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Myopia and presbyopia

Presbyopia affects vision of some short-sighted more of 45: myopia and presbyopia can be subject to refractive surgery.

Myopia and presbyopia: links and differences

Contrary to widespread belief, the myopia does not protect from presbyopia: any myopic older than 45 years is far-sighted. This misconception probably comes from the fact that myopia facilitates near vision... on condition of not not wear or remove its correction by far. Thus, in certain circumstances, myopia can help compensate for presbyopia, but provided that the myopic become presbyopic:

-Don't wear his myopic correction

-doesn't so need to see from a distance when it withdrew its correction (which case returning the glasses or corrective lenses ' caught' again presbyopia).

-has a myopia nor too low (less than 2-D, it does compensate for insufficient presbyopia) or too strong (greater than 3.50 D or 4 d, it imposes a reading too close distance).

Myopia and presbyopia don't offset each other so not really.

Remember to explain these data as the number of myopia (ex: 3 D) corresponds to the inverse of the distance at which the nearsighted eye sees net without effort (this distance is called ' ") Punctum point« ). The myopia the more "useful" to compensate for presbyopia are therefore between-2 D (0.5 m = 50 cm) and-3.50 D (0.3 m = 30 cm). For a 3D myopia, punctume point is therefore 1/3 = 0.33 m 35 cm. There is a small beach not sharpness and the distance of the point (depth of field) punctum, which means that this type of short-sighted to read effortlessly. On the other hand, a myopia of - 8 d does not allow to read comfortably, at least to approach the book around 1/8 = 0.15 m = 15 cm approximately, which is certainly too close to the eye to be comfortable or compatible with playback on screen for example.

 

Vision to the presbyopic myopes

To understand and compare the vision of presbyopic myopes with a far-sighted Emmetropic (an Emmetropic is a patient who sees from afar without effort), we can make the following observations:

A myopic of 3D (eyeglass prescription:-3D) sees from afar without his glasses as an Emmetropic who would wear his glasses of addition + 3 D for near vision but would look through them away.

A myopic of 3D is a 'like' an Emmetropic which would permanently a correction for vision close to + 3 D. It can read without glasses, but sees blurred by far. When become presbyopic myopes puts his glasses or lenses to see from a distance, he sees so blur... If it does not carry an extra addition to correct the presbyopia (ex: glasses double homes, progressive lenses, in addition to lenses reading glasses).

To avoid fiddling with glasses for the far and for the close, progressive lenses with a myopic-3D is an option. In the glass portion dedicated to the vision of far (top), power (vergence) is negative (-3D) to correct myopia, so that the short-sightedness can see net by far. In the lower part of the glass, the power includes an addition. At a far-sighted with all accommodation, the addition is + 3 D. The power of the progressive lens is then zero in the lower part of the glass of glasses (but the myopia of the patient allows him to read without effort of accommodation). Some presbyopic glasses for myopic glasses are also inverted half-moon-shaped: the lower portion of the glass is removed.

Note in passing that in one presbyopic farsighted, the addition of almost adds to the correction by far: under this addition, the glasses are particularly "magnifying", especially in their lower part.

 

The myopia and presbyopia refractive solutions

In practice, many myopic consult for refractive surgery for myopia at the time they become presbyopic. This may seem paradoxical, but the midlife myopic accustomed to a correction in contact lenses can easily remove and replace their lenses during the day, to see "punctually". This is much easier in glasses... But used to live and appear without glasses myopes isn't necessarily happy to deliver these. Thus, for a medium myopic (between-2 and-3.50 D) who doesn't wear glasses for vision from afar, the arrival of presbyopia the forced to make a choice between:

-wear to lenses for correction by far and add a correction for vision closely (glasses)

-postpone glasses by far, which can be more easily removed to read

-try a correction of "monovision", IE reducing the correction on the side of the non dominant eye to benefit from a slight myopia on this side, and read more easily. The 'under fixed"eye so blurred by far...

-try to fit Multifocal lenses (far-sighted lenses), who correct myopia and presbyopia. The multifocalite is often less well tolerated by the short-sighted people who have trouble getting used to the slight blurring by far it imposes (particularly in night vision), and consider their vision as less than they know when they withdraw any correction by far.

Thus, it appears often the vision correction by far simplifies the correction in presbyopic myopes schema: it is possible to propose an operation for presbyopic myopes.  A monovision can be tested in contact lenses in order to allow the short-sighted to test the effect of a correction of an eye.
See the video devoted to presbyopia and its means of correction (show Allo Docteur, 16 October 2012)

See: Surgery for myopia, Presbyopia surgery

50 responses to "myopia and presbyopia"

  1. Carole J says:

    Hello, thanks for this well written and interesting article.
    Let me have another question. I found as a solution to my presbyopia as a myopic the made to wear only one Contact lens on two, by changing the eye, by telling me that I have fatiguing it in an alternative way. ;-)
    I have no headache or feelings of discomfort but is this practice possibly damaging in the long term? I have not had good experiences in surgical procedures and operating my eyes is therefore not an option for me.

  2. Dr. Damien Gatinel says:

    The solution that you have exposed seems to be excellent as it suits you! There is no risk to perform a monovision, same alternating the by far and close eye. Initially he has nothing to fear over time.

  3. LaVie says:

    Hello
    I followed an eye surgery 6 years ago, because I had a very strong myopia that was totally successful...
    Auj, I am again myopic and presbyopic glasses (og-0.75 and-2 OD)..
    I can't find a correct correction for me.
    With the 2 lenses, I see nothing near so wearing glasses and sight from far blurred, the night I am very embarrassed by the headlights of the cars.. The brightness bothers me and I see a Halo around the lights.. I tried the progressive lenses but I don't get used to it.
    What should I do?
    Thank you

  4. Dr. Damien Gatinel says:

    You could try to correct only one eye, priori law by far (ex lens) and check that the slight myopia of the left eye is enough to allow you to read, at least locally, without glasses. If this strategy (monovision) suit you, you might even consider a retouching to correct the myopia of the right eye. It is also possible to test a single correction by far of the left eye (in lens always). Near vision will be sufficient thanks to residual myopia of the right eye, but you may have a little trouble to tolerate the gap between the two eyes.

  5. Lav says:

    BJR doctor,
    I have been operated in LASIK for 11 months with a hyperopia + 5.25 bilat.
    Result: OG emmetrope
    OD (dominant)-1.
    I feel a strong discomfort in vision from afar (tele, driving, supermarket race...).
    Can I hope for an improvement?
    What should I do?
    Thank you for your attention to my message.

  6. Dr. Damien Gatinel says:

    The presence of a-1 D myopia on the dominant eye reflects the presence of a slight overcorrection, which did not regress in 11 months. If the vision from afar seems inadequate, a retouch is conceivable, it is one of the advantages of the LASIK technique.

  7. Virginia says:

    Hello
    For two years I have a myopia of-1.75 OG and-1 OD.
    I can no longer read closely and my ophthalmologist made me try the Monovision but this system gave me dizziness.
    Today I am testing progressive lenses. I see very closely, but the distance is blurred.
    the current correction is-1.5 low and-1 low.
    Would-1.75 low and-1low not be more efficient?
    (I ask you the question because my ophthalmo is on vacation)
    Thank you for your reply

  8. Dr. Damien Gatinel says:

    It is possible that the correction you suggest is more effective in vision from afar, but this may reduce the vision a little. Everything that is added by far correction "shifts" a bit the value of the addition and there is always a "compromise" to be found to satisfy the vision by far and close vision. Multifocal lenses are designed to create a second home (for reading), from certain light rays that are therefore "removed" from the home from afar. In more technical terms, the lenses induce spherical aberration. It is therefore normal to feel a small loss in vision from afar, which can be accentuated in particular under certain circumstances (low light, night vision or dark rooms, etc.).

  9. Michael Cabo says:

    Hello
    I'm 62 years old. I've been corrected with lenses since 1987. From-5.25 (OG)-3.75 (OD), I switched to Monovision 6-7 years ago and my correction is no more than-3.25 (OG) and-2.5 (OD). This solution perfectly agreed to me for about a year. Since then, the need to add "magnifiers" to correct presbyopia when I read has become more and more indispensable. Do you think an operation is possible? If so, what type of operation do you suggest?

  10. Dr. Damien Gatinel says:

    An intervention is actually possible, and a priori a Crystalline lens surgery seems logical. It is important to carry out an oriented balance sheet and try to detect the possibility of an "early" cataract, which could make you eligible for surgery. The laser is not contraindicated formally, but statistically, nearsighted people generally have a Crystalline lens already partially clouded to the Sixties.

  11. David Dean says:

    Hello, I am 50 years old. I'm nearsighted and now far-sighted. I've been wearing mutilfocales lenses for about 3 years. The correction of close (LOW) appears to be insufficient, and a stronger correction (high) is not suitable (yet). My ophthalmologist has just changed his prescription to try to improve my correction closely. What do you think? Thank you.

    Lenses:

    Before:
    right eye:-3.00 LOW and left eye:-2.75 LOW
    After:
    right eye:-3.25 LOW and left eye:-2.25 LOW

    Ditto for glasses:

    Before:
    right eye:-3.25 Add 1.50 and left eye:-3.00 Add 1.50
    After:
    right eye:-3.25 Add 1.25 and left eye:-2.25 Add 1.25

  12. Dr. Damien Gatinel says:

    This difference (under vision correction from far from the left eye) corresponds to a "monovsion" type correction strategy. The vision from afar is privileged on the right side, and close to the left side.

  13. Linda Gamba says:

    Hello
    I have a strong myopia (-6.5 to the right eye and-6 to the left eye), and the presbyopia begins to appear for some years; I'm mostly embarrassed as soon as it's dark. I've been wearing lenses forever, and in a first time, my ophthalmologist offered to sub-correct me to compensate (-6 and-5.5), but that's not enough (reading is at the center of my job), and he prescribed multifocal lenses-6 low and-5.5 low (+ 1.25). I hardly support them: itchy eyes, headaches at the end of the day, and vision from afar becomes really difficult, driving even becomes dangerous. I do not want to wear glasses... So I wonder if, nowadays, an operation would be possible in my case (when I was young, I was told that I was too myopic to be able to operate).
    Thank you in advance for your opinion.

  14. Dr. Damien Gatinel says:

    You have a strong myopia, which does not allow you to read comfortably without glasses (except 15 cm from the eye). A total correction of your myopia would allow you to see well from afar, but not to read without glasses closely because of the presbyopia. A commonly proposed solution is the monovision (the guiding eye is corrected entirely from afar, the other eye is under corrected). The sub-correction must be sufficient to allow you to read at least punctually. You could try a-5d lens for example. If this solution is suitable for you, it can be reproduced in refractive surgery (e.g. LASIK).

  15. Paul Nelly says:

    Hello
    I'm 54 years old and my myopia was at-6.50 and-6.25 with a little presbyopia. Now my myopia starts to go down from-0.25 per eye and my presbyopia continues to rise. I would like to be operated only by myopia because I can no longer support my lenses. I have no problem with glasses to read closely. It is said that myopia must be stable before being operated, but to the extent that it goes down and the presbyopia increases is it possible to envisage an operation against myopia without it coming back.
    In advance thank you and have a good day

  16. Dr. Damien Gatinel says:

    Myopia should not be significantly altered (apart from the occurrence of pathologies such as cataracts). It is possible to envisage surgery of myopia, and may be particularly interesting in your case to leave a slight myopia on the non-dominant eye to allow you not to have to systematically wear an optical correction In close Vision (monovision).

  17. Veronica says:

    Hello

    I read your article with interest it is very well explained! Thanks...:)

    I'm myopic for some years slightly 1.25 and 0.25 and longsighted for a little over a year or so I have 44 years. I tried the progressive goggles and it was a disaster, impossible to get used to, I even had a slight car accident with. So I have two pairs of glasses but it's pretty binding I find...

    So I'm trying at the moment the Acuvue progressive lenses. Well, I can see that mid-distance... the near is super blurry see double, and the very far too. I see well from 60 cm to about 5 meters... Unable to read, unable to use the computer and then of course impossible to sew... I have been wearing these lenses for 3 days, and I only hold 3-4 hours after I have a headache.

    I would like to know if this blur is normal, is it common to see blur at the beginning and double, because it is obvious that I can not work... My ophthalmologist sincerely does not listen to me, finally I had the impression that for him it is equal to him, so I look for solutions alone... Your opinion would be valuable...

    And I have a silly question: if the brains get used to progressive lenses one day, which still seems to me a great effort, as soon as I remove them and put on my normal glasses, do I see blurry?

    Thanks in advance for your advice!

  18. Dr. Damien Gatinel says:

    Weak myopics (like you) are generally uncomfortable with multifocal lenses. These lenses do not give them a clear vision from afar (less than the vision in a lens from afar) or close (less well than the vision without correction near the myopic). The Monovision (an eye set for vision from afar without glasses, the other for close vision without glasses) is a more suitable solution. You'd have to test it in lentils to judge.

  19. Mary says:

    Hello
    My mother recently saw an ophthalmologist. He prescribed a pair of different glasses, one to see from afar and one to see from the Meadows. Is that normal?? Can we put everything together in a pair??

    Thanks in advance for your answer

  20. Blessed Abdoulaye Taker says:

    Thank you doctor for this beautiful essay on Presbyopia and myopia... I am a medical student, there is a question that worries me: I would like to know if the presbyopia is corrected by myopia

  21. Dr. Damien Gatinel says:

    It all depends on what is meant by "correcting the presbyopia". From an anatomical-functional point of view, correcting the presbyopia would be tantamount to restoring the accommodative function (linked to the flexibility of the Crystalline lens, which is reduced over time and is the primitive cause of the presbyopia). However, it is true that a weak myopic (between-1.50 D and-3.50 D) and become longsighted can "compensate" his presbyopia by removing his glasses. Myopia is defined by the existence of a close vision for a non-accommodating eye (cf. the position of the punctum remotum which is not infinite but at a closer distance). A remotum punctum located at 40 cm (1/0.4 m = 2.5 D of myopia) allows a very comfortable reading effortlessly. However, the presbyopia exists: the same myopic will have difficulty reading if it wears its corrective lenses.

  22. Dr. Damien Gatinel says:

    It is possible to correct vision from afar and close vision with progressive lenses, provided that these are well tolerated by patients.

  23. John Petitrenaud says:

    Hello
    I'm very myopic for a long time I wear multifocal lenses correction
    OG-4.5 High
    OD-7.5 Medium
    It took multiple tests before finding the right compromise without a blurry area.
    I can see in the absolute but am obliged to wear corrective glasses of p in spite of everything. What can I do? What do you think of the lenses to wear at night and remove the day that correct myopia? The last question can be obtained in France the corrective drops referred to in certain articles.
    Thank you for your answers I feel like I live more and more in the Blur and the dark.

  24. Ruhi says:

    I have a myopia of-4 and a presbyopia of + 2, can advise me what would be preferable in my case, as lenses or lenses for my prescription in order to be able to read, work on computer and see from afar, thank you.

  25. Dr. Damien Gatinel says:

    You need to try the different types of correction (all possible a priori) to decide. Nothing replaces personal experience with progressive lenses, multifocal lenses, or monovision (under correction of an eye for close vision, the other eye being totally corrected for vision from afar).

  26. Dr. Damien Gatinel says:

    It is sometimes difficult to correct myopia and presbyopia, as Myopics are quite demanding in vision from afar and near (the latter being generally excellent without correction – due to myopia). If we favor the vision closely in multifocal lenses, then we penalise the vision from afar... A compromise is usually necessary, like in your case, and it sometimes takes a correction additional glasses for close-up comfortable vision.

  27. Lecherbonnier says:

    Sir.
    Thank you for this very interesting article and these rewarding exchanges.
    For my part I developed a hereditary myopia at the age of 6 years and now I have 50.
    I have been wearing hydrophilic soft lenses since 1985 (Hydron Z6 for a few years, then Baush leaves and Lomb purevision and now PureVision 2).
    I have a fairly important eye correction:
    – 6.75 OD and OG
    I also have an annual follow-up due to a congenital toxoplasmosis reported 20 years ago and scarred since.
    I wished I had my myopia 10 years ago now, but this was refused due to a very early cataract in the right eye (eye also most affected by the toxo.).
    For about 1 year, after refusal of the ophthalmologist consulted then for a port of bifocal lenses, I wear traditional lenses (for view from afar) and I have progressive glasses (little effective, I cost and read about 15 cm otherwise I see Blur).
    The cataract also continues its path and also attacks the left eye now.
    Would there be a possibility of surgery that would allow me to see better, even if I have to wear glasses for presbyopia.
    I confess I'm lost and I don't know where or who to make an appointment with.
    Does an appointment with a surgeon make more sense than an ophthalmologist alone?
    I thank you in advance for the attention you want to make to this message and the response you will want to bring.
    GLL

  28. Dr. Damien Gatinel says:

    It is legitimate to consider a cataract surgery in your case. A differentiated correction (total or absence reduction of myopia on the dominant eye and a slight correction on the non-dominant eye for intermediate or near vision) may minimise the use of eyeglasses in postoperatively. Extra Goggles (not progresssives) may be prescribed for activities that require far-sighted (driving, performing) or close-up (long-term reading of fine print). You can consult an ophthalmologist who is practicing the cataract surgery.

  29. Hello Dr. Damien,

    I have a myopia of-7.50 and presbyopia of + 1.50 right eye and left since the last review of the view in 2016. And I wear glasses just with the correction of myopia, however, I want to add my presbyopia to my next pair of glasses or maybe a surgery.
    According to my last review of the view dated August 30, 2018, my myopia would be improved by-0.50 and my presbyopia increased by + 0.25, so myopia at-7.00 and presbyopia at + 1.75.
    The question I'm asking myself is how is it possible that my myopia has improved??? And that I see very very well from afar to the-7.50 with my glasses of 2016 without the presbyopia???? Eventually I'll buy a new pair of glasses and add my presbyopia of + 1.75, do I have to keep my myopia prescription to du-7.50 or-7.00??? And another little question, would I be a good candidate for surgery???

    Thank you very much for the answers, good day!

  30. Dr. Damien Gatinel says:

    It is not uncommon to observe a slight reduction in myopia during the installation of the presbyopia. The mechanisms behind this variation are not well elucidated. Be aware that there is not a "single" correction for a strong myopic eye. Indeed, depending on the diameter of the pupil, and the conditions of examinations, even preferably subjective, a myopic said of-7.50 may be more comfortable with a glass of-7.75 D for night driving, and a glass of-7d to work On a well-lit screen. In order to determine the eligibility for surgery, an ophthalmic checkup is required (pre-operative summary of Refractive surgery).

  31. SIROTTEAU says:

    Hello doctor,
    I have a very strong myopia since always (50 years Auj):-9.50 OD and-9 OG and wears lenses for 30 years
    With the appearance of the presbyopia I use multifocal lenses but the low ones are not powerful enough and the Med too.... So my ophthalmologist prescribed a low for one eye and one med for the other... except that I no longer find the prescription... Should we take the low with the strongest myopia correction (OD for me?) or the opposite?
    Thank you

  32. Dr. Damien Gatinel says:

    In general, the lowest (low) addition is intended for the "dominant" eye. The dominant eye is mostly right in the population, but it can of course be the other way around. It is best to get a duplicate of the prescription from your practitioner.

  33. Stephanie says:

    Good evening, I have a myopia that has evolved for a long time... It is now stable at-5 on each side... I'm going to be 40 years old, my ophthalmologist advises against an operation of my myopia, because of a possible presbyopia in the years to come... I've been wearing lenses for 23 years, even finely honed glasses are hard to carry (very blurry all around, much less vision comfort)... What do you recommend? In advance thank you...

  34. Verena says:

    Hello

    I am 40 years old and for 3 weeks I underwent refractive surgery for myopia (-5.5 of both eyes) including anticipation of the presbyopia. However, although I see very well from afar now, I have a hard time getting to the monovision especially for the close view (reading and computer). Besides, I do not see very close (-15 cm) While my view was impeccable before the intervention... so I wonder how this will happen when the presbyopia really happens.
    My question is: Can I use a new correction only of myopia and not presbyopia since the return to the glasses will obviously be inevitable. By the same, will I find my vision very closely?

  35. Dr. Damien Gatinel says:

    Regarding the vision very closely (15 cm), it is not physiological in adults: it was possible in your home thanks to myopia. For reading or computer vision, if you are embarrassed, it would actually be possible to benefit from a retouching.

  36. Dr. Damien Gatinel says:

    It all depends on your visual ambitions. Some myopic presbyopic find it complicated to wear lenses from afar, glasses in addition to vision closely, and wish to simplify their correction by correcting myopia in full on both sides. It is certain that in this case, the near vision requires glasses (the disappearance of myopia no longer allows to compensate for the presbyopia). It is also possible to correct all myopia on the dominant eye, and partially on the non-dominant eye to allow a close vision without glasses (monovision technique or "rocking"). These considerations can be modulated according to your degree of myopia, etc.

  37. ANDRE says:

    Hello, Dr. Ganeshan,

    I am 47 years old, I am a airline pilot and you have operated my wife from myopia a few years ago, she is always absolutely delighted.

    As a personal I am fortunate to always have a very good vision from afar, however my presbyopia increases for 2 years and I am more and more embarrassed, especially by light a little low. The ophthalmologist that makes me pass the medical license visit strongly advises against the operation because of the risks on my "work Tool" – Do you agree with this? What do you think and have you ever operated on presbyopia only? What are the risks and benefits? Thank you for your response.

  38. Dr. Damien Gatinel says:

    Your ophthalmologist is right, because an operation of the presbyopia in a perfectly emmetropic patient (excellent vision by far without correction) will inevitably result in a reduction in the quality of this vision (in exchange of course of a gain in Close vision). It is for this reason that in some case , only one eye (the "non-dominant") is operated because some patients tolerate relatively well the difference in correction between the two eyes. In vision from afar, the dominant eye (not operated) provides the necessary visual information, and in close vision, it is the reverse, the non-dominant eye (rendered totally or "partially" myopic) provides sufficient sharpness for the vision closely. This type of correction can be simulated in contact lenses prior to intervention, and corresponds to the monovision (or "toggle" in more common language). It is not advisable, in a professional context such as yours, to use this type of surgery, although in theory, a maintenance of aptitude is possible, since in vision from afar, it would be possible, after such intervention, to use Eyeglasses to correct vision from afar on the side of the eye operated (with a neutral glass on the dominant eye).

  39. YanGil says:

    Hello
    Thank you for all these explanations and answers to the questions.
    Myopic for thirty years, I have 56, I use the "monovision" for 18 months using only a lens of 2, 75D.
    I work on computer and read a lot (business/leisure), and this process is also suitable for deciphering the signs on the street and in the subway.
    I now wish to undergo refractive surgery to permanently stop wearing lens in the daytime and glasses at night.
    But on reading the above, a problem seems to arise, because it is my non-dominant eye that I correct with a lens to see from afar, leaving my eye dominant (left) without correction, and I got used to it, experiencing nothing but Tingling to the eye that wears this lens.
    Question 1: Do I need to change my strategy in order to have the dominant eye operated to see from afar by laying the lens on my left eye (dominant)? I tried today and a persistent headache started in less than an hour.
    Question 2: How many years later (on average) will it be necessary to undergo reoperation (myopia + presbyopia on one eye), i.e., what is the average duration of the benefit of such intervention in the Fifties (if not, I wait a few more years)?
    Question 3: According to the video of the health show, the witness patient operated a week earlier found a good vision without any inconvenience (pain, Genoa, no blur, etc.). However, on the website of the Vision Clinic where you officiate (and where I intend to address myself), it seems to me that the testimonies almost all say that it took time (in months) to find a perfectly stable vision and to end the least of the unpleasant Gréments above: Can You "enlighten me"?
    Thank you so much in advance.

  40. Dr. Damien Gatinel says:

    As far as your eye/non-dominant lateralization is concerned, close/dominant eye: If this suit suits you, it is not necessarily useful to antagonize it. The operation (on the non-dominant eye) will aim to correct its myopia. The other eye (the dominant) will remain myopic. If this myopia is equal to or greater than-2 diopters, it will suffice to compensate for the present and future presbyopia. The operating suites vary from one patient to the next: In general, we observe simple suites, limiting in a few days (feeling of "discomfort" locally, a slightly fluctuating vision, etc.). A treatment of one month (antibiotic and anti-inflammatory eye drops) is prescribed on the day of the procedure. I operate and consult at the Institut Noemie de Rothschild, at 44 Avenue Mathurin Moreau, in the 19th, next to the main building of the Rothschild Foundation.

  41. Marie - Suzanne Soulet says:

    Hello Dr. Damien, thank you for your "enlightening" approach. I am myopic (-8 and-9), well corrected by wearing lenses until today. I am 63 years old and the ophthalmologist has detected a cataract (quite important seems). I care about my very good vision with no lenses (sewing, embroidery...) which is much less comfortable with lenses + glasses up close. So I would like to keep my myopia; The surgeon consulted tells me not being able to leave me a more important myopia than-4 in case of cataract intervention. Is it possible to operate only cataracts (I am not interested in my myopia)? If not, a close eye when you have a.-4 myopia is it comfortable for high-precision activities?

  42. Jean-Marc LE ROUZIC says:

    Hello
    I am myopic (-3.5 D G and-4d D) and longsighted (+ 1.5) at 49 years
    Not satisfied with multifocal lenses (Menicon), far affected vision quality, especially at night (light blur)
    I don't want to wear my multifocal glasses (the vision is better than with the lenses), I'm too accustomed to my lenses!!
    In addition I have a treatment (Ganfort/eye drops) for the ocular tension
    A suggestion of high-performance multifocal lenses, surgical intervention, other,...
    Thank you in advance for your return and your suggestion
    Kind regards

    John L.

  43. Dr. Damien Gatinel says:

    The vision provided by multifocal lenses is often less well tolerated by myopic than by farsighted. To correct myopia and compensate for presbyopia, the most effective technique in myopic presbyopic is monovision, where the myopia is corrected in full from the side of the dominant eye, while partially correcting it on the side of the non-dominant eye (this Residual slight myopia "compensates" then the presbyopia, allowing some uncorrected reading autonomy). It is quite possible to test this solution with suitable contact lenses (for example, if the eye with-4d is the non-dominant eye, a lens of-2.50 D is prescribed instead of-4d, and in the case A non-dominant right eye, a-2.00 D lens on this side). If the monovision is well tolerated, then it can be programmed for correction of laser myopia (LASIK or PKR).

  44. Dr. Damien Gatinel says:

    Your ophthalmologist is right to induce you not to opt for a myopia greater than-4d; With this one, you should be able to continue to exert a very good visual acuity in close mink without glasses: embroidery, reading, etc. will be possible without glasses. By far without glasses, you will however always see too blurry to pass you correction, but it does not bother you.

  45. Firefly says:

    Hello, doctor.
    I am considering a Monovision oepration because I am myopic but not yet presbyte. One has to correct my vision from afar on right eye and do not touch anything on the left. Correction a-3 on right and-2 on the left. I simulated the Monovision by removing my left lens for a week. This is bearable in everyday life despite the effects of loss of binocular vision.
    I practice tennis intensively. The simulation of the Monovision disturbs me on the appreciation of the ball. In true Monovision, this will disappear or it will last.
    Is it opportune to try the Monovision in Al measure or I am not yet presbyopic glasses (43 years).

    Thank you in advance for your answer.

  46. Dr. Damien Gatinel says:

    It seems quite opportune to propose a correction in Monovision ("rocking") because the presbyopia manifests itself at the age of 43 years on average (in reality the process of gradual loss of accommodation starts from birth, but It is only in the forties that it is no longer effective enough to allow to see at the usual reading distance). Monovision can disrupt the assessment of distances (e.g. tennis) because it is based on binocular vision. The wearing of a Contact lens occasionally (for example, the time of a game or a long drive) must be able to solve the Visual discomfort associated with these particular Visual circumstances). A difference of 2 dioptres is sometimes a little difficult to tolerate at the beginning, but over time, the Visual (cerebral) system adapts and one can then benefit from almost total independence to the correction in glasses from afar and close.

  47. Myriam says:

    Hello doctor,
    I have a myopia of (-2.75 left) and (-2 right) and also a presbyopia (+ 1 of both eyes). I work a lot on the computer, reading documents and email on the phone. When I put on my glasses, I have a lot of difficulty reading, so I have to remove them. Also, I'm tired of wearing glasses, I'd like to go back to the port of contact lenses, which I can't do for reading problems. Would that be a good option, to have contact lenses with correction for the computer (intermediate vision) and add a glasses for vision from afar when I'm not at the computer. If so, what would be the desirable strength of the contact lenses for the computer? I tried Monovision and it bothers me too much. Thank you in advance for your advice.

  48. Dr. Damien Gatinel says:

    With a lens correction close to-0.75 to the right eye and-1.25 to the gauchen eye you should be able to work closely and on computer, reserving the correction glasses for vision del ISO.

  49. Claudot says:

    Hello doctor,
    I have 47 years and a myopia of-9 with each eye with a beginning of presbyopia. I'm only wearing glasses for myopia.
    If I opt for surgery, I am offered to choose between putting my left eye Manager a 10 and the right eye a-2 diopter to prevent future presbyopia or so, a surgery to put my eyes to 10/10. What can you recommend to me and what is best used?

  50. Dr. Damien Gatinel says:

    It is highly recommended that you perform a contact lens test to simulate this correction difference (Monovision). If you tolerate this difference, then it can be reproduced in refractive surgery; Alternatively, a bilateral correction of the myopia is preferable, with the wearing of glasses for the reading in postoépratory. The pre-surgical lens test avoids many problems in postoperative and is very convenient to perform.

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