Glasses – necessity or style? Both can be true. What is better – glasses, contact lenses or surgery?
All depends on a person and his/her eyes. – Saulius Galgauskas, physician ophthalmologist, Doctor of Medical Sciences.
Why does a person visit an ophthalmologist?
He or she comes for the same reason – worsened vision. This can happen at any age. Different age groups and various types of visual impairment. If children or youngsters have worsened vision looking at distant objects, short-sightedness is diagnosed. A person having good sight before, being over 40 years of age, faces another problem – he or she needs glasses to see close objects, i.e., glasses for reading. This is called age-related long-sightedness.
There have been two defects of refraction described – short-sightedness and long-sightedness. The population of short-sighted people is much larger and, according to basic statistics, will increase. The causes of this disorder are still unknown, but inheritance is among the most frequently discussed. Short-sightedness per se is not a hereditary disorder, but one can inherit a tendency to short-sightedness. This disorder is predetermined by intense and continual work at a close distance. People are chained to their computer, smartphones and books. Their eyes do not have opportunities to look at distant objects, thus short-sightedness occurs. When objects in the distance appear blurry, vision should be corrected with negative contact lenses or negative lenses for glasses.
Another group of patients treated by ophthalmologists are long-sighted. Long-sightedness has been commonly diagnosed in children. A child is born with long-sightedness rather often and this is a physiological condition, but he or she has to grow out of this condition by the age of seven. Therefore children of pre-school age must visit an ophthalmologist. If long-sightedness has been diagnosed, it should be corrected with certain glasses, positive lenses. Untreated long-sightedness can lead to strabismus.
As intensive load on eyes occurs in school, children of school age are usually diagnosed with short-sightedness (myopia). Glasses or contact lenses are also required in such cases.
A person with mild myopia in his or her forties is often surprised – they do not require glasses for reading, while other people already use such glasses. And he or she is wrong thinking that their long sight will improve. Following the laws of physiology, age-related long-sightedness usually develops by this age.
A person with mild myopia will see blurred distant objects, but often will be able to read without glasses. This is a case when two or even three pairs of glasses are needed. The glasses to correct long sight are not suitable to correct short sight. This can be explained by the fact that age-related long-sightedness, occurring at the age of 40-45 years, is predetermined by the accommodation properties of the eye lens. The eye lens becomes rigid at this age and is not able to adjust its shape any more, therefore additional correction is required.
Even if an individual has had good eyesight and could manage without glasses during his or her entire life, glasses for reading can be required by this age. People make jokes about their arms getting longer, wishing to have the text for reading as far as possible from their eyes. As a consequence, so-called positive glasses appear in their life.
Bifocal lenses for glasses were invented in the past century, with short and long sight zones mounted in a single lens. Such lenses are also known as bifocal. They are used nowadays, for example for children with long-sightedness and strabismus; for them such glasses result in a beneficial curative effect.
Probably you have noticed elderly people wearing such glasses for a long time. The limitation of these glasses is a sharp zone of dioptres transition and absence of vision channels that are present in progressive lenses. Therefore they offer only two options. This is not convenient, as the objects at short distance are more difficult to see.
Do they have any psychological effects?
People get used to them, but glasses with bifocal lenses are not very aesthetic. Non-coincidentally, such glasses sometimes are known as glasses for elderly people.
Bifocal lenses for glasses can have one, two or more foci. The latter are known as progressive lenses. They ensure good sight at different distances. Nowadays one can select progressive lenses of modern and fashionable design and with a wide vision area. They ensure comfortable reading and observation of distant objects. Such lenses look like ordinary glass, eliminating the psychological barrier of "glasses for elderly people". They have been optically processed through the application of special technology and ensure good eyesight at any distance.
When did you come across progressive lenses for the first time?
The first progressive lenses appeared in Lithuania several years ago. Before now progressive lenses for Lithuania were produced by the German company Zeiss, the French company Escilor or the Japanese company Hoya, with centuries-old traditions. These lenses were very expensive. Other producers entered the market later.
Progressive lenses have been developed in many laboratories by groups of scientists and engineers. Medicine has improved significantly. An individual approach to each client has been increasingly applied.
Progressive lenses of similar design and technologies have already been produced in Lithuania: the BOD laboratory for lens production started its activities at the beginning of the current year. This Lithuanian product according to the technologies applied is equal to those from the leading manufacturers worldwide. There is no need to order products that are produced several hundred or thousand kilometres away when they are available nearby. The modern automatized production technology allows for obtaining a satisfactory product of good quality within the shortest possible time – 48 hours.
Moreover, it creates a different atmosphere, as you know that Lithuanian people speaking Lithuanian work at the facility. Such an aura is very important, like in any other process. France has old traditions in making optics. They have very advanced solutions for individual lens and optics production. The laboratory in Lithuania, applying state-of art technologies, is moving in the same direction.
Now we have a splendid opportunity to select individualised glasses for each person. I am talking about the lenses produced in Lithuania rather than about frames. Lithuanian producers ensure fast production of lenses for glasses of high quality, suitable for every individual, considering his or her personal needs, the condition of the eyes, peculiarities of the face and individual behaviour. They will not be a standard item, as human warmth is incorporated into each of them.
Are the former and present buyers of progressive lenses different?
In the past, only well-off people could buy progressive lenses as well as persons who needed such lenses for their job. Odontologists, architects, and sometimes artists and teachers were among them. These were individuals who had to have good eyesight without needing to change their glasses.
Nowadays the most advanced and modern progressive lenses can be produced for about 200-300 euros. A significant part of this price is paid for the frame, especially if a branded item has been chosen. Obviously, an individually produced lens inserted in to a frame of high quality will be more expensive than the one imported from Asian countries. Semi manufactures are also significantly cheaper when comparing with a fresh and original product.
The truth is that a person obtaining progressive glasses should be informed about some discomfort at the beginning and should be aware that this solution is not suitable for some people. About 10 to 15 percent of all patients starting to wear these glasses experience certain inconveniences, such as dizziness, diplopia or difficulty in climbing stairs. Usually these symptoms are associated with the central nervous system, as both eyes and brain should get used to the new glasses. After all, our eyes are just a part of the brain and central nervous system. They are not an isolated organ. Eyes receive light signals. It can be stated that the vision of human beings is realised by their brain rather than the eyes. Our eyes are designed to receive light signals, to transform them into a nerve impulse and to generate this impulse in the brain.
How long is the adaptation period?
The adaptation period lasts up to one month. Consultation with a competent professional can facilitate the shortening of this period or even its complete elimination. The recommendation exists that progressive lenses should be inserted into a metal frame; this allows an optician to adjust them more easily.
It is important to look through the so-called vision channel of the progressive lens. Let's say you have glasses with progressive lenses and have bent your metal frame accidentally while trying to put the glasses on. Your vision zone will be distorted. You may wear your glasses for a long time and still experience discomfort. Therefore, the qualification of an optician is of great importance. Otherwise, a client can claim that his/her glasses are of poor quality.
Has the patient's age, profession and certain skills been considered during the selection of lenses for glasses for that patient?
The age of a person and his/her needs are assessed during the discussion with a professional. Individual decision is taken considering the habits of specific person.
Have you had patients wishing to order lenses produced in the Lithuanian laboratory?
Yes, we have. The lenses for glasses produced according to individual order and using state-of-the-art technologies can be obtained in a couple of days. If you decide to have lenses of similar quality from abroad, this will take about a couple of weeks.
What vision problems do your patients encounter beside short-sightedness and long-sightedness?
Another problem is astigmatism, in other words, a subtype of short-sightedness and long-sightedness. This is a more complex defect of refraction predetermined by the topographic characteristics of eye surface, i.e. the cornea.
Ideally the cornea should be absolutely even, but usually it is not the case; astigmatism develops when the cornea is uneven. Ideal flatness can be ensured by laser polishing, but this is a surgical intervention. Astigmatism is an inherited disorder. The degree of astigmatism grows with increasing roughness of the cornea.
Such patients need lenses with a more complex technological solution. Production of progressive glasses for individuals with severe astigmatism is a technically complicated but feasible task. I am aware that the BOD laboratory is able to implement technically complicated solutions – they successfully produce lenses for glasses for persons suffering from severe astigmatism. This is very complex process. And a big part of success depends on dioptres. Production of lenses becomes more complex with increased number of dioptres, requiring more knowledge in physics and more solutions.
If a person was not diagnosed with astigmatism, the adaptation period is required after the prescription of cylinder glasses. In some cases the patient is not able to wear such glasses. There is an opinion that people who did not wear glasses in their childhood or youth encounter difficulty in adaptation at an advanced age. A person experiences dizziness and discomfort. However, the adaptation period with individual astigmatic lenses is less complicated, as these lenses are adjusted individually with a unique surface specific for each eye.
I have heard that lenses for glasses designed for people working in offices become more popular.
We call the cousins of progressive lenses office lenses. A person wearing glasses with progressive lenses encounters many problems. This is especially true when progressive lenses are inserted into a small frame. When a bigger frame is used all dioptres are spread over a larger surface area.
What will happen to a person sitting in the office and working a computer and with documents? Let's say he or she works in an accounting position. A person experiences discomfort after incessantly working for many hours. The glasses with so-called office lenses help to increase the reading zone and to some extent, the mean distance, but they reduce the long-sight zone. This is a derivative product resulting from modification of the progressive lenses.
Any glasses prevent a person from taking a break during the work process as any movement of the eyes from a computer or a document will result in discomfort.
There are many people who work without taking any breaks. Such glasses maintain good eyesight of everything located within the distance of four meters. They become a kind of tool.
Office glasses are very popular in Scandinavian countries. They are cheaper on the market; however their production requires similar efforts and work as the production of traditional progressive lenses.
There have been many myths about the eyes and glasses. I would like you to support or to negate them.
Myth 1 Human eyes should work all the time. Therefore the glasses should be weaker than required.
This is not a rule; the individual decision should be taken by the physician prescribing glasses, considering the refraction defect, its degree, etc.
Myth 2 When eyes are exposed to intense load, short breaks should be taken, involving looking at distant objects, e.g., through a window.
Certainly, breaks should be taken while working at a computer or with documents. When a person looks through a window or at distant objects his or her eyes are relaxed and the accommodation process does not take place. This is useful for the eyes of children and adults. After one hour of intensive work at a computer one should look at distant objects for at least few minutes.
Myth 3 Glasses are preferred over contact lenses or eye surgery.
There are three independent vision correction options – glasses, contact lenses and a laser surgery. I am in favour of all three solutions. Why? Because there are patients to whom only glasses can help – they cannot wear contact lenses due to allergy or other medical reasons, or surgery is contraindicated for them as their cornea is very thin. The only possible option in this case is glasses.
On the other hand, people choose what is best for them. Glasses are the classic choice. However, we should not ignore the existence of fashion. Glasses are a part of a certain image. Conspicuousness is characteristic for Western culture, with a willingness to emphasize individuality. Successfully selected glasses contribute to a prettier appearance and even mask some defects. Even after surgery people sometimes wear glasses. They are just an accessory; lenses in the glasses are without dioptres. Young people wear glasses for a more sedate appearance. Glasses are like a silent signal of intellect.
However, for representatives of certain professions glasses have been associated with some discomfort. These include divers, pilots and basketball players, for example. They prefer contact lenses instead of glasses. However, contact lenses have been associated with the highest rate of complications among all three options of vision correction, as they are the foreign bodies in the eyes. Moreover, a wise individual wearing contact lenses should have good glasses, as eyes get tired from the contact lenses.
Only joint understanding of physician and patient leads to the best solution. Surgery is a good option. However, not everyone is able to undergo it. This depends on the patient's age, parameters of the eye and thickness of the cornea.