Other refractive procedures

If you are over 18 and have had a stable prescription, there are a number of other options available for ‘refractive’ correction – that is, adjusting near or distance vision problems, including astigmatism.

Refractive lens exchange

If you need several pairs of glasses – one for reading and another for driving or watching television, a refractive lens exchange might be the solution for you. It’s exactly the same procedure as cataract surgery – the surgeon is simply correcting your ‘refractive error’ for both near and far distance.

A refractive lens exchange – sometimes called a clear lens exchange or a lensectomy – came about when cataract patients were surprised (and thrilled) to find that, after surgery, they no longer needed reading glasses.What’s been a breakthrough is the continuing improvement of intraocular lenses (IOLs). Today, there are bifocal and multifocal lenses available – there are even lenses that can correct astigmatism.

A refractive lens exchange isn’t for everyone, especially when a multifocal lens needs to be used – just like bifocals, it takes some getting used to – however, your ophthalmologist will take you through all of your options.

Monovision/laser blended vision

Ophthalmic surgeons have the ability to use the same laser technology as when performing LASIK to treat presbyopia. 

The outcome is called monovision, and  involves corrective surgery which sets one eye for distance vision, the other for near (reading) vision.  Often, only one eye is corrected. 

Not everyone is suited to monovision or laser blended vision. The best way to know if you’re suitable is to make an appointment with an ophthalmologist (you don’t need a referral for this).  Once they assess your suitability, you can ‘test drive’ monovision by wearing a pair of thin contact lenses for a few hours (part of your assessment). 

Kerataconus treatment

Keratoconus is a degenerative disorder of the eye that occurs in approximately 1 in 1000 people, and usually affects young people. Thin corneas cause the eye to change shape to a cone-like structure, rather than a gradual curve. This, in turn, causes vision to distort. Keratoconus treatment is often categorised as a ‘refractive’ (vision correction) procedure, because vision impairment is the main symptom.

There are a number of treatments for keratoconus, ranging from wearing glasses to corneal transplant surgery. People who suffer from the disease are unsuitable for LASIK.

As keratoconus progresses (usually settling between 10 to 20 years), treatment options include intra-corneal ring segments such as keraring, ferraring and INTAC, a thin corneal ring that is surgically placed to flatten the cornea to a more normal shape. Another treatment, called collagen cross-linking, combines specialized eye drops and ultraviolet light to increase the stiffness of the cornea.

Corneal inlay

A recent development in the treatment of presbyopia, KAMRA is a corneal inlay that is surgically inserted in one eye. The brain then adjusts one eye for distance vision, and one eye for near (reading) vision. The KAMRA inlay can be removed at a later date – say, if cataract surgery is necessary.