lenses, there's a multi-focal option in a soft contact lens, as well as a bifocal or multifocal/progressive in a gas permeable (also known as hard) lens. McKay says the success rate with progressives and bifocal contact lenses is now 80 per cent.
Some contact lens patients are fitted with monovision, with one contact lens for distance, the other for reading. Success with monovision depends on the brain's ability to adapt to different distances. It's not effective for people who rely on their depth perception like runners. As well, it often means a compromise in terms of the quality of the image patients see.
The third option is surgery. For some time now laser surgery has been used to correct nearsightedness. However, many people whose distance vision was corrected in both eyes by laser surgery when they were younger are having the same problems as everyone else reading tiny print.
Herzig explains: "You shrink the collagen in the eye and make the cornea steeper using radio frequency energy. The procedure is known as NearVision CK."
However, it's only a temporary solution, because presbyopia is a progressive condition. The surgery can be performed up to three times on patients with results lasting one to three years.
Another procedure, refractive lens exchange, alters the focusing power of the eye by removing the eye's natural lens and replacing it with a better lens, which acts as a permanent one inside the eye and provides both distance and reading vision.
A third, less invasive procedure, involves inserting an implantable contact lens in the eye. The lens rests on the front of the eye's natural lens, just behind the iris. It's meant to be permanent, but can be removed. It's usually a procedure performed on patients with extremely poor vision and can address presbyopia.
Sometimes it takes a bit of experimenting to figure out which solution is the best for you.
As Herzig says, "It's a matter of choosing the right procedure for the right patient."
The good news is that eventually people's eyes do stop changing.
"The difference between the distance prescription and the reading prescription usually stabilizes at the age of 60," says McKay.
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