Tue, 21 Jun 2005

JP/17/SING3

Giving new life to the over-40s

Life may begin at 40, a proverb says, as you may gain a more fulfilling life, a rejuvenated mind and a well-established job.

Yet, this mature age may not be too compromise to your physical condition, especially to your most valuable asset -- your eyes. How many times do you face difficulties when reading newspapers or paperback novels and need to hold them further away in order to read the printed words clearly and correctly?

Have you ever experienced a sign of fatigue when working with your computer? Do you need a brighter and direct light when reading printed materials?

If your answers are "yes," then you must stay alert. You may hit with presbyopia, a Greek word for old eye, a condition of the lens of the eyes becoming stiffer and the muscles that controls the lens getting weaker, thus hindering its ability to bend and flatten in order to focus light on the retina.

"This condition is common for people of over 40s, but it can occur in people below 30," explained Dr. Steve Seah, head of the Ophthalmology & Presbyopia LASIK (laser in-situ keratomileusis) Center at the newly established one-stop medical center, Excellence Healthcare in Singapore, the first healthcare establishment to perform presbyopia LASIK.

Dr Seah said there are several causes for presbyopia. In addition to age, he added, factors such as hyperopia, occupation, gender, ocular disease, systemic disease, drugs and geography are also contributory factors.

"This inability of the lens to refract light correctly causes the eye to have difficulty focusing on objects up close. People need to depend on bifocals and reading glasses," said Dr. Seah, who is also president of the Singapore Society of Ophthalmology and Head of Glaucoma Service Center at the Singapore National Eye Center.

In Singapore alone, at least 600,000 adults are affected by this condition.

Fidi, a 45-year old architect, complained he could no longer draw lines precisely as he approached his 40s. "I have myopia (short-sightedness) and I have to wear thick glasses or contact lens when I have to go to my project sites. Now, I think I have presbyopia that makes my professional life even more difficult," he said.

Thirty-three year old Nadya, a computer programmer, said it was quite difficult to focus on small printed words especially on the computer screen.

"A lot of patients come saying how frustrated they are in not being able to read the print in newspapers, books, novels, or credit card bills because they forgot to bring their reading glasses. But now there is hope that this condition can be treated," the doctor smiled.

Developed by French ophthalmologist Dr. Alain Telandro, a new technique known as presbyopia LASIK aims to correct presbyopia.

A multizone corneal LASIK treatment, Presbyopia LASIK can give presbyopic patients good near and distance vision with no loss of contrast sensitivity.

Prior to its development, the solutions were multifocal contact lenses and bifocal reading glasses. The more permanent surgical procedures include LASIK and Conducive Kerotaplasty (CK).

As standard LASIK does not offer multifocal ablation profile, most patients opt for monovision or CK correction. MonoVision is employed to help reduce or eliminate the need for bifoals by correcting one myopic eye for distance and the other for near vision.

The CK treatment uses radio frequency energy to reshape the cornea and the corrects only one eye for presbyopia and the other for distant vision. However, there are limitations for both procedures.

MonoVision correction may not be suitable for all patients as it does not provide clear vision in both eyes and there is a loss of stereovision (3-D Vision). As for CK, patients may experience regression post treatment.

"For Indonesian patients, the Presbyopia LASIK procedures do not take a long time. It takes between 20 and 30 minutes for both eyes. The patients later take a rest for a while and they can go back home," the doctor said.

The success rate of Presbyopia Lasik procedures is estimated at around 80 percent to 90 percent.

Despite its high rate of success, Dr. Seah also informed that Presbyopia LASIK is not for everyone. "We have to go through comprehensive eye examination before implementing LASIk procedures," he explained.

There are certain conditions such as flat cornea or people suffering from diseases like lupus would be disqualify for this procedure.

-- Rita Widiadana