Hi, it’s Dr Rajesh Khanna, and if you were born before 1965, you should not miss this episode, because now we’re going to discuss about presbyopia with a flurry of questions. Oh my God, I didn’t even realize that a lot of people would be interested. But the number of questions are even more than what came for lasik. We’ll start with the first question and it is actually related to the same word “start”.
“When does presbyopia start, or when does presbyopia occur?” So presbyopia means ageing eyes in simple terms. Around 40 to 50, between that age group, our lens has hardened, the muscles… they’re called ‘Zonules’ , they’re very thin fibrous but they act like muscles that pull against the shape of the lens, they begin to weaken. So in that age group, it’s almost mathematical how the weakness occurs. Usually at age 40, you need zero diopters of reading add, but by the time you hit sixty, you need plus three reading add. In between for every four – five years, it increases by half a diopter. “When does presbyopia stabilize?” So it begins to stabilize towards the end of 50’s and early 60’s, because the maximum limit is reached, which is 3 diopters.
“Who gets presbyopia?” Everybody gets presbyopia. Whether you are a man, woman, whichever ethnicity, but not 100%, so you know that everything that is a bell-shaped curve, some people will get it in their 30’s, and some people will not get it until 70’s, but the rule of thumb, everybody gets presbyopia around 45 years of age, which affects the near end reading activities.
“Who discovered presbyopia?” I think even as early as Benjamin Franklin, or even if you go back to the 13th century, there are pictures where people have invented some sort of glasses to be able to read. So I think presbyopia had been there for a long time with us. And it might have started when men and women started living longer. Because as you know, people who follow the Paleolithic diet etc, in those times, human age was around 30-32 years, so people did not live long to experience presbyopia. But I think that around the time of our millennia, about 2000 years ago, when human life began to increase, we experienced presbyopia.
“What does it mean presbyopia?” Presbyopia means ageing eyes. “What age does presbyopia start?” We again discussed that, around 40 to 45. “What to do when you get presbyopia?” There are a couple of things you can do. You can push your hands a bit further and try to read. You can get glasses, or you can put a contact lens in one eye and not the other and make it for reading, or there are surgical procedures which we will discuss in following questions and answer.
“What is presbyopia contact lens?” So I was just hinting at that. So if you wear contact lens in one eye, that will help you read with one eye, whereas the other eye will see far. There are also multifocal contact lenses, but they don’t work very well because with each blink, the lenses move. And most of the people are not able to tolerate that fluctuation in image. “What does presbyopia mean in medical terms?” So in medical terms, it’s the failure of the lens to change its power, by changing its shape.
“What is presbyopia and myopia?” So that’s important because presbyopia occurs in everybody. Whether you are farsighted, you’re plano, or myopic. So in farsighted people, it occurs maturely in their 30’s, myopia people who are nearsighted can read fairly longer into their 40’s and sometimes 50’s until it begins to affect them too.
“Why is presbyopia not a refractory error?” This is a very good question, because the refractory errors we say are myopia, hyperopia and astigmatism because they are static. Presbyopia is a failure of the dynamic part. So just to repeat that, nearsightedness, farsightedness and astigmatism are static problems, so they occur under 40, whereas presbyopia is a dynamic problem.
“Are hyperopia and presbyopia the same?” No, hyperopia just now as we mentioned, is a static problem with the eye being small or the cornea being flat, whereas presbyopia is an ageing issue.
And now, we are going to come to some questions which will be tackled in our next episode, ‘How to kill or treat presbyopia’, so stay tuned for the next episode. Thank you and have a wonderful day.
Everyone will experience presbyopia as they grow older. If you are currently using reading glasses or bifocals, you may be interested in some of the more permanent presbyopia treatment options that are now available. Our experienced Beverly Hills ophthalmologist Rajesh Khanna, MD offers three main forms of presbyopia treatment:
There is no reason you should resign yourself to using reading glasses or bifocals for the rest of your life. Today’s presbyopia treatment options make it possible to enjoy clear vision at all distances again, freeing you to do and enjoy more on a daily basis.
To discuss presbyopia treatment in more detail, please contact The Khanna Institute today or call (888) 339-8143 to schedule a consultation with our experienced Beverly Hills eye doctor. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles, California.
Cataract Surgery After LASIK eye procedure requires special expertise. There are many important points to think about. Lets divide the factors to consider into three groups. Calculations before Cataract eye procedure, Techniques during the cataract surgery and management after the cataract eye surgery.
Its very important get certain data before proceeding with cataract eye surgery.
The style of removing the cataract and inserting the new lens.
Correcting the residual refractive errors by laser or limbs relaxing incisions may be required. Aggressive management of dry eyes is essesntial.
LASIK eye surgery involves reshaping your cornea to correct a wide range of refractive errors – providing you with clear, sharp vision that either eliminates or greatly reduces your dependence on glasses and contact lenses. However, LASIK cannot prevent the development of cataracts later in life, since cataracts are a problem with the eye’s lens, not the cornea.
Because LASIK involves reshaping your cornea, you will need to consult with an experienced eye surgeon before undergoing cataract surgery in the future. Once your cornea is reshaped during LASIK, your cataract surgeon will need to perform a careful examination in order to determine the correct degree of power needed for your intraocular lens (IOL) – the artificial lens that is implanted during cataract surgery.
If an inexperienced surgeon takes the incorrect measurements, your vision may become out of focus following cataract surgery, requiring additional procedures to restore ideal vision. Thankfully, Dr. Khanna’s extensive experience with both LASIK and cataract surgery has equipped him with the skill necessary to accurately evaluate the changes in your eyes caused by LASIK surgery, ensuring the best possible vision with your IOL after cataract surgery. After removing the cataract, Dr. Khanna will perform a manifest refraction to determine the appropriate lens power for the IOL. Based on this information, the correct IOL will be implanted. You can read more about this topic in the bestseller book on cataract surgery.
If you have further questions about LASIK or cataract surgery, please contact The Khanna Institute today or call (877) 254-2662 to schedule an appointment with board-certified Beverly Hills LASIK surgeon Dr. Rajesh Khanna. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles.
LASIK eye surgery and PRK both correct vision by re-shaping your cornea with targeted laser energy. The main difference is that in LASIK, a flap is created on the outermost layer of your cornea (the epithelium) to allow the laser to access the treatment area underneath. This flap is then replaced after treatment and allowed to heal. In PRK, no corneal flap is created; instead the entire epithelium is removed using the laser. This outermost layer then regenerates naturally over time.
Because of this difference in method, it may take longer for you to notice results with PRK compared to LASIK. However, the ultimate outcome is the same. Using a corneal flap in LASIK allows the eye to heal more quickly, meaning LASIK patients often notice improved vision as soon as the day after their procedure. PRK patients usually have to wait around three days before improved vision is noticeable, and they will experience light sensitivity for longer than a LASIK patient, as the cornea’s outer layer regenerates.
In short, there is no difference between the quality of your results with PRK and the quality of your results with LASIK. Both procedures can correct myopia, hyperopia, and astigmatism effectively. Since LASIK involves faster healing, it is usually recommended over PRK. However, PRK is ideal for patients who have a thin cornea, or specific corneal irregularities that would make the creation of a flap difficult. Dr. Khanna will discuss all of these factors with you in detail during your consultation.
If you have further questions about LASIK or PRK, please contact The Khanna Institute today or call (888) 339-8143 to schedule a free screening with our experienced Los Angeles LASIK surgeon Dr. Rajesh Khanna. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles, California.
Most patients walk away from a single LASIK treatment with their vision restored to their satisfaction. However, there are certain rare situations where a follow-up treatment may be necessary. A variety of factors may necessitate a follow-up treatment, including medications you may have started after surgery, or simply the way that you heal. People with higher prescriptions are usually more likely to need LASIK revision treatment.
At The Khanna Institute, we cover post-op exams and revision surgery for up to one year after your original Beverly Hills LASIK surgery. Once a year has lapsed, the cost for follow-up treatment will vary. Usually, revision surgery is not performed until at least four months have passed since your initial procedure, to give your eyes time to heal and your vision time to stabilize.
LASIK revision surgery is even safer than the original LASIK procedure, since there is no need to create a new corneal flap. Instead, Dr. Khanna will use the same flap that was made during your last surgery to apply the revised treatment. Healing and recovery will be the same as it was after your initial surgery.
If you have further questions about LASIK, please contact The Khanna Institute or call us today at (877) 254-2662 to schedule a free LASIK screening. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles, California.
LASIK eye surgery works by altering the shape of your cornea, allowing light to focus correctly at a single point. In order to access the part of your cornea that needs to be altered, a flap is created in the outermost layer (called the epithelium). In order to be a good LASIK candidate, your cornea must be thick enough to support the creation of a flap.
Pachymetry is the process of measuring the thickness of your cornea, using a medical device called a pachymeter. This method is used to determine your candidacy for LASIK, LRI surgery, and also to diagnose Keratoconus. Additionally, pachymetry is necessary for glaucoma patients, since the thickness of your cornea can have a significant effect on the accuracy of intraocular pressure readings.
If pachymetry reveals that your cornea is too thin for LASIK surgery, you may still be able to benefit from life-changing vision correction through an alternative procedure, such as LASEK, epi-LASIK, or PRK.
If you live in Beverly Hills, Westlake Village, or anywhere else in the greater Los Angeles area, please contact The Khanna Institute today to schedule a free LASIK screening with our experienced Los Angeles eye surgeon Dr. Khanna.
When you see an ophthalmologist for a regular eye exam, your eyes are tested to determine which lower order aberrations (LOAs) you have. There are three main LOAs: myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Glasses and contact lens prescriptions are designed to correct these lower order aberrations.
However, LOAs are far from the only issues that can affect your vision. Wavefront technology – which is used in LASIK surgery – is capable of detecting higher order aberrations (HOAs) in addition to LOAs, allowing Dr. Khanna to pinpoint every problem that is interfering with your vision.
There are over 60 HOAs. Common examples include:
Some of these irregularities have names, while others are expressed mathematically. Many HOAs are related to dim, low-level light conditions. By identifying your eyes’ HOAs in addition to LOAs, Wavefront technology provides the LASIK laser with a comprehensive “map” of all of your eye’s irregularities, allowing for more precise vision correction. Wavefront diagnosis can also be used in other refractive surgery procedures, including PRK, LASEK, and Epi-LASIK.
If you have further questions about higher order aberrations, please contact The Khanna Institute today or call (877) 254-2662 to schedule your free LASIK screening with Dr. Khanna. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles, California.
We all know the damage that sunlight can cause to skin, but few people realize that the same UV rays that cause skin cancer and other problems can also harm your eyes over time. And unlike other parts of your body, the natural lens in your eye cannot repair itself once it becomes damaged. Over time, sun damage to your lenses can cause serious eye disorders and even loss of vision.
Sun damage can contribute to several different eye conditions, including:
It’s important to wear effective sunglasses that block both UV and blue light rays. It can be helpful to obtain sunglasses with larger lenses in order to better protect the delicate skin surrounding your eyes as well, which can be prone to skin cancer.
While everyone is at risk of eye damage from the sun, certain patients face an increased risk – including children under 10 years old, people with retinal disorders, people with lighter eyes, and anyone taking medication that increases light sensitivity in the eyes.
If you have further questions about proper eye care, please contact The Khanna Institute today or call (877) 254-2662 to schedule a consultation with our experienced Beverly Hills ophthalmologist Dr. Khanna. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles, California.
Whenever you inhale cigarette smoke, nearly 4,000 chemicals are introduced into your bloodstream. If you are a habitual smoker, these chemicals will eventually damage your macula (the center of your retina), resulting in vision problems. Cataracts and macular degeneration are two common consequences of habitual smoking.
Macular degeneration is the leading cause of blindness in people 65+ years old in the United States, and smoking is the number one preventable risk factor of macular degeneration. In fact, according to a 2006 study in the British Journal of Ophthalmology, smoking is directly linked with 25% of macular degeneration cases that end in blindness. Secondhand smoke is also a problem. The study reveals that living with a person who smokes doubles your chances of developing macular degeneration.
Studies also show that the more cigarettes you smoke, and the longer you have been a smoker, the higher your risk of developing cataracts. Heavy smokers are up to three times more likely to have cataracts compared to non-smokers. The free radicals in cigarette smoke increase the oxidative stress in the lens of your eye, damaging important proteins and fiber cell membranes that ultimately result in the opacity of cataracts.
If you are a smoker, or have been a heavy smoker in the past and are concerned about your eye health, please contact The Khanna Institute today or call (877) 254-2662 to schedule an appointment with board-certified Los Angeles ophthalmologist Dr. Rajesh Khanna.
Uncontrolled diabetes poses a risk for eye health. When your blood sugar levels are not properly regulated, vision changes (such as blurriness) can occur, as well as retinal damage. The latter problem – a disease known as diabetic retinopathy – may eventually cause blindness if it is never treated.
If you have diabetes, but do not have retinopathy, you may still potentially be a good candidate for LASIK. However, diabetics do have a higher risk of complications after LASIK. Corneal abnormalities are common in patients with diabetes, which can cause healing after LASIK to be slow and imperfect. You may also experience increased light sensitivity.
In short, diabetes requires a thorough pre-surgical evaluation in order to determine your LASIK candidacy, and to anticipate possible problems. If your retina has fragile blood vessels, or if early cataracts are present in the lens, then the risks of LASIK will most likely outweigh the benefits. However, if no eye damage is found during your screening and your diabetes is adequately controlled, you can still enjoy the benefits of this life-changing procedure.
If you have diabetes and are interested in LASIK, please contact The Khanna Institute today or call (877) 254-2662 to schedule your free LASIK screening. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles, California.