Palm Beach Eye Center: Khouri George G MD

Products And Services

• Eye Doctor Services

  Services Provided at the Palm Beach Eye Center Laser Vision Correction to eliminate or reduce dependence on glasses and contact lenses: LASIK, LASEK, PRK and EPI-LASIK Laser Assisted Cataract Surgery No needle, No stitch, No patch Cataract Surgery using Lifestyle Lens Implants Hyperlinked to reduce or eliminate dependence on glasses for distance, intermediate and near. Refractive Lens Exchange to treat Nearsightedness, Farsightedness, Astigmatism and Presbyopia. Medical and Surgical Treatment of Glaucoma. Pterygium Surgery with conjunctival autograft. Laser Surgery for Glaucoma, Diabetic Retinopathy and other Retinal Vascular Diseases, Retinal Holes and Tears, and Secondary Cataract (Posterior Capsule Opacification).. Treatment of Diabetic Retinopathy and Macular Degeneration with Intravitreal Injections. Treatment of Dry Eyes. General Eye exams for treating Medical Eye Conditions including Eye Prescriptions for glasses and contact lenses. Advanced diagnostic testing including Corneal Topography, Wavefront Aberrometry, Optical Coherence Tomography (OCT), Optical biometry, A scan Ultrasound Biometry, B scan Ultrasonography and Visual Field Perimetry. Fundus Photography and Fluorescein Angiography for the diagnosis of Retinal Diseases such as Diabetic Retinopathy and Macular Degeneration. Eye Doctor Services in Palm Beach & West Palm Beach

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• Laser Vision Correction

  What is Refractive Laser Surgery (LASIK)? Refractive laser surgery eliminates or reduces the need for glasses by altering the shape of the cornea, thus changing the way the eye focuses light. These procedures are performed in only a few minutes using anesthetic eye drops. LASIK (laser in-situ keratomileusis) is a laser vision correction procedure used to correct Refractive Errors such as nearsightedness, farsightedness, and astigmatism using the Excimer laser. This laser procedure was developed in South America, where Dr. George Khouri learned it from one of the world’s first — and most experienced – practitioners in 1996 before it was approved for use in the USA. LASIK was developed and first performed outside the USA in the early 1990s, primarily because it was not subject to our strict FDA regulations. LASIK was FDA approved in 1998. There have been no long term problems reported with LASIK since then. Most experts in the field are confident that the cornea will remain stable permanently, as long as patients are appropriately selected and the safe limit of tissue removal by the laser is not exceeded during the surgery in the case of high refractive errors. The skill and experience of the surgeon are also key factors. Why Choose Dr. Khouri for LASIK? Dr KhouriDr. George Khouri West Palm Beach has performed the LASIK procedure on several of his peers in the community making him “the doctors’ doctor” and the premier West Palm Beach LASIK Surgeon. Dr. Khouri had the LASIK procedure performed on his own eyes. He strongly believes that LASIK is an excellent procedure yielding long lasting results. The success of the visual results following laser vision correction not only depends on excellent surgical skills but also on very accurate preoperative measurements of the refractive error and other corneal parameters to be programmed into the laser computer. Dr. Khouri personally takes and/or oversees all of these preoperative measurements and follows you closely preoperatively and postoperatively in contrast to some other practices that rely solely on their technicians for these tasks. When you choose a highly skilled surgeon, complications from any of these procedures are very rare. Actually, there is a lower risk of visual loss from LASIK than from long-term use of extended wear contact lenses. The reason is that the latter increases the risk of an infection such as a corneal ulcer which could lead to severe visual loss. Why LASIK? LASIK West Palm BeachPrior to the 1980s, physicians were making radial and arcuate incisions to reshape the surface of the cornea and treat myopia and astigmatism respectively. This is called radial keratotomy or RK. The goal of this procedure was to reduce or eliminate a lifetime of dependence on corrective lenses. Since these incisions were about 90% deep, the structural integrity of the cornea was compromised making it more prone to injury and more likely to cause fluctuations in vision due to instability. Researchers found that the technologically advanced Excimer laser was extremely accurate. Its cool ultraviolet beam caused no thermal damage to the corneal tissue as compared to other lasers. The Excimer laser has achieved utmost precision so that it can remove tissue with up to 0.25 microns of accuracy. Laser vision correction also added predictability, stability, and safety to the surgical correction of Refractive Errors such as nearsightedness, farsightedness and astigmatism. 4 Types of Laser Vision Correction There are four types of laser vision correction procedures available using the Excimer laser: PRK (photorefractive keratectomy), LASIK, LASEK (laser epithelial keratomileusis) and Epi-LASIK (epithelial laser in situ keratomileusis). PRK The first human eye ever treated with laser vision correction using PRK in the USA was in 1989 and this procedure was first approved by the FDA in 1995. In PRK, the epithelial surface layer of the cornea is gently removed using a brush. The Excimer laser reshapes the underlying superficial layer. The epithelial surface layer is then allowed to heal over by placing a contact lens for a few days. There are two steps in how your vision is corrected with LASIK. The first step creates a corneal flap with the femtosecond laser which uses ultrashort pulses (one femtosecond is equal to 10-15 second) that cut the corneal tissue using a photodisruption process. This flap is folded back to allow for the second step, which involves the reshaping of the exposed inner corneal surface with the Excimer laser. The corneal flap is then returned in its original position where it adheres securely without the need for stitches. . Most patients recover and see better very quickly.

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• Cataract Treatment

  What is a Cataract? A cataract is present when the lens of the eye becomes cloudy. The lens is located behind the iris, which is the colored part of the eye. The lens helps focus the rays of light coming from an object to form an image on the retina located at the back of the eye. About Cataracts More than fifty percent of people over 60 years of age suffer from cataracts. Looking through a cataract is similar to looking through a window that is frosted or fogged with steam. Common symptoms include painless blurring of vision, need for brighter lights to read, glare or light sensitivity, double vision in one eye, fading or yellowing of colors, and frequent eyeglass prescription changes. Cataract Surgery West Palm Beach What Causes Cataracts? The most common cause of a cataract is aging of the eye. Other causes or risk factors include family history, medical problems such as diabetes, smoking, injury to the eye or previous inflammation, and long term use of steroid medications. A cataract cannot be caused by overusing the eyes. This is a common misconception. How is a Cataract Treated? Currently there is no medical treatment shown to reverse or prevent cataracts. However, sunglasses that filter out ultraviolet light rays or regular glasses with a clear anti-ultraviolet coating may help prevent or slow the progression of cataracts. In the early stages, stronger glasses can usually partially compensate for blurred vision from a cataract. When you feel that the cataract is starting to interfere with your quality of life, it is time to consider surgery. The decision to proceed with surgery is yours and depends on your daily activities and your lifestyle Types of Implantable Lenses Cataract Surgery involves removal of the cataract and replacement with an artificial intraocular lens (IOL) that can restore clear vision. Many of the steps traditionally performed with a blade can now be performed with laser-precision using the Catalys® Laser System. Dr. George Khouri can provide you with a highly customized, more precise and gentle approach to cataract surgery. Dr. Khouri can also discuss options to produce your best visual outcomes using different Lifestyle Lens Implants. Cataract Treatment with Astigmatism or Presbyopia Two aspects of cataract treatment need to be considered: astigmatism if present, and presbyopia in order to achieve reduction or independence from glasses for distance and/or near: The first aspect is astigmatism which is an irregular curvature of the cornea because it is shaped like a football instead of a basketball. When light enters the front part of the eye, this corneal irregularity bends and focuses light in one direction more than another which can lead to a blurred, distorted image on the retina. This condition can be treated with the CATALYS® Laser System which creates corneal arcuate incisions placed strategically to address the corneal irregularity. Depending upon the severity of your astigmatism, another option for correcting the astigmatism would be to use a Toric Lens Implant. The second aspect is presbyopia, which can be treated with Multifocal Lens Implants or Accommodative Lens Implants. What to Expect at a Cataract Consultation Cataract diagnosis is part of a comprehensive eye exam, and you should schedule an appointment as soon as you notice cataract symptoms. Our ophthalmologist will discuss your medical history and ask about vision changes. A series of tests determine cataract formation by doing the following: Testing for Visual Acuity: The standard eye chart is used to measure your ability to read letters of various sizes by covering one eye at a time. Visual acuity tests establish how well you see, diagnose refractive errors and identify vision impairment. Testing for Intraocular Pressure: An applanation tonometry test measures the intraocular pressure of each eye to detect abnormally high or low fluid pressure in the eyes. Slit-lamp Examination: The slit lamp is used to view the structures in the front portion of your eye and magnify them. An intense stream of light (or slit) brightens the cornea, iris and the space in between. The pupils are then dilated with drops to examine the natural eye lens. Changes in the lens help to identify signs of a cataract. A slit-lamp examination helps our eye doctor focus on each eye structure to diagnose eye diseases and conditions based on tiny abnormalities in these areas. Examining the Retina: When your pupils are dilated, our eye doctor examines the back of your eye, where the light-sensitive retinal tissue is located, using a special device called an ophthalmoscope.

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• Macular Degeneration (AMD) Management

  What is Age-related Macular Degeneration? Age-related macular degeneration (AMD) is the leading cause of blindness in people over 65 years of age. There is deterioration of the central part of the retina, the macula (figure 1), which is the area that allows us to see color and detail. This is essential for activities such as driving, reading, and threading a needle. When the macula is not functioning properly, we experience blurriness and distortion in the center of our vision. Both distance and near vision are affected. Total blindness does not occur. Therefore, people continue to have some useful vision and are generally able to take care of themselves. The peripheral retina surrounds the macula. It is responsible for side and night vision, and it is not affected in AMD. For example, you might see the outline of a clock, but would not be able to tell what time it is. Macular Degeneration Causes and Types AMD is most commonly a result of the body’s natural aging process. There are two types of AMD. One is the dry or atrophic type (figures 2 and 3) and the other is the wet or exudative type (figures 4 and 5). Dry AMD Most people have the dry type of macular degeneration. In this type, the tissues break down and become thin with aging causing gradual loss of vision. Yellowish deposits called drusen accumulate under the retina (figure 2) and they usually do not affect vision significantly. In the more advanced stage, there can be a large atrophic area, referred to as geographic atrophy (figure 3), which is associated with loss of central vision. Macular Degeneration Management West Palm Beach FL Figure 2: Dry Macular Degeneration with Drusen Dry Macular Degeneration Management Palm Beach FL Figure 3: Dry Macular Degeneration with Geographic Atrophy Wet AMD Wet macular degeneration accounts for about 10% of all cases. It results when aging of the retina is compounded by growth of abnormal blood vessels, called choroidal neovascularization, underneath the macula. These vessels leak fluid and/or blood which distort the retinal tissue (figures 4 and 5) and blur central vision. Visual loss may be rapid and severe with significant distortion as a result of swelling of the retinal tissue and dense scar tissue formation (figure 5). Wet Macular Degeneration Management Palm Beach FL Figure 4: Wet Macular Degeneration with Blood Under the Macula. Wet Macular Degeneration Management West Palm Beach FL Figure 5: Wet Macular Degeneration with scar tissue formation. Do I Have An Increased Risk For Macular Degeneration? The most important risk is increasing age. Other risks include family history, European descent, smoking, obesity, excessive exposure to sunlight, high blood pressure and a diet deficient in fruits and vegetables. Macular Degeneration Symptoms Symptoms are variable. The condition may not be noticeable in its early stages. Sometimes there is loss of vision in only one eye while vision remains good in the other eye for many years. When both eyes are affected, the loss of central vision is usually noticed earlier. Some common ways visual loss is detected include: Words in the center of a page appear blurred A dark or blind spot appears in the center of vision Straight lines appear wavy or distorted Colors decrease in intensity or brightness How is Macular Degeneration Diagnosed? Many people do not realize that they have a macular problem until blurred vision becomes obvious. Your ophthalmologist can detect early stages of the disease during an eye examination by: Examining the macula at the slit lamp microscope. Performing a simple test in which you look at a grid resembling graph paper called an Amsler grid to determine if you see the grid lines as wavy or distorted. Taking special photographs after a dye is injected in the arm to locate abnormal blood vessels and fluid under the macula. This procedure is called Fluorescein Angiography. Performing an Optical Coherence Tomography (OCT) scan. An OCT scan provides high resolution cross sectional images of the retina to determine if there is fluid under the macula by showing its thickness, to look at the size and location of the yellowish drusen deposits and to look for scar tissue formation under the macula. How is Macular Degeneration Treated? Dr George Khouri is fellowship trained in retinal diseases which makes him very well versed in the diagnosis and treatment of macular degeneration. Dry AMD Management There is no treatment for dry AMD at this time. The Age-Related Eye Disease Studies (AREDS) which were conducted by the National Eye Institute, showed that a certain combination of nutritional supplements may slow or prevent the degenerative process. These include vitamins C and E, lutein, zeaxanthin, zinc and copper. Regular use of the Amsler grid helps patients detect the development of wet macular degeneration so they can seek care with the ophthalmologist immediately.

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• Diabetic Retinopathy Treatment

  How Diabetic Retinopathy Works People with diabetes can get an ocular complication called diabetic retinopathy which causes damage to their retinal blood vessels due to elevated sugar levels. During the initial stages of this condition, you may be asymptomatic. In more advanced stages, you may notice symptoms such as blurred vision, floaters, distortion, fading of colors and/or a shadow across the field of your vision. Dr George Khouri is fellowship trained in retinal diseases which makes him very well versed in the diagnosis and treatment of this condition. In the early stages, retinal blood vessels leak fluid in the retinal tissues resulting in swelling of these tissues especially in the macula, the central part of the retina. This condition is called macular edema and is the most common cause of decreased vision in diabetic retinopathy. This is one of the signs of the first stage which is called non proliferative diabetic retinopathy. At this stage, some blood vessels can also close off, a condition called macular ischemia which prevents the macula from being nourished with oxygen and nutrients. This can result in the appearance of cotton wool spots which are small yellow-white spots. In certain cases there is accumulation of small areas of swelling called exudates which can affect your vision. The walls of retinal vessels usually become weak and start forming a localized enlargement called aneurysm which has the tendency to leak blood resulting in retinal hemorrhages. As the condition progresses, the retina starts growth and proliferation of abnormal new blood vessels also known as neovascularization. These new blood vessels grow outside the surface of the retina into the vitreous cavity, the jelly like substance in your eye located between the lens and the retina. This advanced stage of the disease is called proliferative diabetic retinopathy. The wall lining of these vessels is defective, making them fragile and likely to bleed into the vitreous, known as vitreous hemorrhage. This can manifest as floaters and can even block the field of vision almost completely. Scar tissue also forms due to these abnormal new vessels. Pulling and traction on the retina by this scar tissue can occur, leading to retinal tears and tractional retinal detachment with decreased vision. Diagnostic Testing For Diabetic Retinopathy The first step in the diagnosis is to dilate both eyes in order to visualize the retina and vitreous. This is why regular dilated eye examinations by an ophthalmologist are essential. Optical coherence tomography (OCT) provides high resolution cross sectional images of the retina to determine if there is fluid in the macula by showing its thickness. Fundus Photography also helps visualize the retina. OCT and fundus photography provide a way to monitor the condition on follow up visits and check its progress. Fluorescein angiography is a test which evaluates the retinal circulation and is conducted by injecting fluorescein dye in your arm and taking sequential black and white photographs to study its course and determine which vessels are leaking, damaged or closed off. This dye is like a food colorant and does not affect the kidneys as compared to dyes used for CAT scans and MRI scans. In the event the vitreous hemorrhage is significant to the extent that it blocks the view of the clinician, B-scan ultrasonography can determine if the retina is attached or detached and helps to follow progression to determine the timing and approach of treatment. Diabetic Retinopathy Treatment Options Intravitreal injections are used to treat macular edema. The injections consist of medications given in the vitreous cavity. These medications inhibit vascular endothelial growth factor (VEGF), a chemical which stimulates retinal leakage and abnormal blood vessel growth (neovasularization). They are usually given in the office to help treat or reverse the signs and symptoms of retinopathy. These injections may need to be repeated for effective treatment. Examples of anti VEGF injections include Avastin, Lucentis and Eylea. Sometimes, a steroid injection is used to complement anti VEGF injections. Focal laser surgery is used in some cases to seal off leaking blood vessels. Retinal neovascularization can also be treated with panretinal photocoagulation (PRP) laser surgery to help regression of the abnormal blood vessels.

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• Glaucoma Treatment/ Management

  What is Glaucoma? Glaucoma is a condition with elevated pressure within the eye affecting the optic nerve which is responsible for transmitting perceived images from the retina to the brain (figure 1). If not treated, damage to the optic nerve will cause blind spots which are undetectable in the early stages. If the disease progresses without treatment, it can lead to loss of side vision followed by loss of central vision and even blindness. Glaucoma is a leading cause of blindness in the United States among adults. However, this can be prevented with early detection and treatment. In many instances there are no symptoms. Optic nerve damage is irreversible when it occurs. For these reasons, it is very important for all adults to have regular eye examinations in order to be screened for this condition. How Does Glaucoma Cause Optic Nerve Damage? A clear fluid called the aqueous humor, which is produced in the front part of the eye, circulates in a space called the anterior chamber and drains from an area where the cornea and iris meet called the angle (figures 2 and 3). When the fluid drains too slowly through the trabecular meshwork of the angle or is blocked, it builds up in the eye causing elevated pressure. Most cases of optic nerve damage from glaucoma are due to elevated eye pressure but some cases can develop in the presence of a normal eye pressure, due to poor blood flow to the optic nerve. Glaucoma Risk Factors The most common risk factors include age, elevated eye pressure, family history of glaucoma/anatomic predisposition, African or Hispanic heritage, vascular conditions such as diabetes and/or hypertension, nearsightedness, farsightedness, previous eye injuries and a cornea that is thinner than normal. Types of Glaucoma? Primary open angle glaucoma is the most common form of glaucoma and is usually due to the drainage angle of the eye becoming less efficient (figure 3). Angle closure glaucoma occurs when the angle between the iris and the cornea is very narrow especially in farsighted and short eyes. This usually leads to complete blockage or closure of the drainage angle (figure 3) leading to a rapid buildup of eye pressure causing an acute episode of blurred vision, severe eye pain with redness, headache, halos around lights, nausea and vomiting. This is a medical emergency as the acute and severe rise in eye pressure can lead to blindness. If you are experiencing any of these symptoms, you need to call an ophthalmologist immediately as prompt treatment with eye medications followed by laser surgery can relieve the blockage, lower the eye pressure and protect vision. How is Glaucoma Detected? The only definitive way to detect glaucoma is through a comprehensive glaucoma evaluation, including central visual acuity testing, intraocular pressure measurement (tonometry), examination of the drainage angle (gonioscopy), examination of the optic nerve, peripheral vision testing known as Visual Field Perimetry, scanning of the optic nerve structure called Optical Coherence Tomography (OCT) and measurement of the corneal thickness (pachymetry). Glaucoma Treatment Options Daily medication eyedrops which lower eye pressure are usually given. The goal of treatment is to lower the pressure to a normal level of 20 or below. In cases where eye drops are not effective or they are causing side effects, laser treatment can be performed. In open angle glaucoma, multiple laser spots are applied to increase the fluid drainage through the trabecular meshwork. This procedure, called trabeculoplasty, can decrease eye pressure and dependence on eyedrops. In closed angle glaucoma, the laser makes a hole through the iris called iridotomy, thus relieving and bypassing the fluid blockage in the drainage angle (see figure 5 C and D). Glaucoma Surgery In cases where neither medication eye drops nor laser treatment are effective, glaucoma surgery is performed to create a new filter or drainage channel for the fluid to leave the anterior chamber. This procedure is called trabeculectomy. Understanding Intraocular Pressure (IOP) Your eyes produce fluid that helps nourish internal structures. When this fluid builds up due to poor drainage, it increases intraocular pressure (IOP). Elevated IOP damages the optic nerve, making it the primary cause of glaucoma. Keeping IOP within a healthy range is central to successful treatment and management.

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• Routine & Comprehensive Eye Care

  Routine eye exams are important to detect vision changes and disorders as early as possible. At Palm Beach Eye Center, we use the most advanced technology of today in order to provide you with the best possible treatment. Comprehensive eye exams can detect disorders affecting the whole body, such as diabetes, high blood pressure, blocked arteries and others. Our examinations include a comprehensive evaluation of the optical visual system of your eye, which determines if you have Refractive Errors such as nearsightedness (myopia), farsightedness (hyperopia), astigmatism and presbyopia (the need for reading glasses for people starting in their forties). These are called lower-order aberrations. You will also be evaluated for higher-order aberrations, which are optical imperfections of the eye. You will obtain eye prescriptions for glasses or contact lenses, depending on your needs. How Does A Comprehensive Eye Exam Work? Comprehensive eye exams are crucial to your eye health, vision and overall well-being. Regular eye exams and vision screenings should be part of your preventive health care as many eye diseases, vision problems and other ocular concerns don’t show obvious symptoms at first. Early diagnosis is key in treating eye problems and preventing or stopping vision loss. During these eye exams, our ophthalmologist will ask about vision-related issues you’re experiencing and conditions affecting your overall health. Visual acuity measurements are taken during comprehensive exams. These tests measure how distinctly you can see at various distances using letters on a chart. Visual acuity is measured and written as a fraction. Excellent vision is considered 20/20, but people with nearsightedness, farsightedness or astigmatism require corrective eyewear to see objects clearly. A visual acuity of 20/40, for example, means that you can see an object from 20 feet as compared to a person with 20/20 who would be able to see the same object from 40 feet. To be able to obtain a driver’s license in Florida, a visual acuity of 20/40 in one eye is required if the other eye is 20/200 or worse. Otherwise, the minimal requirement would be to have a level of at least 20/70 in either eye or both eyes. If you need glasses or contact lenses, further tests are done to find the correct focusing power for your lenses using a phoropter. A phoropter device uses various lenses in front of your eyes to determine which strength improves your vision and is combined with a handheld lighted instrument called a retinoscope. Some tools automatically calculate focusing power, and the lens power is tweaked based on your input for the clearest vision. The prescription for glasses or contact lenses is measured in diopters. The negative sign is used in front of the diopter value for nearsightedness and the positive sign is used for farsightedness. Other tests are done to determine eye health and how well the eyes focus, move and work together. Dilating eye drops are often used to see the eye’s internal structures to detect changes that indicate eye disease or a health condition, such as diabetes. Intraocular eye pressure is measured to test for glaucoma. Our ophthalmologist recommends bringing sunglasses to wear after comprehensive eye exams because the dilating eye drops enlarge your pupils and can make bright lights uncomfortable. Our office provides you with disposable sunglasses at the end of your visit if your eyes are dilated during that specific visit. How Is a Comprehensive Eye Exam Different From a Vision Screening? Comprehensive eye exams discuss your family health history and your medical history and go beyond screening for vision problems. These appointments measure visual acuity and involve various tests to evaluate eye health and visual function. Refractive errors are still assessed, along with how well the eyes move and focus together. Depending on the exam’s findings, additional tests may be used to diagnose eye conditions or diseases, such as diabetic retinopathy, glaucoma, keratoconus and cataracts. How Often Should Children and Adults Have Eye Exams? The American Academy of Ophthalmology (AAO) recommends infants have eye exams between six and 12 months old depending on their risk factors for refractive errors and whether they exhibit warning signs of vision problems. Children ages three to five should have an eye exam at least once and again before first grade. It’s recommended that school-age kids have eye exams every year until they’re 18. Premature infants, children born with low birth weight or those with a family history of refractive errors and eye conditions should be evaluated regularly.

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• Refractive Errors for Glasses & Contacts

  Myopia (Nearsightedness) Nearsighted individuals typically have problems seeing well at a distance and are forced to wear glasses or contact lenses. The nearsighted eye is usually longer than a normal eye, and its cornea may also be steeper. Therefore, when light passes through the cornea and lens, it is focused in front of the retina. This will make distant images appear blurred. Treatment Options There are several refractive surgery solutions available to correct nearly all levels of nearsightedness. Hyperopia (Farsightedness) Farsighted individuals typically develop problems reading up close before the age of 40. The farsighted eye is usually slightly shorter than a normal eye and may have a flatter cornea. Thus, the light of distant objects focuses behind the retina unless the natural lens can compensate fully. Near objects require even greater focusing power to be seen clearly and therefore, blur more easily. Treatment Options LASIK, Refractive Lens Exchange and Contact lenses are a few of the options available to correct farsightedness. Astigmatism Prescription Glasses Palm Beach FL Asymmetric steepening of the cornea or natural lens causes light to be focused unevenly, which is the main optical problem in astigmatism. To individuals with uncorrected astigmatism, images may look blurry or shadowed. Astigmatism can accompany any form of refractive error and is very common. Treatment Options Astigmatism can be corrected with glasses, contact lenses, corneal relaxing incisions, laser vision correction, and special implant lenses. Presbyopia Prescription Glasses West Palm Beach FL Presbyopia is a condition that typically becomes noticeable for most people around age 45. In children and young adults, the lens inside the eye can easily focus on distant and near objects. With age, the lens loses its ability to focus adequately. Treatment Options Although presbyopia is not completely understood, it is thought that the lens and its supporting structures lose the ability to make the lens longer during close vision effort. To compensate, affected individuals usually find that holding reading material further away makes the image clearer. Ultimately, aids such as reading glasses are typically needed by the mid-forties. Besides glasses, presbyopia can be dealt with in a number of ways. Options include: monovision and multifocal contact lenses, monovision laser vision correction, and new presbyopia correcting implant lenses. Understanding Refractive Errors Refractive errors develop when the shape of your eye disrupts how light focuses on the retina. As a result, your vision may appear blurry, distorted, or unfocused. Common types include myopia (nearsightedness), hyperopia (farsightedness), astigmatism (irregular curvature), and presbyopia (age-related near vision decline). Your Options: Glasses, Contacts, or LASIK Glasses and contact lenses are trusted and effective tools for correcting refractive errors. They’re non-invasive, affordable, and tailored to your exact prescription. For many, they’re the first line of defense against visual discomfort. LASIK, however, offers a long-term solution for many patients. Standard LASIK reshapes the cornea, improving focus, while custom LASIK adjusts for minor corneal irregularities, offering sharper and more precise vision correction. Both options depend heavily on the current shape and health of your cornea. Aging, Vision, and Eye Health As you age, your eye’s natural lens loses flexibility, especially noticeable when you hit your 40s and beyond. This condition—presbyopia—makes close-up tasks like reading more difficult. Night vision may also decline, making driving in low light challenging. While natural reversal isn’t possible, corrective options like bifocal lenses or surgical alternatives can help manage the change. Eye Exams: Staying Ahead of Vision Changes Your eyes can change gradually, and catching those shifts early is crucial. If you already have a refractive error, you should schedule an eye exam every one to two years. These exams not only update your prescription but can also detect early signs of more serious eye conditions. FAQ: Your Refractive Error Questions Answered Do refractive errors get worse over time? Yes, especially during childhood and teenage years. In adults, progression can continue gradually, particularly with age-related presbyopia. Is LASIK a permanent solution for refractive errors? LASIK typically offers permanent vision correction, but age-related changes or other eye conditions may still affect your vision later in life. How often should I get an eye exam if I have a refractive error? You should get an exam every one to two years to monitor changes and update your prescription if needed.

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