Tue, Jul 20, 2010
The Star/Asia News Network
These old, blurry eyes
Dr Aloysius Joseph Low
THEY say 40 is the new 30! But your eyes may give you away. Having
been in the eye healthcare industry for over 20 years, I've heard
all sorts of stories, both funny and not so funny, from patients
hitting 40 and above.
And if you're around 40 and reading this, you've probably gone
through the same situation: went shopping and thought you found a
great deal for a RM100 (S$43) branded shirt, only to find out it's
RM700 when you took it to the cashier.
Perhaps you got all dressed up to take your client for lunch at
a posh restaurant, only to whip out a pair of "oldie" reading
glasses to read the menu and check the bill at the end of the meal.
Despite the smart cut of your yuppie power suit and new trendy
shoes, you suddenly feel old because of your not-so-perfect reading
vision.
Who says 40 is the new 30?
However, this is nothing to fret about. It is a natural
progression in life. The majority of people in their 40s begin to
experience deteriorating quality of their reading vision. This is
known as presbyopia, or in regular lingo, rabun dekat and lou
fa.
For many, reading is no longer a pleasure and worse still,
modern technology has increased the need to read on-the-go, from
handheld objects such as handphones to the latest iPad.
What is presbyopia?
Presbyopia is when our eye's natural lens and muscles become too
stiff to focus on near objects, due to age. Distance vision is
still clear, but objects up close are blurry.
All these can occur:
So, if it's just a sign of ageing, what's the big
deal?
The World Health Organization Vision 2020 Global Initiative for
the Elimination of Avoidable Blindness views presbyopia as a large,
unmet need, and acknowledges that presbyopia has not been
sufficiently addressed as a public health issue.
If you are reading this with reading glasses or multi-focal
glasses, you are one of over a billion people in the world who have
presbyopia.
Although a high rate of shortsightedness (myopia) in the Asian
region enables many people with presbyopia to have functional near
vision, the global prevalence of presbyopia is predicted to
increase to 1.4 billion by the year 2020.
What causes presbyopia?
Presbyopia is a result of lessening elasticity in the lens, and
the loss of flexibilty and strength in the muscle that controls the
shape of the lens. Thus, distance vision is not usually affected,
but the eye has difficulty focusing on close objects.
There are some uncommon cases of people developing presbyopia in
their 30s. This usually happens to those with high hyperopia,
otherwise known as longsightedness.
Advanced technology - from blur to clear
When I had my LASIK procedure for shortsightedness done in my
40s, I knew that it would be a matter of time before my near vision
would no longer be as clear as before. The common procedure up to
the mid-2000s for presbyopic patients with shortsightedness was to
deliberately under-correct one eye for them to see near objects,
even at the slight expense of their distance vision.
Fortunately for us, there is now a solution available in
Malaysia that can improve your reading vision for a lifetime,
without compromising on your distance vision.
This is a recent innovative medical device from the US, the
AcuFocus KAMRAO inlay, a corneal inlay that restores natural
reading vision for presbyopia sufferers. It is a micro-thin inlay
in the shape of a "micro-disc" with an opening in the centre, much
like a tiny black Polo mint.
The corneal inlay restores near and intermediate vision while
maintaining distance vision via a "pinhole effect" that focuses
light entering into the eye and blocks unfocused light from
reaching the retina.
Lighter than a grain of salt and precision-embedded in the
cornea, the inlay is barely visible to the naked eye, and patients
will not feel it at all.
The procedure will not affect the patient's suitability for
further vision correction procedures such as cataract surgery, and
what's more, does not involve any tissue removal.
For shortsighted patients, LASIK is first performed on both eyes
to improve distance vision, and then the corneal inlay is placed in
one eye to improve near vision.
Involving just a 15-20 minute procedure, a presbyopic patient's
near vision is thus restored:
1. A flap is created in one (non-dominant) eye with the same
laser used in LASIK surgeries.
2. The corneal inlay is then placed onto the eye's cornea layer
and centered directly over the pupil.
3. The flap is then repositioned and the cornea seals itself
naturally.
4. Post-procedure, the patient rests for a short while before
leaving the eye centre.
5. The patient is provided with medicated eyedrops and natural
tears to use at regular intervals.
Safety profile of corneal inlay
The corneal inlay has been implanted in more than a thousand
patients during a worldwide clinical trial, which included many
countries such as Europe, Japan, UK, US, Australia, New Zealand,
Singapore, and the Philippines (during the last seven years). The
AcuFocus KAMRAO corneal inlay obtained the CE Mark in 2005, a
mandatory mark which certifies that a product has met the European
Union consumer safety, health or environmental requirements.
A study published in the Journal of Refractive Surgery (April
2010) concluded that the corneal inlay has the potential for
offering a safe and effective treatment for presbyopia. The study
shows that corneal inlay has significant improvement in patients'
reading vision.
Available in Singapore since March 2008, the corneal inlay is
also now available in Malaysia.
The first batch of Malaysian patients who received their corneal
inlay in May this year reported a noticeable difference in their
near vision within the same day itself. Within days, the majority
of patients were able to read moderate to small-sized print
unaided, such as text on their mobile phones.
An associate in the eye healthcare industry, US-based Dr Jim
Socks, led a highly active lifestyle, until the time came when his
deteriorating near vision meant that he could no longer enjoy
sports such as scuba-diving. With the corneal inlay, he says he can
now admire the beauty of underwater vistas like he used to.
Quoting Dr Socks: "The advantage is that it assists presbyopia
sufferers in regaining their active lifestyles without sacrificing
intermediate and distance vision.
"The groundbreaking concept behind it is incredibly simple, and
the procedure itself is quite straightforward."
Over the years, I have received so many patient requests for
something that can restore their reading vision for a lifetime. If
you're one of those who can pull off that sophisticated,
bespectacled look, count yourself fortunate. But, if like many of
my patients, you find your style and freedom cramped by those
reading glasses, the corneal inlay may very well be the solution
that you have been waiting for.
Choosing the right eye doctor
Our eyes are the windows to our soul, but many of us do not
truly value them until our regular vision is compromised.
As many eye conditions do not show obvious symptoms in the early
stages, an ophthalmologist would be the best person to go to as
they are likely to have the latest and most advanced technology
available to examine your eyes and recommend timely treatment.
When choosing which eye specialist to go to, there are a variety
of factors to take into account:
Word of mouth: Have you been recommended
any particular centre or eye specialist by family and friends? You
might feel more comfortable being attended to by people who have
treated someone you know.
Authenticity of information: If you are
doing your own research on the internet, please make sure that your
sources of information are genuine, professional websites, and that
the information is backed up by comprehensive medical research and
accreditated by medical bodies.
Safety procedures: When visiting your eye
doctor, ask for an explanation of the safety procedures in place,
and the standards adhered to when undergoing procedures, such as
the cleanliness of the operating environment, sterilisation of
equipment, and the hygiene of the surgical kit. Is there a 24-hour
emergency line you can call for post-surgery needs?
Commitment to patients: Do find out if
your eye doctor offers any commitment programmes towards achieving
set service outcomes, for example, no additional charge for
enhancement of previous LASIK procedure.
Location: Your pupils will be dilated for
comprehensive eye check-ups and surgeries, and driving is not
recommended for several hours. Make sure that you have accessible
transport to return home after your visit to the eye doctor.
Convenience of payment: Does your eye
centre provide you with easy, no-frills, transparent, and
convenient methods of payment?
Your gut feeling: Our eyes are the windows
to our world. When visiting an eye healthcare centre, your safety
and comfort is always first priority. If at any time you feel
uncomfortable with the place or the people, consider going to a
different eye centre or seeing a different eye specialist.
Dr Aloysius Joseph Low is a refractive and cataract surgeon
with over 20 years' experience in the eye healthcare industry. He
represents Malaysia at the International Society of Refractive
Surgery, and is a member of the American Society of Cataract and
Refractive Surgery. For more information on Presbyopia and the
AcuFocus KAMRAO inlay, visit
http://www.acufocus.com/others/the-acufocus-corneal-inlay.html. For
further information, e-mail [email protected] The
information provided is for educational and communication purposes
only and it should not be construed as personal medical advice.
Information published in this article is not intended to replace,
supplant or augment a consultation with a health professional
regarding the reader's own medical care. The Star does not give any
warranty on accuracy, completeness, functionality, usefulness or
other assurances as to the content appearing in this column. The
Star disclaims all responsibility for any losses, damage to
property or personal injury suffered directly or indirectly from
reliance on such information.
-The Star/Asia News Network