Latest / See Better without Glasses by Dr. Scott Spector / How to Improve Near Vision (Eye Doctor Ranks Best & Worst Treatments)

Transcript

How to Improve Near Vision (Eye Doctor Ranks Best & Worst Treatments) · See Better without Glasses by Dr. Scott Spector

• 0:00
  SPEAKER_00: The question I get more than any other from people in their 40s and 50s is what can actually be done to improve their reading vision?
• 0:07
  SPEAKER_00: This condition is called presbyopia, and it affects everyone in their 40s and 50s.
• 0:12
  SPEAKER_00: Many people fight it or deny it or work around it.
• 0:15
  SPEAKER_00: In the end, it gets us all.
• 0:16
  SPEAKER_00: Obviously, it's completely normal.
• 0:18
  SPEAKER_00: So the big question is, what can be done about it?
• 0:20
  SPEAKER_00: Are stronger glasses the only option?
• 0:22
  SPEAKER_00: It isn't.
• 0:23
  SPEAKER_00: Hi, I'm Dr.
• 0:23
  SPEAKER_00: Scott Spector, and I'm a board certified ophthalmologist with offices in Norwalk, Connecticut, Manhattan, and Westchester.
• 0:29
  SPEAKER_00: I am on a mission to educate people about their eyes using simple to understand explanations.
• 0:35
  SPEAKER_00: I do a new video every week, so subscribe and like us.
• 0:38
  SPEAKER_00: There are at least seven ways to deal with this.
• 0:40
  SPEAKER_00: They're not equally good, and most people never hear about more than two or three.
• 0:44
  SPEAKER_00: So without knowledge, they buy a stronger pair of glasses every couple of years for the next 15 years and called out a plan.
• 0:51
  SPEAKER_00: I had a man in my office convinced there was something drastically wrong with his eyes.
• 0:56
  SPEAKER_00: He had a routine eye exam, they dilated him, and afterwards it took him about a week before he could read normally again.
• 1:02
  SPEAKER_00: He spent that week thinking he had an injury that was slowly healing or was caused by the eye drops.
• 1:08
  SPEAKER_00: There was nothing wrong with his eyes.
• 1:10
  SPEAKER_00: He was 50 years old and he needed reading glasses.
• 1:13
  SPEAKER_00: Nobody had told him what else he could do, so I'm going to rank seven treatment options, worst to best, and who each one is actually for.
• 1:20
  SPEAKER_00: Quickly, so the ranking makes sense.
• 1:22
  SPEAKER_00: The lens inside your eye isn't a fixed piece of glass.
• 1:26
  SPEAKER_00: When you were 20, it was clear and flexible, and it changed shape to close things into focus and allowed distance things to come into focus as well.
• 1:34
  SPEAKER_00: That's why kids can read in the dark and hold the book as close as they want.
• 1:37
  SPEAKER_00: But as we age, the lens gradually loses its flexibility.
• 1:40
  SPEAKER_00: Every year, a bit more.
• 1:42
  SPEAKER_00: It's still there, it's still clear, it just can't flex the way it used to.
• 1:46
  SPEAKER_00: So the close-up focusing starts to suffer.
• 1:48
  SPEAKER_00: Every option below either works around that stiffany or it deals with the lens itself.
• 1:53
  SPEAKER_00: And I'm ranking them on two things.
• 1:55
  SPEAKER_00: How much of the problem does it solve?
• 1:57
  SPEAKER_00: And what does it cost you to get it done?
• 1:59
  SPEAKER_00: Not what it costs in dollars, what it costs you in convenience, in trade-offs, in what you have to carry around or put up with.
• 2:07
  SPEAKER_00: Number seven, the worst.
• 2:09
  SPEAKER_00: Buying stronger drugstore readers over and over and doing nothing else.
• 2:13
  SPEAKER_00: Don't get me wrong, drugstore readers are a good product.
• 2:16
  SPEAKER_00: They're cheap, they work, and for somebody at the start of this, they're the right answer.
• 2:20
  SPEAKER_00: What puts us at the bottom is doing it as a strategy for 15 or 20 years, because a stronger pair solves reading and nothing else, and it hides how much your eyes are really changing.
• 2:30
  SPEAKER_00: You never find out because every couple of years you buy the next number up, and the problem goes away for a while.
• 2:35
  SPEAKER_00: Prescription reading glasses are better.
• 2:37
  SPEAKER_00: The optics are better than off the rack, and they account for the difference between your two eyes, which the rack doesn't.
• 2:42
  SPEAKER_00: Same limitations though, one distance solve.
• 2:45
  SPEAKER_00: Number five, progressives, which is what I'm wearing.
• 2:48
  SPEAKER_00: Now we're solving more than one distance in a single pair, and for a lot of people, this is where they live and they're perfectly happy.
• 2:54
  SPEAKER_00: What it costs you is at the edges.
• 2:56
  SPEAKER_00: There's a narrow corridor of sharp vision, and everything on either side of it is a bit blurry.
• 3:01
  SPEAKER_00: In order to use progressive lenses, you have to learn to turn your head instead of your eyes.
• 3:05
  SPEAKER_00: Stairs take some getting used to.
• 3:07
  SPEAKER_00: Some people adapt in a week or so and completely stop thinking about them.
• 3:10
  SPEAKER_00: Some people struggle forever and give them up.
• 3:12
  SPEAKER_00: This is a good one.
• 3:13
  SPEAKER_00: Number four, computer glasses.
• 3:15
  SPEAKER_00: Single purpose, and I rank them here because they solve the one distance that everything else on the list handles badly.
• 3:21
  SPEAKER_00: There's a spot about two feet in front of you, 24 inches or so, where your readers are too strong and your distance glasses do nothing, and that's exactly where your monitor is.
• 3:30
  SPEAKER_00: A dedicated pair fixes that completely.
• 3:33
  SPEAKER_00: The cost is that it's a third pair of glasses in your life.
• 3:36
  SPEAKER_00: Sometimes we will actually prescribe a pair of computer bifocals where the top is for the computer and the bottom is for reading up close.
• 3:42
  SPEAKER_00: Certainly a reasonable option.
• 3:44
  SPEAKER_00: If you're finding this useful, hit subscribe.
• 3:46
  SPEAKER_00: New one every week.
• 3:47
  SPEAKER_00: Back to the list.
• 3:48
  SPEAKER_00: Number three, monovision.
• 3:50
  SPEAKER_00: In contact lenses.
• 3:52
  SPEAKER_00: Most people have never even heard of this, and certainly have never been offered this one.
• 3:56
  SPEAKER_00: You've set one eye for distance and one eye for near, and your brain uses whichever one it needs.
• 4:01
  SPEAKER_00: Nothing on your face for most of the day.
• 4:03
  SPEAKER_00: I actually did that in my late 40s.
• 4:05
  SPEAKER_00: Some people love it immediately, some people can't stand it and never adapt.
• 4:09
  SPEAKER_00: And there's no way to know which one you are by thinking about it.
• 4:12
  SPEAKER_00: The reason it ranks this high is that contacts come out at night.
• 4:15
  SPEAKER_00: You can find out whether you're one of the people who tolerates it before anybody does anything permanent.
• 4:20
  SPEAKER_00: Number two, the same arrangement done permanently with a laser on the surface of your eye.
• 4:24
  SPEAKER_00: What we do is one set for distance, one set for near, and nothing to put in or take out ever again.
• 4:30
  SPEAKER_00: We often create a situation where you will always have good distance and computer vision and will wear a custom-made reader for near vision.
• 4:36
  SPEAKER_00: The key to making this work is eye dominance.
• 4:39
  SPEAKER_00: If you set the dominant eye for near and the non-dominant eye for distance, you've got it backwards, and that person is going to be unhappy nine out of ten times and never quite able to explain why.
• 4:49
  SPEAKER_00: The dominant eye goes for distance every time.
• 4:52
  SPEAKER_00: Like throwing a ball, you use your dominant hand.
• 4:54
  SPEAKER_00: I'm a LASIK surgeon as well as a cataract surgeon, and eye dominance is bread and butter on the LASIK side.
• 5:00
  SPEAKER_00: It is not routinely checked in the cataract world, which I think is a gap in care for surgeons who don't do both kinds like I do.
• 5:06
  SPEAKER_00: And number one, replacing the aging lens inside your eye.
• 5:09
  SPEAKER_00: Since all of this is caused by your lens, everything above this works around a lens that's stiffening.
• 5:14
  SPEAKER_00: This is the only option that deals with the lens itself.
• 5:16
  SPEAKER_00: I can remove your aging lens and replace it with a premium lens that allows you to see at all distances.
• 5:22
  SPEAKER_00: We can use a multifocal that gives you vision from 12 inches out to infinity.
• 5:26
  SPEAKER_00: We can also use an extended depth of focus lens that gives you extraordinary vision at distance and up to about 16 inches.
• 5:32
  SPEAKER_00: For super close vision, you may occasionally need a low-powered reader.
• 5:36
  SPEAKER_00: It's the biggest of the seven and it's an operation.
• 5:38
  SPEAKER_00: So it isn't where most people start.
• 5:40
  SPEAKER_00: But if you're already at the strongest readers on the rack and the lens is going to need dealing with in the next several years anyway, it stops being an extreme option and starts being the obvious one.
• 5:50
  SPEAKER_00: So how do you know which option is best for you?
• 5:52
  SPEAKER_00: It's not your age and it's not the number on your glasses.
• 5:55
  SPEAKER_00: It's this.
• 5:56
  SPEAKER_00: How many different pairs are you getting through in an ordinary day?
• 5:59
  SPEAKER_00: One pair and you're fine.
• 6:01
  SPEAKER_00: You're at the bottom of the list, and the bottom of the list is the right place for you.
• 6:04
  SPEAKER_00: You might even want to try one of the new drops for Presbyopia.
• 6:08
  SPEAKER_00: The two pairs, and you're swapping, and at the one point where the next thing on the list is worth a conversation.
• 6:13
  SPEAKER_00: Three pairs and a drawer full of ones that don't work anymore, and you've been solving this the same way for a decade or two.
• 6:20
  SPEAKER_00: That becomes a different story.
• 6:22
  SPEAKER_00: So here's what I do.
• 6:23
  SPEAKER_00: Next time the readers stop being enough, don't buy the stronger pair.
• 6:26
  SPEAKER_00: Go and find out what's really happening with your eyes and then decide whether you want something that deals with it properly rather than another pair of glasses.
• 6:35
  SPEAKER_00: Because plenty of people, once they see the whole list of options, are perfectly happy where they are.
• 6:40
  SPEAKER_00: That's fine.
• 6:40
  SPEAKER_00: It's just a much better answer when you've made an educated decision.
• 6:44
  SPEAKER_00: One more thing.
• 6:45
  SPEAKER_00: If your reading is also worse at the end of the day than it was in the morning and blinking hard makes the print snap back for a second, that isn't this at all.
• 6:52
  SPEAKER_00: That's the surface of your eye, and it's a completely different problem, and it's a much easier one to deal with.
• 6:57
  SPEAKER_00: I did a whole video on that.
• 6:59
  SPEAKER_00: Go watch that one next.
• 7:00
  SPEAKER_00: And subscribe so you don't miss the next one.
• 7:02
  SPEAKER_00: Your reading vision isn't going to stop changing.
• 7:04
  SPEAKER_00: You have seven options, but most people only ever get told about two.
• 7:08
  SPEAKER_00: Now you've got all of them.