Educational Platform for patients and physicians

FAQ

The FAQ section includes questions that most patients ask about presbyopia, answered by experts from the Polish “Presbyopia 21” Club.

Contact lenses

Contact lenses allow for effective correction of virtually any visual defect, and patients using them tend to see better than they did when using glasses. You can put your glasses away, but do not throw them out — in some situations, they might still come in handy.
Contact lenses can be classified by:
– material — into soft and rigid lenses;
– optical structure — into monofocal, multifocal, and toric lenses;
– wearing time — into yearly, quarterly, monthly, biweekly, and daily lenses.
These parameters provide a basic description of currently available contact lenses.
The cost of contact lenses depends on the type and degree of correction (simpler defects can be corrected with cheaper lenses) and the frequency with which they are replaced (more frequent replacement is more expensive). The cost of high-quality contact lenses for myopia correction, replaced once a month or once every two weeks, is several hundred PLN per year, while daily lenses with the same parameters will cost more than PLN 1000 per year.
At the first visit, your ophthalmologist should provide you with detailed information on how to put in and remove your lenses, how to care for them, and what to do in any unusual situations. Beside this information, you will receive a leaflet, developed by the manufacturer based on guidelines from the Polish Contact Lens Association. When using contact lenses, it is important to strictly follow all instructions.
Contact lenses are very simple to apply and remove. The only difficulty results from some patients’ fear of touching their eyes. Your ophthalmologist should teach you how to put in and take out your contact lenses at the first visit.
Contact lenses are medical devices worn directly on the eye for multiple hours, which is why they must be precisely matched to the anatomy of your eye by a specialist. Knowing the optical power you need is not enough to buy the right lenses.
Depending on your exact visual defect, you can be able to use multifocal contact lenses, which ensure both good distance vision and comfortable near vision. Your near vision changes after the age of 40, and multifocal contact lenses may be the solution.
There are several contact lens models that do not have to be removed before sleeping, as they allow oxygen to reach the eye and have the appropriate approvals — but in general, you should not sleep with your lenses on without a good reason to do so.
Yes, but the sizes must be properly interpreted by a specialist. As opposed to e.g. footwear, where a size 9 pair is usually comparable to another size 9 pair, when it comes to contact lenses, a size such as 8.6 might mean something different in two different models.
Wearing contact lenses when swimming is controversial, and there are many factors to consider if you want to safely wear contacts underwater. If you do not have a large defect, it is best to remove contact lenses before going in the water. If necessary, talk to a specialist about how to wear contacts safely when swimming.

Laser presbyopia correction

The procedure is available to patients over 40 years of age. There is no upper age limit.
Eligibility criteria:
– near-sightedness up to –8.5 diopters;
– far-sightedness up to +3.5 diopters;
– astigmatism up to 2.25 diopters;
– presbyopia in patients with emmetropia (i.e. those who have good distance vision, but need reading glasses);
– normal binocular vision
– positive monovision tolerance (“cross-blur”) test, performed at the initial examination
According to published medical literature and our experience, the Presbyond procedure is very safe.
Presbyopia correction is an entirely painless procedure, and your eyes are anesthetized with special eye drops. You may experience some stinging or watering for about an hour after the treatment, and in a few hours, you will be able to function normally again.
– Do not wear contact lenses for at least one week before the procedure.
– Eat a light breakfast before the procedure — you do not need to fast.
– On the day of the procedure, do not apply any make-up or face creams.
– Do not drink alcohol for 48 hours before the procedure.
– Wear comfortable clothes and footwear.
– You will need to spend about 2–3 hours at the clinic, so plan your day accordingly.
– It is best to have someone pick you up after the procedure.
The procedure itself takes about 15 minutes, but you will spend a few hours at the clinic.
The procedure is indicated for most patients over 40 years of age. There are, however, certain contraindications, including:
– pregnancy and breastfeeding;
– corneal abnormalities;
– myopia with visual acuity below 0.9;
– impaired binocular vision or strabismus;
– corneal inflammation, degeneration, or dystrophy;
– severe dry eye syndrome;
– vision impaired by cataract
– advanced or uncontrolled glaucoma;
– diabetic retinopathy.
You should notice improved near and distance vision just minutes after the procedure. Over the first few weeks after the treatment, you will undergo “neuroadaptation” as your brain gets used to the new way of seeing at different distances. In practice, most patients can function normally just hours after the procedure, seeing comfortably at near, intermediate, and far distances.
The treatment costs approx. PLN 10,000 for both eyes. In most patients, it just needs to be performed once.
No, laser presbyopia correction is not reimbursed by the Polish National Health Fund.

Intraocular lenses

There are some eligibility criteria for lens replacement, but there are no absolute contraindications. Your ophthalmologist will decide whether you are eligible. Restrictions include:
– degenerative spine disease, which does not allow the patient to lie down still;
– Parkinson's disease, which causes involuntary movement
– claustrophobia — if the patient is afraid of having their face covered;
– asthma, respiratory diseases, chronic bronchial disease;
– high myopia.
Lens surgery is among the safest medical procedures, and intraoperative complications are rare. Due to its easier course, anti-presbyopic lens replacement is even safer than cataract surgery. Reasons include a shorter duration of the procedure. In cases of cataract, the lens is harder than natural, and more ultrasound must be used to break it down, causing a risk of corneal damage.
Complications after refractive lens replacement are very rare, and the risk of such complications can usually be predicted by the ophthalmologist based on patient history.
Complication risk is increased by:
– some medications;
– narrow pupil;
– lens subluxation.
Refractive lens replacement is recommended to all patients who are not satisfied with less invasive correction methods (eyeglasses or contact lenses) and can tolerate the minimal risks associated with the surgery. The patient must be aware that multifocal lenses are not a perfect solution. In some cases, quality of vision may be slightly lower after the surgery, and there is a small risk of dysphotopsias causing difficulty in seeing. Dysphotopsias occur in 10–20% of cases, and in most, they subside over time. 95% of patients report they would agree to the surgery again.
The patient should be aware of the limitations of currently available solutions. For instance, the lenses do not completely eliminate the need to use eyeglasses when reading for an extended time — but in most cases, they do considerably increase comfort in daily life.
Modern eye microsurgery techniques, including intraocular lens implantation, involve incisions just 2–3 mm in length and do not require sutures. The lens does not have any nerves, so the removal is not painful. The cornea is densely innervated, but it is very susceptible to anesthesia using eye drops. During the procedure, the patient stays conscious and only local anesthesia is used. This means that the extraocular muscles are not blocked, and the patient must cooperate (e.g. hold their head and eye still).
The lens has three parts: the capsule, the cortex, and the nucleus. During the procedure, the lens cortex and nucleus are removed, and an artificial lens is placed in the remaining capsule. These structures are not innervated, so you will not be able to feel the new lens in your eye.
The cost of the treatment depends on two things: the cost of the procedure and the cost of the lens. Depending on the clinic, the procedure typically costs between PLN 2000 and 3000, while multifocal intraocular lenses cost between PLN 1000 and 3000.
Unfortunately, refractive lens replacement is currently not reimbursed. The Polish National Health Fund only covers the cost of cataract surgery, but even then, multifocal lenses are not reimbursed.

Polish “Presbyopia 21” Club section

The Polish “Presbyopia 21” Club was established in April 2016 in Poznań, Poland, by Professor Andrzej Grzybowski. The creation of this first-ever Polish group of experts on presbyopia was motivated by the ophthalmologic community’s virtually unanimous view that access to reliable knowledge on modern presbyopia correction methods was insufficient.

The club brings together Polish and international ophthalmology practitioners and professors interested in modern methods for presbyopia correction.

The Foundation for the Development of Ophthalmology “OPHTHALMOLOGY 21”

Adam Mickiewicz Street 24/3b
60-836 Poznań
Greater Poland Voivodeship
NIP: 7811880464

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