Eye Care Advice from Israel


By Dr. Andrew Fink


Jerusalem----December 24......Are your arms too short to read the menu?
Ever seen friends in their mid forties struggling to read the menu, needing to push it further away, complaining their arms aren`t long enough? They have presbyopia, or that middle aged eye affliction that eventually affects us all - difficulty focusing close up and a need for reading glasses.

Why it actually occurs is controversial and as a result a permanent and effective cure has so far proved elusive, in contrast to today`s extremely successful and safe eye laser surgery vision correction treatments for other focusing problems .

Current theories by eye care professionals include aging changes in the eye’s natural lens, and weakening of the focusing muscle which acts on the lens. Most people I see in the clinic start to have difficulty reading at around the age of 45, give or take 2-3 years. There are of course exceptions. People who are long sighted have difficulty seeing close up at an earlier age. In contrast the nearsighted see better for reading by taking their glasses off.

Most eye care specialists agree that presbyopia is caused by an age-related process. This is different from astigmatism, nearsightedness and farsightedness, which are related to the shape of the eyeball and caused by genetic factors, disease, or trauma. Presbyopia is generally believed to stem from a gradual loss of flexibility in the natural lens inside your eye. The eye's lens hardens with age, resulting in blurred near vision. This is called presbyopia. The eye's lens stiffens with age, so it is less able to focus when you view something up close. The result is blurred near vision. These age-related changes occur within the proteins in the lens, making the lens harder and less elastic with the years. Age-related changes also take place in the muscle fibers surrounding the lens. With less elasticity, the eye has a harder time focusing up close. Other, less popular theories exist as well.

Usually a transitional period of two to three years occurs when dependence on reading glasses gradually increases. Whilst at first difficulty may be experienced when tired, or reading small print in poor lightening (that’s why straining to decipher a menu in dimly lit restaurants late at night is often an early sign), slowly the need becomes greater until all reading material is blurred without glasses.

Acquiring your first pair of reading glasses is not just a technical issue, but also a psychological one. For many the need for readers is the first concrete physical sign that middle age has arrived, and eternal youth is, after all, a myth. Reluctance to take the plunge and buy that first pair is understandable. When to do so is a lifestyle issue. Delaying the inevitable is not damaging, nor beneficial, but if it makes you feel younger for a little longer, that’s fine!

Eyeglasses with bifocal or progressive addition lenses (PALs) are the most common correction for presbyopia. Bifocal means two points of focus: the main part of the spectacle lens contains a prescription for nearsightedness or farsightedness, while the lower portion of the lens holds the stronger near prescription for close work. Progressive addition lenses are similar to bifocal lenses, but they offer a more gradual visual transition between the two prescriptions, with no visible lines between them. Reading glasses are another choice. Unlike bifocals and PALs, which most people wear all day, reading glasses are typically worn just during close work. If you wear contact lenses, your eye doctor can prescribe reading glasses that you wear while your contacts are in. You may purchase readers over-the-counter at a retail store, or you can get higher-quality versions prescribed by your eyecare practitioner.

For people who have good vision in both eyes for distance, the cheap “off the peg” glasses available in pharmacies and elsewhere are a good choice. Start with the weakest pair labeled +1 and work up until you find a comfortable pair, holding some reading matter at your usual reading distance. For others who already wear glasses, or can’t find a comfortable pair, a trip to your eye care professional will be needed.

Your optometrist will discuss the pros and cons of multifocal and bifocal lenses according to your lifestyle needs. Whatever, starting in middle age, don’t forget to visit your eye doctor regularly for a general eye health check.

Currently an estimated 90 million people just in the United States either have presbyopia or will develop it by 2014. This is generating a huge demand for eyewear, contact lenses, and surgery that can help presbyopes deal with their failing near vision.

The following are some simple tips to prevent eye damage and to enhance your eye health care for many years to come.

Have your eyes and vision checked at least once a year. Any minor vision problem will be aggravated by computer use. If you wear glasses or contact lenses, be sure they are appropriate for computer use and for the distance between you and your computer. Be sure to rest your eyes regularly, especially if you are new to computers. Remember the 20:20 rule. Every 20 minutes, look in to the distance for 20 seconds. Continuous use of any part of the body, including your eyes, will inevitably lead to fatigue.

Your computer should be at a comfortable distance (about 30-40cm) and the top of the screen should be facing you and slightly below eye level. Adjust your desk or chair so that this is the case. Our eyes are designed to point forwards and downwards when looking at near objects, e.g. when reading. Looking upwards or sideways at your computer will rapidly lead to eye strain. Hang any material you are copying at the same distance and as close to the screen as possible. Use a manuscript holder. This will prevent constant refocusing to differing distances and directions. Minimise glare from your computer screen due to reflections from lights or windows. This can be done by adjusting the direction of your screen or by attaching a glare reduction filter.

Your pupil changes in size according to the brightness of the screen and excessive movement of the pupil caused by multiple reflections can cause headaches. Bright sunlight from a window behind your screen will have a similar effect. Glare also causes you to screw up your eyes, which if prolonged, will lead to headaches. However make sure your desk and key board are sufficiently illuminated. Occasional use of artificial tear eye drops (as recommended by your eye doctor) can help dry eyes symptoms. We tend to blink less when concentrating intently, and when looking straight ahead much of the eye is exposed leading to increased tear evaporation and dry eyes. Keep your computer screen clean. Dust and fingerprints can reduce clarity. Poor quality computer screens can lead to eye strain.

Low resolution, low pixel numbers and high contrast colors can put an extra strain on the eyes when reading from a screen. The Refresh Rate of a computer is a measure of how often the display unit refreshes or redraws the picture per second. In the past rates of 60Hz were acceptable, but flickering of the screen was evident at this rate causing headaches.It is now recommended that the rate should not be less than 70Hz and most new monitors are 75-85 Hz.

Sensible use of your computer in Israel or in any region of the world will reduce headaches and eye discomfort, and increase productivity

Dr. Fink, who practices in Israel, the UK and in Holland specializes in laser vision correction. Lasik or PRK means freedom from corrective lenses-either glasses or contact lenses. Laser treatment corrects for myopia (near or short sight), hyperopia (a long or far sight) and astigmatism (cylinder). It enables you to see well when driving, watching TV and playing sport. You can see the clock when you wake in the morning. It removes your dependence on heavy glasses and the hassle of inserting, removing and cleaning contact lenses. Lasik eliminates the risks associated with long term contact lens wearing. Laser vision eye correction It saves time and money caring for, and replacing contacts and glasses year after year. Today permanent and safe procedures - LASIK and Advanced PRK- have enabled millions to finally throw away their glasses forever.

Dr. Fink is the director of the Ra'anana Eye Clinic which aims to be a "Centre of Excellence" in diagnosing and treating all forms of eye and sight problems in Israel. The Ra'anana Eye Care Clinic specialises in Laser Vision Correction (Lasik and PRK) and modern Cataract Surgery. Learn more about common eye problems and see our list of eye and vision articles. The Ra'anana Eye Clinic welcomes children and adults who wish to consult with an eye doctor, and co-operate actively with local family doctors, optometrists and the hospital eye departments. We accept private patients, work directly with Kupot Holim Meuchedet and Leumit, and Dr Fink is registered as an eye surgeon with the private medical insurance companies. The Ra'anana Eye Care Clinic in Israel views eye problems holistically and see education and good communication as vital components of overall eyecare.

Andrew (Aviram) Fink is a MD, FRCOphth and MRCGP. After qualifying in medicine in England, he specialised in Ophthalmology becoming a Fellow of the Royal College of Ophthalmologists in England in 1991. After moving to Israel in 1994, Dr. Fink joined the Tel Aviv University Hospital eye department at Sheba Medical Centre, Tel Hashomer, Israel. Between 1997-1999, he returned to the UK to specialise in Laser Vision Correction and Cataract Surgery, gaining unique experience, and publishing scientific research papers on vision correction.

Dr. Fink is a senior laser surgeon with Care Vision, one of the largest eye care laser companies in Israel, and with whom he has operated since the company opened in the year 2000. He has performed thousands of laser treatments over the last few years, with excellent results and enjoys the use of the most modern technology. He has been active in training new laser surgeons both in Israel and in Care Visions overseas branches. Dr. Fink is a senior doctor in Tel Hashomer eye department, and performs modern Cataract Surgery (phacoemulsification) in Tel Aviv.

Israel News Agency

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