Can't read the fine print? Find a solution that's right for you.

Ahhh . . . a special night out, an evening on the town with a loved one at a hot, new restaurant. You've heard all about this place and can't wait to eat. With much anticipation, you open the menu. You look up and down each blurry page and proceed to discreetly inch it further and further from your face until your arms are completely extended. Hmmmm . . . if only your arms were two to three inches longer. You search for your drugstore readers that you now recall are on your bedroom nightstand. Drat. Feeling defeated you turn to the waiter with a sigh and ask, "Well, what would you recommend?" Happened to you? Well, it happens a lot.  

From age 40 onward our eyes' lenses gradually lose the ability to focus on close-up objects, a condition called presbyopia. By our 50s or 60s, almost everyone experiences blurry near vision, although distance vision often remains good. More than 60 million people in the United States are presbyopic, as are more than 400 million worldwide. It turns out that while presbyopia is inevitable, blurry vision is not.

Reading glasses are one solution, but for those who want to be glasses-free, two contact lens options include monovision and multifocal lenses.

Monovision contacts correct one eye for distance vision and the other eye for close-up vision. Because you need to train your brain to use one eye for distance and the other eye for near vision, it usually takes some time to adjust to monovision. Some depth perception may also be lost and not all people can tolerate monovision.

There are many different types of multifocal contacts available. Multifocal contacts have different focus zones within each lens, allowing for both near and distance vision. These different focus zones may cause vision to be less sharp when compared to a monofocal lens. However, with this loss in sharpness comes the ability to be able to see at both near and distance. Most people can adjust to multifocal lenses, but they do not work for everyone.

Also available is a form of LASIK that improves near vision in one eye, called monovision LASIK, and intraocular lenses (IOLs), typically used in cataract surgery, that replace the eyes' natural lenses. In monovision LASIK, one eye is corrected for near vision and the other for far vision. This procedure isn't ideal for every patient. You may wish to consider trying monovision with contact lenses before surgery to determine your ability to adapt to this correction. Soon after the surgery, the patient's brain learns to select the clear image and disregard the blurry one transmitted from each eye, thus improving vision at all distances.

Several types of "premium" IOLs are available, and with their doctors' advice, people can select the type that best suits their lifestyle and vision needs.

More glasses-free options are coming to the US soon. All of them improve near vision while maintaining distance vision. Although none have FDA approval yet, all are in clinical trials in the US or Europe, and some are already in use in Europe, South America, and Asia. The new options include:  

Corneal Lenses. An extremely thin lens is inserted into the cornea (the clear outer structure) of the patient's non-dominant eye through a tiny pocket made with a highly precise laser. The person's specific vision-correcting prescription is built into the lens.

Corneal Inlays. A corneal inlay is used to block the peripheral light coming into the eye while central rays are unaffected. This enables near vision to be sharper and clearer.  

Reshaping the Cornea. In this method, the ophthalmologist applies laser pulses just under the surface of the cornea. Unlike LASIK, no tissue is removed; instead, the pulses cause a biomechanical change in the cornea that shifts its center slightly forward.

As with all surgery, it's important that people discuss risks and benefits with their doctors and be certain that a procedure is right for them before going forward.

So, what's the take away? Solutions are available for those who are annoyed and inconvenienced by presbyopia. The procedures described here all seem less drastic than that arm extension surgery that you were contemplating.

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