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.
Presbyopia Treatment Options by Dr.Rajesh Khanna
“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.
As you grow older, you may find that is more difficult to read, use the computer and focus on near objects. The reason is presbyopia. This is a medical condition where people begin to lose the ability for their eyes to focus.
The earliest warning signs can be seen between the ages of 40 and 50, though some experience symptoms years before.
Difficulty reading and blurred near vision are two of the most common signs of presbyopia. Some individuals may also experience headaches and eye fatigue as well.That is when the need for readers and cheaters starts. Gradually the dependence increases.
The most common symptoms of Presbyopia include:
Hyperopia, or farsightedness. Objects at a distance are clear, but objects close up are blurry
Farsightedness increasing with age
Difficulty focusing on nearby objects
Experience eyestrain or headaches from prolonged reading or close work
Holding books or magazines at a distance to read clearly
If you or a loved one is exhibiting the early signs of presbyopia, it is important that you contact our Ventura or Los Angeles County Office as soon as possible so that your condition does not worsen. We offer free vision screenings for all new patients. Please schedule your appointment with Dr. Khanna today.
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Hi folks. This is doctor Khanna, your laser eye man. Coming to you with some new information. Today, I am going to talk to you about the 7 myths of cataract eye surgery. Cataract surgery has been there for many ages. You have probably heard about it but what is interesting is that your grandparents have probably heard about it. Even their grandparents knew about cataract surgery. Over the years, cataract surgery has advanced so much. The surgical finesse has become so much better that the modern day cataract surgery is way ahead the cataract surgery that was performed 60-70 years ago. The problem is all the new information and knowledge has not circulated to the masses. Most of the information from decades old technology is still circulating amongst our friends and relatives. Today, I want to destroy all these myths, which are still existing.
MYTH 1 Cataract Surgery You have to wait for cataract to get ripe before they can have surgery.
This might have been true around 60 years ago when we did not have microscopes, surgical lubes and stitches. We did not have modern technology to pulverize the lens and take it out through small openings. At that time, the only to take it out was when you could see that the cataract is white, red or black. Freeze it and then pull it out in mass. Over the years, we have developed surgical loops, microscopes to binocular microscopes and we can see the smallest things in there. We can make minute openings, go in there and remove lens, which might not have been visible to the naked eye. That is the first myth that we have to destroy totally. In fact, the opposite is true. You should never wait for the cataract to get ripe because as the cataract matures, it gets hard and requires more energy to be taken out. Why is so much energy bad? It is because we are in a closes space in the eye and the energy is going to hit the iris (the colored part of the eye), the cornea (the clear front part of the eye) and damage the cells. We want to avoid that. The first myth has been dismissed.
Myth 2 The doctor has to decide when you need cataract surgery.
This is news from a by-era when the doctor has to see the cataract and he was comfortable with the surgery. Today, it is all about you. Even Medi-care, medical insurance and everybody says that. The best time to do cataract surgery is when you feel that the cataract are bothering you and interfering with your active lifestyle. For different people it might be different. If you are 52-years old, and you have cataract that cause a lot of glaring driving, it might be troublesome for you and you might an early intervention. If you are a librarian or a stay-at -home person who does not drive a lot, then those minor cataract might not cause a lot of difficulty to you. You get to decide not the doctor or the insurance.
Myths Cataract Surgery #3 You cannot go blind with cataracts.
It is important because many people are fearful of cataract surgery. They feel that the surgery will harm them and that cataracts are not going to cause any problem in the long run. That is wrong because the cataract is hardening and changing the lens and it gradually keeps cutting off the light until there is no light. You would be surprised to know that cataract is the most common preventable cause of blindness in the world. When the cataract hardens, it can lead to increased pressure and inflammation leading to blindness. The third myth that cataracts cannot make you go blind has been busted. You should do everything at all cost to avoid it.
Myths Cataract Surgery #4 The cataract has to be removed entirely.
This was the in the 70’s when the cataract had to be taken out in mass. That is not true and in fact, the opposite is true. We do not want to take out the entire cataract. We take out the cataract bag, clean out the contents and put in a new synthetic lens using the old lens as a support of the new lens. If you do not do that, the new lens would fall down and you do not want that. It is like taking your car for an engine oil change, out comes the old and in comes the new. You do not change the whole cask of the engine itself.
Cataract surgery is painful. Myths Cataract Surgery #5
This myth is close to everybody. Today, it is not true. Today, cataract surgery is one of the simplest and easiest procedure to perform. We keep it pain free both by topical drops and specially formulated drops that are instilled inside your eye. We make sure that your eye is numb and is pain free. We do not have to numb your whole body.
If we are operating on your eye, we do not have to numb the whole body. We can take care of the pain.
#7 Myth Cataract Surgery Recovery is long and painful. That is not true. Why? It is because it is a simple surgery performed in a short period of time for about 7-10 minutes. You are pain free and not totally asleep. Many people can go and work or even drive the same day if we do not give them enough medications. That is not what we are recommending. It is not like before when it was six weeks, in a day or two, you can go back to your activities of daily living. I hope this information is useful and we have destroyed these 7 myths for now and forever. Thank you and have a wonderful day.
Hi. How are you? This is doctor Khanna, laser man here once again, bringing you up to speed with the latest in eye technology. Today, we are going to talk about a very exciting and new topic; laser cataract surgery. There are a lot of myths about laser cataract surgery and we are going to bust them all. We are going to talk about 7 myths of laser cataract surgery, which has been found not to be true and we are going to go over it one-by-one.
Laser cataract surgery is safer the manual cataract surgery. Even doctors believe that but reports came out of a study that showed that it was not the case. Laser surgery is at best as good as manual cataract surgery but not safer. That is one myth, which has been busted not by me but by published and reviewed journal studies of Europe.
Laser cataract surgery is going to be free and covered by insurance. That is not true. Medical insurance has determined that if someone wants to upgrade to laser cataract surgery, they will have to pay extra.
Laser can perform all the steps of cataract surgery. I think that is one of the biggest myths out there, thinking that it is going to be a robotic surgery and robots are going to come and do everything. That is not true. Lasers do certain steps pf the procedure, mainly opening in the lens and sometimes cutting the lens. They cannot do all the steps. In fact, some steps are done better by hand.
Cataract wounds made by lasers are better than those made by diamond knives. The reverse is true, diamond knives can make better and more precise wounds than the current generation of lasers used in cataract surgery. It is very logical why this happens, because the laser will need to see where they have to act. They are seen by using ‘ocular coherence topography’. The wounds have to made at the junction between the clear part and the hazy part which is the cornea and sclera. It is sometimes not discreet for the machines and that is why human eyes can detect them better and make better wounds.
If we do laser cataract surgery, we would not have to wear glasses after the procedure. That is not true. Only ‘presbyopic implants in eye’, can free you from the bondage of contact lens and glasses after cataract surgery and not laser.
After cataract surgery, drops will not be needed. Again, that does not hold the light of day. You will need drops. Drop less surgeries is a different concept. After the laser cataract surgery, you might need more drops.
Laser cataract surgery might be less painful and faster by cataract surgery done by hand. I feel sorry but, we have to bust that one too. When we do laser cataract surgery, we have to apply something that would hold your eye while the laser moves around making the openings and cutting the lens up. That is held by negative suction pressure, which is painful and we have to give you medication for that. For that, we have to add another step, we have to do the part of the surgery done with laser first and then in the operative room, we have to do the rest of the surgery by hand. It increases the time that you would be in the operating theater.
I hope you have seen the truth about laser cataracts surgery. It is a good procedure but it is not recommended for all based on knowledge and published studies that we have. Thank you for listening to me. Have a wonderful day. Keep sending your questions here.
Up until recently, if you wanted to fix your presbyopia (age-related long-sightedness) you would need to get a Multifocal IOL (Intraocular Lens). The problem with a Multifocal IOL is that to be able to additionally improve your reading vision your distance vision would suffer. You would have to decide whether you would rather have better distance vision and still need reading glasses (Monofocal IOL), or if you would rather have slightly better distance and good reading vision (Multifocal IOL). You also had the option to get a Monofocal IOL in one eye and a Multifocal IOL in the other, so you could have at least one strong distance eye. Enter the Symfony IOL.
The Symfony IOL is the first and only extended range of vision IOL that corrects presbyopia. This means, that unlike the Monofocal IOL that only allows you to correct distance vision, or the Multifocal IOL that allows you to correct both but with a compromise in your distance vision, that you can now correct both without loss of quality. It also comes in a Non-Toric and Toric version for patients with astigmatism! Another added benefit of the Symfony IOL, which the Multifocal IOL had a problem with, is that there are no glares or halos with this lens, making your newly corrected vision even better!
Implanting the Symfony IOL
The Symfony IOL is implanted during a routine cataract operation. Completed with minimum recovery time, most patients are able to go back to their normal lives within 24 hours. With a routine operation, minimal recovery time, and improved distance and reading vision without glares or halos, the Symfony IOL sounds like a great choice! If you agree and would like more information or would like to schedule a consultation call today 310 482 1240
Bifocal Implants – A Breakthrough from Monofocal Lenses
Cataract surgery done these days is good and safe. The surgery can even be finished in less than 20 minutes on top of a very short recovery period requirement. This attracts most people with cataract to have cataract surgery. Unfortunately, despite these advancements, a major downturn is that the treatment by insurance only uses monofocal implants, which means that only a single point can be focused. If this is the case, the patient will still be required to use correction glasses to help make their vision a lot clearer.
Monofocal implants were used before in making clearer vision for patients, but by the last few decades, a new implant known as bifocal was introduced. This means that the lenses are multifunctional, which also indicates that the patient can focus different distances already and do all things independently after the treatment. Infact I inserted bifocal implants in the early nineteen nineties. Thats over two decades of experience implanting sight improving intraocular implants. These bifocal implants were manufactured for the first time by the company Shah and Shah.
The bifocal implants lenses are beneficial for people who do not want to depend on glasses and have reached an age over 45. This is different from the LASIK surgery because the latter does not require implants. Lasik eye surgery does not require a sterile surgical suite; but instead performed in a clean laser suite
There are three different types of FDA approved bifocal implants lenses and they are called Tecnis, Restor, and Crystalens. You must know what these types of lenses are as well as what their differences are before agreeing on what type of surgery has to be done for you. The discussion must be done by the surgeon who will do you the surgery. A good source of information for these bifocal implant lenses is this book on cataract surgery. You must not rely solely on the advertisements you can see in the media since some aspects might not be discussed thoroughly.
Your decision in choosing what type of lens to use for your cataract procedure might then be affected by the cost associated with the implant types. This is because only few insurance providers cover these types of services and lenses, so therefore you may need to look at your finances and available options of monthly payments.. At our Cataract eye center, of Thousand Oaks, we offer patient lens implants based on what people with fixed income can afford and what they desire in regard to vision correction. Out Top Cataract Surgeon makes sure to offer the most appropriate up to date technology in cataract surgery and provides an array of lens options for each patient.
Article written by
Rajesh Khanna, MD
*Los Angeles Bifocal Implant Expert
See First Sight Reactions After Surgery With Dr. Khanna
Having an eyesight problem like cataract can surely be a hassle, as it will not allow you to do more things that require clear vision. If you want to get back your life before you have cataract, you should look for a surgeon and make an appointment for cataract removal treatment immediately. You must not wait until it gets worse. If you are not sure yet whether you already need treatment, here are some of the Instances That Suggests You to Have Cataracts.
Eyesight Changes Too Often
Have you experienced times wherein you need to change your eyeglasses often because the recently prescribed eyeglasses do not fit your current needs? Maybe it is time for you to stop relying on eyeglasses, as it will just cost you a lot of hassle over time. It is best to look for a doctor and have a cataract surgery immediately. Inconsistent eyeglass grade necessity is a symptom of cataract.
Poor Overall Vision
You must understand that having an unclear vision does not immediately suggest you will need to have cataract surgery since some individuals might just need correction glasses. However, if you notice that even with using eyeglasses you still cannot see clearly, especially at night, you must see a doctor immediately. Not all people show the same cataract symptoms, so you must be aware of what is happening with your own eyesight.
The Color You See Fades
You must take note the at times individuals can see color differently from other individuals. Commonly, doctors perform a test to determine this by examining two patients. The doctor will show a image and if you cannot state what the real color is, you may need to be subjected to cataract removal.
Cataracts are notorious in causing multiple images. This may lead to difficulty in perceiving the right image. Seeing double of an object is termed as diplopia. Cataracts cause monocular diplopia – that is when one eye is covered the other still sees two objects
Difficulty driving at night
When driving at night cataracts can cause difficulty causing glare, haloes, and decreased overall vision. If you have difficulty with light at night or see glare and haloes this may be cause for a cataract removal. Glare and Haloes may not be solely due to cataracts so a exam with an ophthalmologist is required to find the correct cause.
Extra light to Read (Forget those Menus)
Cataracts can cut off incoming light into the eye, preventing the light from reaching the back of the eye. Therefore you may notice you require extra light when reading your favorite book in bed or menus in restaurants.
Having all or any of the symptoms above might alarm you, as those are the symptoms of patients who need cataract removal. Hence, do not be hesitant in calling up an appointment with your doctor as early as possible. Dr. Khanna of Khanna Vision Institute, serving Los Angeles, has performed cataract removal on thousands of individuals including his own mother. Cataract surgery is a common procedure and can be performed safely and easily with the correct surgeon.
No more cataracts with Khanna Vision Institute!
a member of American Society of Cataract and Refractive Surgery
Cataract surgery is a type of operation that has been around for decades now. This is deemed as one of the safest surgeries there is. The success rate of cataract surgery is at 98% as per the American Society of Cataract and Refractive Surgery . However, no matter how safe a procedure is, possible cases of complications of Cataract Surgery still arise. Though these complications may be of minor ones and can be easily corrected, knowing them would still be best so you may prepare in case they happen.
Possible Complications of Cataract Surgery
Infection and Bleeding – these two are common complications that can happen in surgeries and cataract surgery is no exception to this complication.
Posterior Capsule Opacity – this is one of the most common complications of cataract surgery. This side effect happens when the lens capsule protecting the eye lens grows cells from the outer layer of the cornea onto the capsule. This will then result into a hazy vision. Nevertheless, a laser treatment procedure can correct this. This complication may happen in 20% of cataract surgery patients.
Double Vision – Double vision happens when the implanted intraocular lens gets out of place or dislocated. This can be treated by your eye surgeon by re-positioning your dislocated lens. If the dislocation happens again, this can be corrected by sewing the lens in place.
Other Cataract Surgery Complications – other complications following a cataract surgery may include, but is not limited to the following:
Droopy eyelid or swelling: More common with prolonged surgeries using a speculum to pry the eye open.
Decreased vision or Cystoid macula edema. Found more often with Surgeons using a high level of illumination directly focussed on the eye
Retinal detachment : A curtain coming in front of eyes. Highly nearsighted people are more prone to this
Dislocated lens material: In cases of complicated surgery
Pain : from the increase in intraocular eye pressure
Redness : If conunctival tissue has been tampered with by the cataract surgeon
Light Sensitivity – multifactorial
Cataract surgery complications, like the ones mentioned above, should be reported immediately to your doctor as soon as you notice them. One reason for this is because in just a few weeks or months post-surgery, the implanted lens can grow in place. This will then become a lot harder for your surgeon to remove or reposition.