Seeing Things
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Posted: 10:37 AM Nov 4, 2006
Seeing Things
Implants counter the years
Do you find yourself doing arm extensions just to read the newspaper? By 50, nearly everyone has some degree of age-related vision loss.
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Do you find yourself doing arm extensions just to read the newspaper? By 50, nearly everyone has some degree of age-related vision loss.

Larry Hobbs is one of the millions of baby boomers who have trouble focusing on things up close. It’s a condition called presbyopia.

"My arms just weren’t long enough to get that far enough out to see it," he says. "And so, I’d been wearing glasses since I was about 40-years-old.”

Dr. Larry Lothringer says, "It’s a normal outcome of too many birthdays.”

Dr. Lothringer is an ophthalmologist and he says after age 40, we all begin to lose the ability to focus on things up close.

He’s studying a new treatment called the presVIEW procedure. It uses plastic implants that are each the size of a grain of rice. During surgery, Dr. Lothringer places the implants in four areas of the eye. The implants force the muscles to contract and change the shape of the lens.

“So it returns your reading vision to the point where you’d lost it," Dr. Lothringer says. "It doesn’t return it to that of a 20-year-old. It’s more like a 35-year old.”

Larry says the procedure was pain-free, but the results were not immediate. He had to do daily eye exercises to strengthen his eye muscles to make the most of the implants but he saw improvement after six weeks.

“When I close one eye and focus with that one, I can read much, much closer than I could before,” he says.

PresVIEW is not FDA approved yet, but doctors hope it will be in the next few years. Researchers are still looking for nationwide study participants. All exams and procedures are free. For more information, call the Refocus Group at 1-888-821-EYES.

Fast Facts:

  • Presbyopia is a vision condition in which the lens of the eye loses its ability to quickly change focus between near and distant objects. It’s a common condition among those over 40.
  • People with presbyopia often need reading glasses to read and do up-close work.
  • A new, investigational device, called the presVIEW scleral implant, might help some patients with presbyopia eliminate their need for reading glasses.

    Supplemental Information

    Normal Vision
    When we look at an object, light from the image enters the eye and is bent by the cornea (the transparent outer covering). The image is then focused by the lens onto the retina. The retina acts like film in a camera. It contains special light-sensitive cells that detect images and convert the information into electrical signals. The image signals travel through the optic nerve to the brain for processing.

    Refractive Errors
    Refractive errors occur when images coming into the eye don’t bend at the right angle and land in front of or behind the retina. In nearsightedness (myopia) the shape of the eyeball is elongated or the cornea is curved too steeply. This causes images to fall at a point somewhere in front the retina. People who are nearsighted see near objects clearly, but distant objects appear blurred.

    Farsightedness (hyperopia) occurs when the eye is shorter than normal or the cornea doesn’t have enough curvature. Images entering the eye are focused at a spot behind the retina. Distant objects are seen clearly, but near objects are out of focus.

    When we move between near and distance vision, the lens of the eye changes shape to bring the image into focus. As we age, the soft lens becomes harder and loses some of its flexibility. As a result, near objects appear to be out of focus. This condition is called presbyopia. Presbyopia occurs slowly, but usually becomes noticeable during early to mid-forties. Patients may experience an inability to read close-up materials, tiring of the eyes, eyestrain and headaches. Some people hold reading materials at arm-length to keep words in focus.

    PresVIEW for Aging Eyes
    Presbyopia is a natural part of aging. Eye care specialists may recommend the use of reading glasses, bifocal glasses or special contacts to ease reading ability and eliminate eye strain and headaches.

    Larry Lothringer, M.D., Ophthalmologist, is now testing the use of a new device for treatment of presbyopia. It’s called the PresVIEW Scleral Implant. The surgery can be done using topical or local anesthesia.

    The PresVIEW system contains four tiny plastic segments, each about the size of a grain of rice. The surgeon makes four equally spaced cuts around the surface of the sclera (the white part of the eye). One implant is placed into each of the cuts. Once placed, the PresVIEW implants slightly “lift” the sclera, giving the muscles that surround the eye’s lens more room to move.

    The results of PresVIEW are not immediate. With aging, the muscles of the eye that control the lens’ ability to focus have not been in full use. So they need to be “retrained.” Doctors prescribe eye exercises that can be done a few minutes at a time, several times a day to “rehabilitate” the eye muscles. The workout may cause a cramping sensation in the focusing muscles for the first few days after receiving PresVIEW implants.

    PresVIEW will not return a patient’s vision to that of a 20-year old, but will hopefully provide at least some correction. Currently, eye care specialists are testing the use of PresVIEW in patients with presbyopia. The study hopes to confirm the usefulness of the procedure and determine who may benefit the most from the implants. The only side effect seen with the procedure is a minor rubbing or tickling of the eyelid due to rubbing of the raised sclera. If these symptoms occur, doctors prescribe lubricating eye drops to lessen the irritation.

    The PresVIEW trial is underway in Beverly Hills, CA; Reseda, CA; Lake Villa, IL, Amherst, NY; New York, NY; Houston, TX; and San Antonio, TX. Participants must participate in follow-up visits, so researchers are requiring those who enroll to be within a one-hour’s drive (about 75 miles) away from a clinical site.

    Web Resources
    For information on presVIEW, visit the Refocus Group Web site.

    For information on presbyopia or other vision conditions:

  • American Optometric Association Web site