Presbyopia Treatment in Singapore
What is Presbyopia?
Presbyopia is a natural part of aging, typically starting in our 40s due to the gradual stiffening of the lens in the eye, resulting in decreased ability to focus on close objects. This condition progresses until around 60 years of age, with initial symptoms often involving difficulty reading fine print or needing brighter lighting. As it advances, reading aids or surgical options may be required.
Types of Presbyopia
Understanding the different types can help identify when treatment is necessary:
- Incipient Presbyopia: Early signs, such as subtle difficulty with small text.
- Nocturnal Presbyopia: Challenges in low-light conditions.
- Premature Presbyopia: Occurs before age 40, influenced by health factors.
- Functional Presbyopia: Daily tasks become increasingly difficult.
- Absolute Presbyopia: Complete inability to focus on near objects, requiring immediate correction.
Symptoms of Presbyopia
Common symptoms include:
- Difficulty reading fine print, especially in dim light
- Eye strain during close work
- Holding reading material farther away
- Frequent headaches after reading
- Double vision when focusing on nearby objects
These symptoms generally emerge around age 40 but can develop earlier due to conditions like diabetes or high blood pressure. Timely treatment can help prevent worsening symptoms. If you are experiencing any symptoms of presbyopia, schedule an eye examination at our EyeWise Vision Clinic in Singapore today.
Diagnosis of Presbyopia
Diagnosis involves a series of tests:
- Initial Consultation: Discussing your vision issues.
- Medical History Review: Evaluating your overall health and any medications.
- Visual Acuity Test: Assessing your ability to see at different distances.
- Refraction Assessment: Determining the prescription needed for clear vision.
- Slit-Lamp Examination: Checking the health of the eye structures.
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Treatment Options for Presbyopia
Several treatment options are available for presbyopia, and the most suitable option for each individual may vary depending on factors such as age, health, and lifestyle. Some common treatment options include:
1. Bifocal Spectacles
Bifocal spectacles are a widely used option for presbyopia correction. These glasses feature two distinct optical zones: the upper part is for distance vision, and the lower is for near vision. This dual functionality lets you switch focus between distant and close-up objects without changing glasses.While some individuals with myopia might find relief by simply removing their glasses for close-up tasks, bifocal spectacles offer a more versatile solution. They are useful for those with both presbyopia and other refractive errors like myopia or hyperopia.2. Bifocal and Multifocal Contact Lenses
Alternative nonsurgical methods involve bifocal or multifocal contact lenses, and contact lenses worn for an optical approach called “monovision”. Essentially, this calls for full optical presbyopia correction with a contact lens in the master eye, with slight under-correction in the other eye, leaving a low amount of myopia or short-sightedness. This low amount of myopia allows clear near vision.3. Implantation of Multifocal Lenses
Cataract surgery is often recommended for presbyopia correction, particularly when cataracts are already present. During this procedure, the clouded lens is replaced with a multifocal lens, which provides clear vision at various distances—distance, intermediate, and near. This approach helps prevent the progression of presbyopia by addressing it directly through the lens implant.- Presence of Cataracts: If cataracts are affecting your vision, cataract surgery with the implantation of multifocal lenses is an effective option. These lenses can restore your vision to what it was in your 30s, reducing or eliminating the need for glasses.
- Dry Eyes or Contact Lens Issues: If you experience dry eyes or other issues that make contact lenses unsuitable and you wish to avoid glasses, multifocal lens implantation can be a suitable alternative.
Presbyopia Surgery: Preparation, Recovery & Risks
Pre-Presbyopia Surgery PreparationBefore undergoing eye surgery for presbyopia, it is essential to consult with your ophthalmologist for a comprehensive eye exam to evaluate your suitability for the procedure. Your eye doctor may recommend stopping contact lens use a week prior to the evaluation to ensure your cornea’s shape is in its natural state. Additionally, blood tests and other medical evaluations may be required to confirm that you are fit for surgery.Post-Presbyopia Surgery Guidelines and RecoveryAfter presbyopia correction surgery, your eye doctor will prescribe specific eye drops, including antibiotics and anti-inflammatories, to prevent infection and manage swelling. It is crucial to follow your medication schedule and make lifestyle adjustments, such as avoiding strenuous activities and reducing screen time, to support the healing process.Regular follow-up appointments are vital to monitor recovery and address any complications early. Having someone assist you during the initial recovery phase is also recommended as your vision stabilizes.Possible Risks and Side Effects of Presbyopia Surgery- Dry Eyes: A common but usually temporary side effect, dry eyes can cause discomfort and may require lubricating eye drops for relief.
- Glare and Halos: Increased sensitivity to light may lead to glare or halos around light sources, especially in low-light conditions.
- Infection: Although rare, post-operative infections are a serious concern that requires prompt medical attention to prevent further complications.
- Corneal Haze: Temporary cloudiness in the cornea can affect vision quality but usually resolves on its own. Persistent cases may need treatment.
- Epithelial Ingrowth: This occurs when corneal epithelial cells grow under the flap created during surgery and may require additional surgical intervention.
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About Dr Christopher Khng
Dr. Christopher Khng specialises in Complex Cataract and Anterior Segment Reconstruction Surgery, particularly Iris Reconstruction and Surgery for Aniridia. His other areas of expertise include Complex Lens surgery, New Lens and Phacoemulsification technologies, Refractive surgery, Phakic IOLs (the Implantable Collamer Lens, ICL), and small-incision, topical anaesthesia phacoemulsification cataract surgery.
He completed his first two years of medical undergraduate studies at Aberdeen University, Scotland (UK). Because of cost, he completed his medical degree of MBBS at the National University of Singapore (NUS).
Dr. Khng served as Registrar, then Associate Consultant Ophthalmic Surgeon at the Singapore National Eye Centre (SNEC). Following his stint in SNEC, Dr. Khng was a Consultant at The Eye Institute, Tan Tock Seng Hospital, Singapore.
Dr. Khng’s interest in correcting Presbyopia employs a multi-faceted approach, including progressive lens implant technologies and surgical methods like corneal inlays and monovision strategies. By conducting thorough pre-operative assessments, he provides treatment plans to match each patient’s visual requirements and lifestyle needs. His approach aims to help near vision and reduce the reliance on reading glasses, offering a more functional range of vision for daily activities.
Dr Christopher Khng
MBBS, M.Med(Ophth), FRCS(Edin), AMS(Ophth 2003) Consultant Ophthalmologist