Eye surgery for presbyopia....otherwise known as "Old Bloke Eyes"

[bamboozled]

There are a few eye surgery posts on here but I didn't quite see one about the above condition. To the point: my close-up vision has gotten worse fairly dramatically (in my view) in the last 2 or 3 years. Typical as we age. I need to wear cheater glasses to view anything close-up but distance is no problem. I am finding it hard to accept this. Is there any operation to correct this particular condition? I have searched the internet but feel a bit confused. Perhaps because I don't want to admit that there is no easy solution or no solution at all.

 

Anyone have experience with this?

 

Thank you.

[msbkk]

Instead of searching the internet and asking at aseannow it is recommended  to consult with a hospital or an eye clinic for a real eye check up. Declining vision can have different reasons and the doctor can find this out within minutes.

[bamboozled]

You're right, thank you. I did actually see an ophthalmologist and have my eyes checked. She said I had dry eyes and the above condition, presbyopia, but no other issue. I asked what could be done and she mentioned surgery where one eye would be corrected for near vision and the other eye for distant vision. And the brain would compensate for the difference when necessary. I did not feel 100% confident with this doctor's answer. I don't think she is a specialist in correcting eyes but in diagnosing the condition. I have not found such a procedure that she suggested online, either. So, yes, I will ultimately search out a specialist but I'm doing my online sleuthing first, as much as possible.

 

Cheers!

[bamboozled]

But of course! Now I HAVE found reference to the surgery the doctor talked about where one eye is laser corrected for near and the other for far, just after posting my question. Sometimes just asking kicks things into gear. My apologies, doctor!

10 minutes ago, bamboozled said:

 

[expat_4_life]

42 minutes ago, bamboozled said:

I need to wear cheater glasses to view anything close-up but distance is no problem. I am finding it hard to accept this. Is there any operation to correct this particular condition?

 

Personally, I'd go with cheater glasses if the other option is eye surgery.
The corrective surgeries are commonplace and generally successful.  That does not mean however that corrective surgery is without risk.  You'll get used to the glasses.

Good luck whatever you decide

[Felton Jarvis]

I am told that this surgery gives only temporary results, so it's not worth the price in my view.

[expat_4_life]

24 minutes ago, bamboozled said:

But of course! Now I HAVE found reference to the surgery the doctor talked about where one eye is laser corrected for near and the other for far, just after posting my question. Sometimes just asking kicks things into gear. My apologies, doctor!

 

I suspect you are referring to LASIK surgery

Monovision LASIK is a specialized technique in LASIK surgery to reduce or eliminate the need for reading glasses. Monovision LASIK works by correcting one eye for emmetropia (distance) and the other eye for myopia (near vision).

 

To quantify the risks involved - The intraoperative complication rate of Laser in situ keratomileusis (LASIK) has been reported to be in between 0.7-6.6%.

For reference visit
LASIK Complications

 

[connda]

You could spend the money to have a lens replacement with an artificial lens that corrects for far-sightedness, but honestly, do you really want to undergo that type of invasive surgery and the cost associated with it when the condition you have can be corrected with prescription eye-glasses?  Personally, I wouldn't.  But that's just me.

[tgw]

1 minute ago, connda said:

You could spend the money to have a lens replacement with an artificial lens that corrects for far-sightedness, but honestly, do you really want to undergo that type of invasive surgery and the cost associated with it when the condition you have can be corrected with prescription eye-glasses?  Personally, I wouldn't.  But that's just me.

 

you mean non-prescription off-the-shelf glasses for 25 baht...

[Sheryl]

Thsi is the best place to have such surgery

 

https://www.trsclasik.com/en/nearvision

 

However before contemplating such surgery, try monovision out first by wearing a contact lens in one eye that renders that eye a bit nearsighted.  Give it a few weeks and see if your brain adjusts, some do not -- a huge problem if you already had surgery. Need doctor to give you the contact prescription of course.

 

For that matter, you could do only that(wear a contact lens in one eye only)  and skip the expensive surgery.

 

Especially since sooner or later you will need cataract surgery and when lens are removeed and replaced for that, could  pursue monovision at that time.

[bamboozled]

This is all good advice, people, thank you. I'm not in a rush. Perhaps, yes, I can get used to them. I don't WANT to get used to them...is part of the problem. I did read about contact lenses for this issue. I guess they are cheaters in the bottom half and normal in the top half, something like that? It might be worth trying.

[khlongtoey]

the art of ageing includes not trying to fix everything, guess you will find out

[Classic Ray]

Have a proper eye test at a good optician and buy varifocal lenses without visible steps between the zones. I got some for 5000 baht with an ordinary frame from Seven Day Optics.

 

They will deal with both near and far vision. Why bother with surgery?

[Chosenfew]

Dr Somchai at Bangkok/Pattaya hospital, Supersight, he is world renowned and completely changed my life. You can watch his videos on YouTube.

[Sheryl]

8 hours ago, bamboozled said:

This is all good advice, people, thank you. I'm not in a rush. Perhaps, yes, I can get used to them. I don't WANT to get used to them...is part of the problem. I did read about contact lenses for this issue. I guess they are cheaters in the bottom half and normal in the top half, something like that? It might be worth trying.

 

No just wear only 1 contact lens for near reading. Regular lens but prescription aims to make that one eye a bit nearsighted. So you will have monovision. If this works, then when you eventually need cataract surgery ask doctor to select lens accordingly.

[CanadaSam]

You mention that the problem is only for the past 2/3 years?

 

A bit early for an operation, IMO.

 

Get some glasses, some may even may you look more "hansum"!

[bamboozled]

35 minutes ago, Sheryl said:

 

No just wear only 1 contact lens for near reading. Regular lens but prescription aims to make that one eye a bit nearsighted. So you will have monovision. If this works, then when you eventually need cataract surgery ask doctor to select lens accordingly.

I will give his a shot, Sheryl. Who do I need to see for this, an ophthalmologist or simply an optometrist? Why will I eventually need cataract surgery? I did not realize such a thing was a given as we age.

 

 

[soalbundy]

14 hours ago, expat_4_life said:

 

Personally, I'd go with cheater glasses if the other option is eye surgery.
The corrective surgeries are commonplace and generally successful.  That does not mean however that corrective surgery is without risk.  You'll get used to the glasses.

Good luck whatever you decide

I agree, I have glasses because  I am short and far sighted.  My eye doctor in Germany had his own small clinic and could perform laser surgery (3,000 Euro per eye) but even though he offered this possibility he said I wouldn't do this surgery on my wife as the long term affects are unknown (this was 25 years ago). I've worn glasses since then.

[Sydebolle]

www.rutnin.com - the only dedicated eye hospital in the region, very professional and affordable. Get a proper eye check; see Dr. Roy Chumdermpadetsuk who was the only expert who diagnosed my AMD "age-related macula degeneration", treated it over 3+ years and now I'm OK again. 

[Freddy42OZ]

16 hours ago, bamboozled said:

There are a few eye surgery posts on here but I didn't quite see one about the above condition. To the point: my close-up vision has gotten worse fairly dramatically (in my view) in the last 2 or 3 years. Typical as we age. I need to wear cheater glasses to view anything close-up but distance is no problem. I am finding it hard to accept this. Is there any operation to correct this particular condition? I have searched the internet but feel a bit confused. Perhaps because I don't want to admit that there is no easy solution or no solution at all.

 

Anyone have experience with this?

 

Thank you.

Good info here

https://eyewiki.aao.org/Presbyopia_Treatment

 

[Wrwest]

16 hours ago, bamboozled said:

You're right, thank you. I did actually see an ophthalmologist and have my eyes checked. She said I had dry eyes and the above condition, presbyopia, but no other issue. I asked what could be done and she mentioned surgery where one eye would be corrected for near vision and the other eye for distant vision. And the brain would compensate for the difference when necessary. I did not feel 100% confident with this doctor's answer. I don't think she is a specialist in correcting eyes but in diagnosing the condition. I have not found such a procedure that she suggested online, either. So, yes, I will ultimately search out a specialist but I'm doing my online sleuthing first, as much as possible.

 

Cheers!

I had my natural (nearsighted) lens removed and variable prescription lens put in. Recommend Rutnin Eye Hospital, Asoke & Montri for consultation and any need. All they do is eye health.

[Grusa]

2 hours ago, Chosenfew said:

Dr Somchai at Bangkok/Pattaya hospital, Supersight, he is world renowned and completely changed my life. You can watch his videos on YouTube.

This is well worth considering, and he has a world-beating track record of success, BUT all surgery carries risk, and unless you have cataract this is unecessary elective surgery.

[Gandtee]

15 hours ago, connda said:

You could spend the money to have a lens replacement with an artificial lens that corrects for far-sightedness, but honestly, do you really want to undergo that type of invasive surgery and the cost associated with it when the condition you have can be corrected with prescription eye-glasses?  Personally, I wouldn't.  But that's just me.

Similarly I have been diagnosed with Macular degeneration in one eye. There is a treatment whereby the affected eye is injected. It's not a cure. It just retards the progress. Just yesterday the doctor that carries out this procedure said "You are ninety. I would not let my mother undergo the treatment. One small infection during the procedure and you could go blind." Needless to say I heeded his advice and will learn to live with it. All part of the aging problem. Old age? I'm not looking forward to it.😉

[Sheryl]

3 hours ago, bamboozled said:

I will give his a shot, Sheryl. Who do I need to see for this, an ophthalmologist or simply an optometrist? Why will I eventually need cataract surgery? I did not realize such a thing was a given as we age.

 

 

For contact lens prescription usually need an opthalmologist.

 

Once you have prescription, can buy ftom optician.

 

Yes cataracts are pretty much a given as you age. Happens sooner in some, later in others. If you're over 60, good chance you already have at least early cataracts.  Only need surgery when they reach the point that vision impairment affects daily life. If you live long enough, that time will come. 

[Pib]

@bamboozled

You are experiencing what almost everyone experiences as they age.    First the near vision gets worst but your far vision is still good....so people start wearing reading/cheater glasses.   If you don't have any or much astimgmatisn or any other eye problems then just buying some cheap 100 baht reading glasses that's sold everywhere will usually work.  But probably every year or so you'll need to replace those reading glasses with a slight stronger pair....no biggie, most anybody can afford Bt100. 

 

But as you continue to age you now start to notice more and more the far vision is not as good as it use to be....maybe as you drive your car you notice you have to be a lot close to that sign before you can clearing read the text on the sign to turn right to go to whereever.  Or maybe you can't read small text on your big screen TV so good anymore....that's your intermeidiate and far vision also beginning to go downhill along with your near vision that you use to look at things close up like reading a book.   So, maybe now you get another pair of Bt100 glasses geared to correct "far" vision....and then switch to the Bt100 glasses for the "near" vision stuff.  Have two pairs of glasses hanging on your shirt, in your pocket, etc.   

 

If you are like me (which I think you are when it comes to the desire of wearing glasses) you just "hate" that....although you could deal with using some cheapie glasses for reading you hate having to switch to your other glasses for seeing clearing at distance. 

 

And although you could surely buy some expensive glasses (like bifocal, trifocal, progessive) for MANY baht from your local glasses shop the fact remaings you just dont' want to wear glasses whether cheap or expensive.  So what choice do you have now?

 

Well, there is the possibility of LASIK surgery where they cut a small flap in your cornea, pull the flap back (kinda like a trap door), then they use a laser to slightly reshape the "cornea", and then you should bel be good to go for "a while."    Notice I said "for a while" because that LASIK surgery did not treat/fix the root cause of your near and/or far vision problem....the root problem is probably the "lens" of the eye which is behind the cornea.  As you age your eye lens will become "not as flexible" as it use to be (i.e., it hardens) which prevents it from being able to focus like you use to when you were younger...and the lens may even start developing "cataracts" which furhter impacts the ability of the lens to focus like it use to in its younger days. 

 

Also, with LASIK surgery the eye doc may recommend against it depending on your age (unless the doc is really money hungry)....like if  your are 60-65 or older.   Maybe that's because they know the lens' focusing abllity is going downhill as you get older (that's just life) and LASIK would merely make vision better for a couple of years before it would be time to do another expensive LASIK surgery (or get new cheater glasses)...and the customer is NOT happy about doing this surgery again.  And it's not like a person can do LASIK surgeries over and over even if they are a billionaire. 

 

So, what to do.  Well, it probably "Inter Ocular Lens (IOL)" surgery time which is where the root cause is fixed...that is, your aging eye natural lens that may also have the beginning of cateracts which just makes your vision even worst is removed (a simple and quick process) and replaced with a man-made IOL.   Once doing that the lens of your eye (now a man-made lens vs natural lens from birth) will not further harden/lose flexibility/abiltiy to focus as you continue to age...even if your live to the ripe old age of 125.  Now other parts of your eye may get worst as you age, like your retina (back of your eye) but your eye "lens" is good to go for many decades/a lifetime.

 

IOLs come in all varieties...from single focus, bifocal, trifocal, etc., and many price ranges.  Single focus (set for near, intermediate, or far) is the cheapest....been around for many decades.  Many people go the "monovision" IOL route of having one eye outfitted with a near vision IOL and the other eye with a far vision IOL....and then the brain picks which eye to use when looking at something.  Many people get along fine with monovison and some don't.  Definitely best to try monovision with some contact lens which simulates monovision before taking the permament just of monovision IOL surgery.

 

But monovision is from the earlier days before new & improved IOLs were developed like Bifocal and Trifocal IOLs which cost more than single distance IOLs.   Bifocal IOLs (can set to two distances usually intermediate and far) but you may still need reading glasses.  Trifoal IOLs are good at all distances (near, intermediate, and far)...glasses shouldn't be needed at any distance.   

 

I went the Trifocal IOL route....first in one eye...and about 6 weeks later in the other eye....this was almost 4 years ago....and my vision in both eyes is excellent....pretty much like having young adult vision again....zero need for glasses.  With "both" eyes I can see clearly at near, intermediate, and far.  I could put an eye patch over either eye and the other eye can see clearly at near, intermediate, and far....something that folks who went the monovision route can not say.   

 

The particular IOL I went with was the Panoptix Trifocal IOL.   Had it done in late 2020 at a Thai govt hosptial, specifically Mettapracharak Hospital in Nakhon Pathon province....just outside of western Bangkok where my home is.   My total cost for "both" eyes was $4,600 USD (approx Bt165K)  for both eyes which included a total of 7 visits....2 of 7 being the days of surgery...the other 5 days just pre-op and post-op checks.  That $4,600/Bt165K is approx half the price of what you'll pay for a Trifocal IOL (probably a Panoptix Tricfoca) at a major eye clinic in Bangkok like Rutnin.  No overnight stays....just visit of a couple hours each of those 7 days.  Now on the day of each operation that's about a 4 hour visit.   This hospital has a whole floor dedicated to eye surgery/vision problems...really first class.   Thais know it as one of the best places in Thailand to have eye surgery....almost like how Thais consider Siriraj Hospital in Bangkok as the gold standard for Thai hospitals.  I expect Thais also like it it due to their prices being about half of high end Bangkok eye clinics.  Mettapracharak Hosptial also has a eye clinic right in Bankgok called the Metta International Eye Center although I've never been to it...and I don't know if their prices are the same as at the govt hosptial.

 

Good luck...be sure to study up on the various IOL choices....and I can vouch for the Panoptix trifocal IOL after having two of them in my head for almost 4 years now.  

 

.

Mettapracharak Hospital in Nakorn Pathom province....just oustide of western Bangkok

 

 

 

 

Metta International Eye Center in Bangok

 

 

 

 

 

 

 

 

 

[Wonderyenta]

Sheryl’s advice is excellent… correct one eye with a contact lens and leave the other eye without any correction. I’m a Dispensing Optician and that’s exactly how I’d do it too. Presbyopia is totally normal and generally starts around 45 -50 years old. It’s generally noticed when you have to hold an object away from you in order to focus. It will increase as time goes on, that’s the main reason why surgery at this early stage may not be a good idea. By using the mono vision contact lens idea, you get pretty much the same result as surgery. Some people’s brains don’t manage the change, not often, but it can be a problem. 
Do your Optom will prescribe a mono vision contact lens for you, a daily disposable lens may be useful as there’s no cleaning, solutions etc needed. 

[Paris333]

Compromise with the problem of presbyopia and don't go for expensive surgeries.
An ophthalmologist can examine your eyes and he will  prescribe you, increasing the focal lenses in your eyeglasses.

LASIK surgery is performed with a laser programmed to remove a defined amount of tissue from a part of your eye called the cornea.

Actually it "destroy" the surplus vision in one of your eyes in order to be coordinated with the other eye for clear vision.

So first step go to ophthalmologist (in Greece is free  in shops) and according to his/her prescription you can order higher presbyopia quality eyeglasses.

The problem of presbyopia -myopia -astygmatism exist and lasik laser is not a magic bullet.

[greg67]

Check out PRESBYOND procedure. Bangkok Hospital offers it. Relatively new but gaining popularity in the West.

[bamboozled]

4 hours ago, Pib said:

@bamboozled

You are experiencing what almost everyone experiences as they age.    First the near vision gets worst but your far vision is still good....so people start wearing reading/cheater glasses.   If you don't have any or much astimgmatisn or any other eye problems then just buying some cheap 100 baht reading glasses that's sold everywhere will usually work.  But probably every year or so you'll need to replace those reading glasses with a slight stronger pair....no biggie, most anybody can afford Bt100. 

 

But as you continue to age you now start to notice more and more the far vision is not as good as it use to be....maybe as you drive your car you notice you have to be a lot close to that sign before you can clearing read the text on the sign to turn right to go to whereever.  Or maybe you can't read small text on your big screen TV so good anymore....that's your intermeidiate and far vision also beginning to go downhill along with your near vision that you use to look at things close up like reading a book.   So, maybe now you get another pair of Bt100 glasses geared to correct "far" vision....and then switch to the Bt100 glasses for the "near" vision stuff.  Have two pairs of glasses hanging on your shirt, in your pocket, etc.   

 

If you are like me (which I think you are when it comes to the desire of wearing glasses) you just "hate" that....although you could deal with using some cheapie glasses for reading you hate having to switch to your other glasses for seeing clearing at distance. 

 

And although you could surely buy some expensive glasses (like bifocal, trifocal, progessive) for MANY baht from your local glasses shop the fact remaings you just dont' want to wear glasses whether cheap or expensive.  So what choice do you have now?

 

Well, there is the possibility of LASIK surgery where they cut a small flap in your cornea, pull the flap back (kinda like a trap door), then they use a laser to slightly reshape the "cornea", and then you should bel be good to go for "a while."    Notice I said "for a while" because that LASIK surgery did not treat/fix the root cause of your near and/or far vision problem....the root problem is probably the "lens" of the eye which is behind the cornea.  As you age your eye lens will become "not as flexible" as it use to be (i.e., it hardens) which prevents it from being able to focus like you use to when you were younger...and the lens may even start developing "cataracts" which furhter impacts the ability of the lens to focus like it use to in its younger days. 

 

Also, with LASIK surgery the eye doc may recommend against it depending on your age (unless the doc is really money hungry)....like if  your are 60-65 or older.   Maybe that's because they know the lens' focusing abllity is going downhill as you get older (that's just life) and LASIK would merely make vision better for a couple of years before it would be time to do another expensive LASIK surgery (or get new cheater glasses)...and the customer is NOT happy about doing this surgery again.  And it's not like a person can do LASIK surgeries over and over even if they are a billionaire. 

 

So, what to do.  Well, it probably "Inter Ocular Lens (IOL)" surgery time which is where the root cause is fixed...that is, your aging eye natural lens that may also have the beginning of cateracts which just makes your vision even worst is removed (a simple and quick process) and replaced with a man-made IOL.   Once doing that the lens of your eye (now a man-made lens vs natural lens from birth) will not further harden/lose flexibility/abiltiy to focus as you continue to age...even if your live to the ripe old age of 125.  Now other parts of your eye may get worst as you age, like your retina (back of your eye) but your eye "lens" is good to go for many decades/a lifetime.

 

IOLs come in all varieties...from single focus, bifocal, trifocal, etc., and many price ranges.  Single focus (set for near, intermediate, or far) is the cheapest....been around for many decades.  Many people go the "monovision" IOL route of having one eye outfitted with a near vision IOL and the other eye with a far vision IOL....and then the brain picks which eye to use when looking at something.  Many people get along fine with monovison and some don't.  Definitely best to try monovision with some contact lens which simulates monovision before taking the permament just of monovision IOL surgery.

 

But monovision is from the earlier days before new & improved IOLs were developed like Bifocal and Trifocal IOLs which cost more than single distance IOLs.   Bifocal IOLs (can set to two distances usually intermediate and far) but you may still need reading glasses.  Trifoal IOLs are good at all distances (near, intermediate, and far)...glasses shouldn't be needed at any distance.   

 

I went the Trifocal IOL route....first in one eye...and about 6 weeks later in the other eye....this was almost 4 years ago....and my vision in both eyes is excellent....pretty much like having young adult vision again....zero need for glasses.  With "both" eyes I can see clearly at near, intermediate, and far.  I could put an eye patch over either eye and the other eye can see clearly at near, intermediate, and far....something that folks who went the monovision route can not say.   

 

The particular IOL I went with was the Panoptix Trifocal IOL.   Had it done in late 2020 at a Thai govt hosptial, specifically Mettapracharak Hospital in Nakhon Pathon province....just outside of western Bangkok where my home is.   My total cost for "both" eyes was $4,600 USD (approx Bt165K)  for both eyes which included a total of 7 visits....2 of 7 being the days of surgery...the other 5 days just pre-op and post-op checks.  That $4,600/Bt165K is approx half the price of what you'll pay for a Trifocal IOL (probably a Panoptix Tricfoca) at a major eye clinic in Bangkok like Rutnin.  No overnight stays....just visit of a couple hours each of those 7 days.  Now on the day of each operation that's about a 4 hour visit.   This hospital has a whole floor dedicated to eye surgery/vision problems...really first class.   Thais know it as one of the best places in Thailand to have eye surgery....almost like how Thais consider Siriraj Hospital in Bangkok as the gold standard for Thai hospitals.  I expect Thais also like it it due to their prices being about half of high end Bangkok eye clinics.  Mettapracharak Hosptial also has a eye clinic right in Bankgok called the Metta International Eye Center although I've never been to it...and I don't know if their prices are the same as at the govt hosptial.

 

Good luck...be sure to study up on the various IOL choices....and I can vouch for the Panoptix trifocal IOL after having two of them in my head for almost 4 years now.  

 

.

Mettapracharak Hospital in Nakorn Pathom province....just oustide of western Bangkok

 

 

 

 

Metta International Eye Center in Bangok

 

 

 

 

 

 

 

 

 

Incredible amount of good information here, Pib. Thank you very much for taking the time to explain in such detail and break down the various possibilities. As of now, my far away vision doesn't seem to be affected. But I'm glad I can look forward to that deteriorating, too! What you describe, the IOL, seems pretty amazing. And not super, super expensive. I will do some more research about that and for the meantime, try the one contact lens approach and see how that works. It's reassuring to know that this procedure exists. I will copy and save all the info in my computer for when/if I want to move forward with an operation.I guess I have been caught off guard that my eyes have become such an issue. I always had good vision and for some reason didn't expect this to happen until later in life.

 

Thanks again!

[bamboozled]

8 hours ago, Freddy42OZ said:

Good info here

https://eyewiki.aao.org/Presbyopia_Treatment

 

Awesome, thank you!