Understanding Vision

Glasses, contact lenses or laser surgery – what's right for you?

Around half the population has a vision problem of some kind. However, these conditions are now easy to correct since there is a suitable solution for virtually each one.

16 October 2021
  • Glasses, contact lenses or laser surgery – what's right for you?

The eye is our most important sensory organ. Medicine still has not found a way to prevent the natural deterioration of our eyesight. However, glasses, contact lenses or surgery make it possible for almost everyone to see clearly. Read on to find out all you need to knowabout the advantages and disadvantages of eyeglasses, laser surgery and contact lenses.

It can be done now, thanks to medical and technical advances. Today, an eye care professional can help almost everyone with a vision problem. Glasses, contact lenses and laser surgery are all ways to achieve clearer vision. Each of these options to correct vision weaknesses has its advantages and disadvantages. Here's some information that will help you decide which is best for you:

Eyeglasses – the classic for every occasion and in use since the 13th century

Glasses are the most common and effective way to correct a vision problem. Modern, individually customized glasses are now available for virtually every occasion and every vision need.

Advantages:

They are easy to wear, and modern frames and eyeglass lenses make them very comfortable. The high-refraction plastic lenses used today also considerably reduce the weight of strong eyeglass lenses. Modern eyeglass lenses allow wearers to see precisely at all distances. Anti-reflective eyeglass lenses prevent annoying light reflections, while self-tinting (also known as photochromic) eyeglass lenses darken when exposed to ultraviolet light. Glasses also help protect your eyes against dirt, dust and insects. There are ideal glasses for every occasion including work glasses for those who spend a lot of time on computers or tablet PCs, i.e., those who want comfortable and clear vision primarily in the near and mid-range distances, which can be customized as needed. The same is true for active applications, such sports and leisure activities. Special design and production technology now make it possible to produce lenses in your own prescription to fit highly-curved frames. Special, innovative coatings turn even plastic lenses, which used to be rather delicate, into durable precision vision aids.

Disadvantages:

Eyeglass lenses with strong prescriptions can be uncomfortably thick and heavy. They can fog up when you move from the cold outside into the warmth inside. Sometimes glasses can be unwieldy, for instance when lying on your side or while watching TV or reading. Moreover, the geometry of some eyeglass lenses results in areas that appear blurry, which may be more or less pronounced depending on the quality.

  • Glasses or contact lenses?

Contact lenses – whether disposable or custom-produced

The small and practically invisible plastic lenses were the first alternative to eyeglasses. Modern, and custom-produced contact lenses in particular, allow for precise correction of almost all types of vision problems. There are contact lenses for both near and far-sightedness. The technology is now so advanced that contact lenses are available for presbyopia; these function like progressive lenses on the eye, they are known as multifocal contact lenses.

Advantages:

Contact lenses result in only slight magnification or reduction of the image. Sideways vision is also sharp and is not interrupted by an edge, as can happen with some eyeglasses. Contact lenses don't fog up, which can be a major factor for some professions – such as sailors, chefs, actors and athletes. Also, different vision impairments in the right and left eye can easily be corrected.

Disadvantages:

A certain degree of manual dexterity is required to put in contact lenses. Wearing them too long can disrupt oxygen supply to the eye, at the time of purchase ask your eye care professional whether the contact lenses have good oxygen permeability. People who suffer from dry eyes should use hard lenses. In general, tolerability of contact lenses varies greatly from one individual to the next, some people get used to them quickly, while others require more time. Contact lenses require more maintenance than eyeglasses, this is especially important since incorrect maintenance and contamination can lead to infections. With multifocal contact lenses, some people have issues switching between the far and near range, or require more time to get used to it.

Laser surgery – small procedure, big effect

Having laser surgery to correct vision impairment has been an option for about 20 years. There is a range of procedures, such as Femto-LASIK, LASIK (laser in situ keratomileusis), LASEK (laser-assisted subepithelial keratectomy) and PRK (photorefractive keratectomy), as well as the minimally invasive ReLEx smile treatment method. The physician decides what method is best for each individual patient. Femto-LASIK is considered the most familiar and is the state-of-the-art procedure. A femtosecond laser is used to cut a thin flap from the cornea, which is then folded to the side. Then the excimer laser ablates the necessary tissue to correct the specific type of vision impairment, all within seconds. In the case of near-sightedness, the cornea is flatter, while it has a more angular shape in the case of far-sightedness. Once the procedure is complete, the flap is folded back into place. Patients can see clearly again shortly after the procedure. The most important requirement for an optimal procedure is that the physician must determine whether it is possible to perform laser surgery at all. The procedure can now be performed on an out-patient basis and usually only takes a few minutes.

The new ReLEx™ smile treatment method from Carl Zeiss Meditec revolutionizes laser treatment

The new ReLEx™ smile treatment method from Carl Zeiss Meditec revolutionizes laser treatment

The new ReLEx™ smile treatment method from Carl Zeiss Meditec revolutionizes laser treatment

Of all the other methods, the new ReLEx smile treatment method from Carl Zeiss Meditec is the first method in which vision impairments can be corrected without having to peel back the corneal flap. This means that the procedure is significantly less invasive for the eye. A laser is used within the intact cornea to create a thin, lens-shaped piece of tissue called a lenticule, which is then removed from under the cornea through an aperture measuring less than four millimeters. This translates into 80-percent less incision area in the upper layers of the cornea than previously (in LASIK) and a shorter treatment.

Advantages:

No glasses are required after the surgery. Modern laser correction procedures can even correct presbyopia. Laser surgery can be a good solution for people with vision problems who cannot get used to glasses or who don't tolerate contact lenses. The diopter range within which vision impairments can be corrected depends on the procedure used. For instance, ReLEx smile can usually correct near-sightedness of up to minus 10 diopters. Other requirements: the eye must be fully formed (in general, patients should be over 18), the degree of near-or far-sightedness (with or without astigmatism) should not have changed within the last two years and the cornea must also be of a certain thickness. With an experienced doctor, this is a very low-risk surgery.

Disadvantages:

Laser surgery is an invasive procedure performed on an essentially healthy organ. Potential side effects and complications include temporarily dry eyes. These symptoms can last up to twelve weeks. Even if the procedure is successful, the vision impairment may not be completely corrected and it may still be necessary to wear glasses. Patients with autoimmune disorders should not undergo laser surgery, along with most diabetics, since this condition can cause damage to the cornea. Beware of cheap offers from abroad as they have significant shortcomings.

Implantable multifocal lenses – surgical assistance for presbyopia

A relatively new option to correct presbyopia and vision impairments is the implantable multifocal lens. While at first these products were inflexible and rigid, modern models are extremely flexible, foldable and can be implanted in the eye through a tiny incision. The procedure only takes about 10 minutes per eye and can be performed within a few days. It is also completely painless thanks to local anesthetic. During the procedure, the multifocal lens is usually placed in the capsular sac, directly behind the pupil, and held in place using a haptic anchor. A new technology has optimized the structuring of the near, mid and far-range zones, significantly increasing visual acuity in all ranges and reducing the risk of glare to a minimum.

Advantages:

The new generation of multifocal lenses is very well tolerated and does not cause pain or discomfort due to the feeling of having a foreign body in your eye. They are primarily implanted in individuals who suffer from age-related cataracts. Around 20 million people worldwide undergo cataract surgery every year. Clinical studies show that 90 percent of patients no longer require a visual aid at any time after the surgery. The benefits of the operation last for a lifetime and it is no longer necessary to have a follow-up procedure since the refraction values generally remain stable. Patients can perform any kind of daily task and even play sports.

Disadvantages:

Patients suffering from certain pathological changes in the eye are not eligible for the procedure. If a patient has this kind of eye disorder, any potential cataract operation will be discussed with the eye care professional during the consultation.


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