Latest / See Better without Glasses by Dr. Scott Spector / Eye Surgeon: Can You Get 20/20 Vision Without Glasses? (Even If You’re 50+)

Transcript

Eye Surgeon: Can You Get 20/20 Vision Without Glasses? (Even If You’re 50+) · See Better without Glasses by Dr. Scott Spector

• 0:00
  SPEAKER_00: Have you ever been told your eye is like a camera?
• 0:02
  SPEAKER_00: A camera has a lens, your eye has a lens.
• 0:04
  SPEAKER_00: Light goes in, a picture comes out, close enough for most conversations.
• 0:08
  SPEAKER_00: The main difference, a camera has one lens and the eye has two.
• 0:12
  SPEAKER_00: They sit one behind the other and work together to focus light onto the retina or the film of your camera.
• 0:18
  SPEAKER_00: For a variety of reasons, this combination lens system may not focus light exactly.
• 0:23
  SPEAKER_00: When this happens, your vision is blurry and you need eyeglasses to correct the problem.
• 0:27
  SPEAKER_00: This two-lens system allows us to consider a few different procedures to get you out of them.
• 0:32
  SPEAKER_00: The nice thing is there is something that can be done safely and effectively for almost everyone that wears glasses.
• 0:38
  SPEAKER_00: Hi, I'm Dr.
• 0:38
  SPEAKER_00: Scott Spector, and I'd like to help you understand how the eye works and what we can do to correct it.
• 0:43
  SPEAKER_00: It's pretty simple and will take just a few minutes, and when I'm done, it will all make sense.
• 0:48
  SPEAKER_00: Here's the eye from the side.
• 0:50
  SPEAKER_00: This clear dome at the very front of the eye is the cornea.
• 0:53
  SPEAKER_00: It's like the crystal of your watch or the windshield of your car.
• 0:56
  SPEAKER_00: In the middle of the eye, behind the colored part, is the actual lens of your eye.
• 1:01
  SPEAKER_00: That's a lens in the literal sense made of clear living tissue, about the size of an MM.
• 1:06
  SPEAKER_00: Light comes in through the cornea, passes through the lens, and lands back here on the retina, which is the film at the back that turns it into a picture.
• 1:14
  SPEAKER_00: Two lenses, both bending the light, both aiming at the same target.
• 1:18
  SPEAKER_00: And the only thing that matters for our purposes is whether the two of them focus the light exactly on the retina.
• 1:24
  SPEAKER_00: Not in front of it, not behind it, right on it.
• 1:27
  SPEAKER_00: Now both of these structures have a focusing power.
• 1:30
  SPEAKER_00: In a healthy eye, the cornea has a power of 40 and the lens has a power of 20.
• 1:35
  SPEAKER_00: For reference, your eyeglasses or contact lenses also have a power, but the numbers are usually much smaller, like minus two or plus 1.5.
• 1:43
  SPEAKER_00: 40 plus 20, 60.
• 1:45
  SPEAKER_00: That's an eye that's in focus.
• 1:46
  SPEAKER_00: That is a name, and it's called emetropia.
• 1:49
  SPEAKER_00: No need for glasses.
• 1:50
  SPEAKER_00: So here's the thing about that 60.
• 1:52
  SPEAKER_00: Your eye doesn't check its own work.
• 1:53
  SPEAKER_00: It grows the way it grows, and the cornea and the lens don't consult each other about it.
• 1:58
  SPEAKER_00: So a very large number of people end up with two perfectly healthy lenses that simply add up to the wrong number for the length of their own eyeball.
• 2:05
  SPEAKER_00: Nothing is diseased, nothing is damaged, the math just doesn't work out.
• 2:10
  SPEAKER_00: As an example, say you're 30 years old and your eye adds up to 63 instead of 60.
• 2:15
  SPEAKER_00: Light gets bent too hard, it comes to a point in front of the retina instead of on it, and by the time it reaches the back of the eye, it spreads out again.
• 2:24
  SPEAKER_00: Things are blurry, and that means you are nearsighted.
• 2:27
  SPEAKER_00: So you go and get glasses, and the number of your prescription is minus three.
• 2:32
  SPEAKER_00: 63 minus three is 60.
• 2:35
  SPEAKER_00: That's the whole reason people wear glasses.
• 2:37
  SPEAKER_00: There's nothing wrong with your eye.
• 2:38
  SPEAKER_00: The two numbers just don't come out to 60.
• 2:40
  SPEAKER_00: Which raises the obvious question, if it's just math, can you fix the math?
• 2:45
  SPEAKER_00: If this is the kind of thing you want more of, hit subscribe.
• 2:48
  SPEAKER_00: I love simplifying eye problems so that my patients can understand it.
• 2:52
  SPEAKER_00: I'll be putting one of these out every week.
• 2:54
  SPEAKER_00: This is actually a lot of fun for me and hopefully informative to you.
• 2:58
  SPEAKER_00: Now back to the eyes.
• 2:59
  SPEAKER_00: You can fix the math in two places.
• 3:02
  SPEAKER_00: You can change the front lens, I can reshape the cornea, take that 40 and make it a 37, and now your eye adds up to 60, and you're in focus without anything on your face.
• 3:12
  SPEAKER_00: That's done on the outside of the eye with a laser, and that's LASIK or PRK.
• 3:17
  SPEAKER_00: Same math your glasses were doing, but done once on the eye instead of putting glasses on every day.
• 3:22
  SPEAKER_00: Technically, this is called corneal-based refractive surgery.
• 3:26
  SPEAKER_00: To reshape the cornea means the laser removes a very thin layer of tissue to change the curve, and there's a limit to how much cornea is sitting there to work with.
• 3:34
  SPEAKER_00: That's the actual reason people get told they aren't candidates.
• 3:37
  SPEAKER_00: It usually has very little to do with how bad their vision is.
• 3:40
  SPEAKER_00: The correction they need is simply too much for the tissue they've got.
• 3:44
  SPEAKER_00: One newer procedure is called the Evo ICL, which is essentially an implantable contact lens.
• 3:49
  SPEAKER_00: We actually insert a custom-made contact lens made out of a special colymer into the eye directly on top of your internal lens.
• 3:57
  SPEAKER_00: This is for people who have a much higher prescription, usually minus seven or more.
• 4:01
  SPEAKER_00: The third option is you can remove and replace the lens in the middle of the eye.
• 4:05
  SPEAKER_00: Using a laser, I break up the natural lens, suction out the material, and replace the lens with an artificial one.
• 4:11
  SPEAKER_00: These lenses allow us to fully correct vision, even for reading.
• 4:15
  SPEAKER_00: The math is the same.
• 4:16
  SPEAKER_00: I select your lens based on complex measurements, but the math is simple.
• 4:21
  SPEAKER_00: At the end, I want the power of your eye to add up to 60.
• 4:24
  SPEAKER_00: Complex testing, simple arithmetic.
• 4:27
  SPEAKER_00: This and the Evo ICL are considered lenticular or lens-based refractive surgery.
• 4:33
  SPEAKER_00: Different operations, different parts of the eye, identical math.
• 4:36
  SPEAKER_00: That's it.
• 4:37
  SPEAKER_00: To fix your eyesight and not have to wear glasses, you either fix the outside of the eye with corneal-based refractive surgery, or the inside of the eye with lenticular-based refractive surgery.
• 4:48
  SPEAKER_00: And that's how I fix eyeballs.
• 4:49
  SPEAKER_00: So which one applies to you?
• 4:51
  SPEAKER_00: Mostly that's an age question.
• 4:52
  SPEAKER_00: And here's why.
• 4:53
  SPEAKER_00: When you're young, the lens in the middle of your eye is clear and it's flexible.
• 4:58
  SPEAKER_00: It's doing its job and it's got nothing wrong with it.
• 5:01
  SPEAKER_00: There's no reason on earth to take out a completely clear, healthy lens.
• 5:05
  SPEAKER_00: So I leave it alone and I do the math on the cornea.
• 5:08
  SPEAKER_00: That's why LASIK is mostly a younger person's procedure.
• 5:12
  SPEAKER_00: Same thing with the Evo ICL for much more nearsighted eyes.
• 5:15
  SPEAKER_00: As we get older, that inside lens changes.
• 5:18
  SPEAKER_00: It stiffens, it yellows, it stops passing light the way it used to.
• 5:22
  SPEAKER_00: That's not a disease.
• 5:24
  SPEAKER_00: It happens to everybody, and it's a whole video on its own.
• 5:27
  SPEAKER_00: But once that situation, reshaping the cornea, is only doing half the job, I'd be perfecting the math in front of a lens that's the actual problem.
• 5:35
  SPEAKER_00: So the sensible move flips.
• 5:37
  SPEAKER_00: Leave the cornea alone, replace the lens, and choose the power while I'm in there.
• 5:42
  SPEAKER_00: You have to understand the measurements of both in order to determine what operation is best.
• 5:47
  SPEAKER_00: Most eye surgeons work on one side or the other.
• 5:50
  SPEAKER_00: Almost every surgeon who operates on eyes does the inside.
• 5:53
  SPEAKER_00: Most people do cataract surgery.
• 5:55
  SPEAKER_00: Only a small number of those also work on the outside or LASIK surgery.
• 5:59
  SPEAKER_00: So the answer you get can often depend on which office you go to.
• 6:03
  SPEAKER_00: For me, the best professional decision I've ever made was to be both a cataract and a LASIK surgeon.
• 6:09
  SPEAKER_00: It's nice to have options as a surgeon and it allows me to offer all the options.
• 6:13
  SPEAKER_00: So, two lenses, about 40 at the front, about 20 in the middle, and they need to come out to 60.
• 6:19
  SPEAKER_00: Your prescription is the gap between the numbers, and that is the number of your eyeglasses.
• 6:24
  SPEAKER_00: If somebody has told you at some point that you weren't a candidate, they may not have thought through all the options.
• 6:29
  SPEAKER_00: If you are open-minded, it's worth understanding your entire situation.
• 6:33
  SPEAKER_00: Hopefully the 40 plus 20 rule will help you understand your eyes a little bit better.
• 6:38
  SPEAKER_00: The next thing worth understanding is what happens to that inside lens as it gets older.
• 6:43
  SPEAKER_00: Because it happens to everybody and it starts far earlier than people think.
• 6:47
  SPEAKER_00: And the way it's usually described to patients does more harm than good.
• 6:51
  SPEAKER_00: I made a video on it.
• 6:52
  SPEAKER_00: That one's next.
• 6:53
  SPEAKER_00: So subscribe to my channel and allow me to educate you about your eyes.
• 6:58
  SPEAKER_00: Most people only know about one of their lenses.
• 7:00
  SPEAKER_00: Now you know what the other one does and what it means for you.
• 7:04
  SPEAKER_00: Who knows?
• 7:04
  SPEAKER_00: You might be able to fix your eyes so you don't have to wear glasses anymore.
• 7:08
  SPEAKER_00: I'll see you on the next one.