Wrangling my vanity, wrangling my glasses

Thursday, December 16, 2004

When I first heard the word presbyopia, I intuitively loathed the sound of it. I tried to distance myself from it by deciding it was some awful condition that only diseased Presbyterians got.

Presbyopia turns out to be much more secular. By age 51, everyone is impacted by it. Technically, it is what happens when a lens in your eye begins to stiffen up, sort of like your joints do as you age. It thus becomes less flexible and can't accommodate your view of things close up. The original Greek word says it all: "Old sight."

It is insidious how the indignities of presbyopia emerge in your life. Without realizing it, you are suddenly knocking over wine glasses in dimly lit restaurants as you jettison your menu away from you in order to read it. Soon enough you are furtively buying cheap "readers" at the drug store. All shreds of vanity depart as you develop that permanent professorial scowl that comes from looking out over those reading glasses.

Next, you will be putting glasses all over your house, like a squirrel storing nuts for a long winter.

And if you are like me, you are at the stage of losing your glasses.

They seem to disappear just like errant socks in the washing machine. This leaves me screaming around my house like a madman: "Where the [bleep] are my [bleeping] glasses!"

Yes, I could start wearing those beaded eyeglass leashes my Great Aunt Lillie sported. But my vanity has already taken enough knocks for this year, thank you.

I'm not ready to give up reading, and I am tired of spending my retirement fund on replacement glasses. So what is a "presbyope" -- that's what they call us -- supposed to do? One medical solution is the "off-label" use of the LASIK (laser) surgery. Considered effective for treating nearsightedness, it has had mixed results for presbyopia.

LASIK surgery creates an odd sounding situation called "monovision." One eye is surgically corrected for presbyopia, the other is left unaltered, or, if nearsighted, corrected for that. The brain integrates the inputs from the mismatched eyes into a clear single vision.

A less invasive way to create this monovision has been to use two different contacts, one to boost near vision, and the other for distance vision. But not everyone adapts to it. Many people have trouble with poor night vision and the loss of depth of field.

This past March, the FDA approved a procedure that has excited every baby boomer tired of wrangling their reading glasses. Called conductive keratoplasty (CK), it uses radio waves to reshape the cornea so that near vision is restored. A simple and safe procedure, it takes only three minutes to perform, and has a 98 percent success rate. However, it is not effective for those who are also nearsighted.

But age does not stop for any man, nor for CK. Our eyes still continue to age which means the effects will only last three to five years. One can expect to repeat the procedure and one important consideration is that CK can not be repeated more than three times over a lifetime.

We presbyopes have choices, but none without side effects. For now, I think I will try to work on accepting the inevitable visible signs of aging. It's a good opportunity to learn how to wrangle my vanity.

As for my ongoing problem of wrangling my glasses ... maybe I can "reframe" this problem as an opportunity to work on developing my mind.

If you prefer the medical route, check out this Web site on conductive keratoplasty: www.my clearvision.com.

Dr. Michael O.L. Seabaugh, a Cape Girardeau native, is a clinical psychologist who lives and works in Santa Barbara, Calif. Contact him at mseabaugh@semissourian.com.

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