Myopia is determined mainly by genetic factors (heredity) and to a lesser extent by lifestyle factors. It usually rises until or shortly after the completion of the person's growth.
However, there are cases where myopia can continue to increase in much older ages. If in everyday life a person spends many hours in activities that require near vision (eg reading, computer, mobile) then a small increase in myopia may occur.
For this reason, it is recommended that these people take frequent breaks e.g. every half hour and focus even for 1-2 minutes on some distant target.
Another factor that can cause an increase in myopia at older ages is the onset of cataract, which, in addition to blurring the vision due to opacities of the crystalline lens of the eye, can also change the refractive power of the eye and raise its myopia.
Presbyopia is defined as the difficulty of the crystalline lens of the eye to change its shape as it does at younger ages, so that it can focus on nearby targets.
From an age onwards, somewhere around 40-45 years, the inner lens of the eye has difficulty in "zooming" to see near objects. This happens to all people.
However, not all people need the same near-correction at every age. What varies from person to person and determines who will need near glasses, when they will need them and to what degree they will need them, is related to their refractive error for far sight and to the age of the person.
In other words, a person who has hypermetropia will need nearsighted glasses sooner and to a greater extent than a person who does not have hypermetropia. Conversely, a person who has myopia can focus near from an age onwards by taking off their nearsighted glasses.
This does not mean that the person with myopia does not have presbyopia, but that myopia helps him to see near. It's kind of like balancing out his presbyopia. That is, before the ophthalmologist gives the prescription for near glasses, he needs to measure the refractive error for distance (even if the person does not wear glasses for distance). In addition, it needs to know the person's age, as well as whether they have undergone any eye surgery, such as cataract surgery.
Cataract surgery is now done with modern methods and takes about 10 - 15 minutes for each eye. Both eyes can be operated on the same day.
Anesthesia is achieved with eye drops and the patient does not feel any pain. However, he may feel some pressure. In addition, the patient is conscious and can even talk to the doctor.
In cataract surgery, some drugs are administered inside the eye, such as antibiotics, which are absorbed in the following days. The vision clears in about a week, but even before the week, the patient’s vision is functional.
The operation is performed with the modern method of phacoemulsification. Through tiny holes in the eye sides, the blurred cataract lens is removed after it is shattered, and replaced with an intraocular lens (IOL) for the needs of each eye, which is inserted folded into the eye with a tiny tool and then unfolded.
There is a wide variety of IOLs in use and pre-operative measurements are taken with many modern devices to determine which IOL to use.
Intraocular lens technology has advanced both in lens material (important to minimize potential long-term problems) and optics so we can offer the best visual acuity.
The differences in IOL quality are huge between simple generic lenses and advanced (premium IOLs). In combination, cataract surgery can correct myopia, hypermetropia and astigmatism, with the goal that the patient no longer needs glasses.
There is also the choice of inserting a multifocal intraocular lens, so that the patient can get rid of his near glasses. This is done after discussion with the surgeon and taking into account the needs of each patient.
- Be over 18 years old.
- Your refractive error must be stable for at least 1 year.
- Your corneal thickness meets the criteria for your refractive error degrees to be deducted (this is measured in the pre-op check).
- There must be no other eye disease (cornea, retina, glaucoma, old injury).
- If you are a woman, do not be pregnant or breastfeeding.
Also, the pre-operative check is necessary because each eye is different and each case is individualized.
Your ophthalmologist will consider all the data and through your discussion will suggest which method is suitable for you.
If you wear contact lenses, you should remove them and not wear them for at least 10 days before the test if they are soft and at least 1 month before if they are hard, in order for the test results to be reliable.
The duration of the laser in the eyes is short, about 10 minutes for each eye, and has some small differences depending on the technique (LASIK, transPRK).
In both techniques the laser focuses on the cornea, i.e. the outer lens of the eye and not on deeper structures.
The patient is given local anesthetic drops so that it does not hurt, but they may feel a pressure in the LASIK technique. After LASIK surgery, the vision clears within a few hours and there is no pain.
With the transPRK technique the vision clears up within 2 weeks and there is a little discomfort in the first few days.
The decision of which technique to be used is assessed during the preoperative examination and depends on the characteristics of the eye and the amount of the refractive error to be removed.