Seeing without specs

news: Seeing without specs

I AM sure you have all thought: “wouldn’t it be wonderful to be able to see clearly without having to wear spectacles?” So, today I am going to discuss four different ways which have been, or are used to try to achieve this.

Bates technique

This was a holistic system devised by Dr Bates and demonstrated in his book Better eyesight without glasses, published in 1920.

He advocated such things as palming of the eyes, lying in the sun with your eyes closed to energise them (in today’s world considered unwise due to the effect of UV radiation in causing cataracts and skin cancer), rapid horizontal eye movements, which are pooh-poohed by modern practitioners. He did advocate frequent rest periods for people doing concentrated eye work (very sensible) and one intriguing piece of advice was to improve your sight by learning the eye test chart!

Contact lenses

Most of you will be aware of what contact lenses are like, but not many know for how long they have been around. There are records, in the pre-Christian days of the Chinese empire, of primitive lenses being placed very close to the eye to give a correction, and then Leonardo da Vinci produced accurate optical drawings, showing a design very similar to today’s lenses.

The forerunner of today’s lenses was the scleral (or haptic) lenses, which were produced firstly in glass, and later in plastic, in the 1920s by Dr Dallos in Prague. They were made by taking a mould of the eye and working an optical correction in the central area. These sound pretty horrific, but, in fact, many people in the 1950 to 1970 period managed to wear them all day, and in fact I still occasionally fit them when full eye protection is needed.

In the 1960s, the corneal lens was produced, which only fits on the central part of the eye – this revolutionised things with wearing times of up to 18 hours continuously. These are still commonly prescribed, although nowadays from materials which allow the eye to breathe. These are known as GP (gas permeable) lenses.

In 1975, the forerunner of today’s most common lens, the soft lens, was produced again in the laboratories of Prague and, as with the corneal lens, these have been refined in terms of improved materials and designs, to a point, where nowadays, there is virtually no one who is classed as unsuitable.

There are literally hundreds of designs, single vision, bifocal, varifocal, daily disposable, monthly, tri-monthly, annual, continuous wear, colour correcting, cosmetics, and so on.Which are for you? Get advice from a qualified, experienced practitioner!

Orthokeratology

This is a procedure which utilises rigid contact lenses worn at night when you are asleep, and which are shaped to mould the cornea to a shape which will correct your sight. The advocates of this cite the advantages as being non-invasive, simple and without the problems of wearing lenses conventionally, such as dust going behind the lens for example.

However, the disadvantage is that the cornea, being an elastic tissue, gradually reverts to its normal shape so that, even if your sight is wonderful first thing in the morning, come evening when you want to drive home, things are starting to blur again. The technique has nonetheless been used to get people who are marginal for, say a driving test, to squeak through!

Laser refractive surgery

This is a technique which started in the 1980s, utilising a laser to remove tissue from the under layers of the cornea in order to correct the focussing of the eye. There are various procedures for this and it would require an article on its own to detail all of them, but there are basically three main ones:

PRK involves softening and then scraping off (under local anaesthetic) the top layer of the cornea, and applying the laser for the appropriate correction.

This was the original method and there are many successful cases around the world, but the first 48 hours are pretty painful, and it can take up to four months for optimum vision to be realised.

LASIK involves cutting a flap of skin from the cornea, folding it back, lasering the correction, and then replacing the flap. This has the advantage of virtually no pain and vision recovery normally within 48 hours, but it is more complex surgically, and potentially more problematical.

LASEK is a combination of the above techniques wherein the cornea is softened and a very thin flap produced and moved to one side, the cornea (not so deeply as in LASIK) lasered, and the flap replaced. There is more discomfort than with LASIK, but because the flap is replaced rather than having to re-grow – vision recovery is almost as quick.

Confused? While I have tried to give you a brief outline in this article, it is impossible to cover everything, and what is best for one person may not be so for another. The only answer is to discuss your requirements with a practitioner who is conversant with all procedures to give an unbiased opinion.

• Roy can be contacted at his clinics in Carvoeiro on 282 084 936 and Vale do Lobo 289 398 009