Invisible Fixes for Aging Eyes
There's no avoiding mid-life squint. But three new options won't betray your age.
By Curtis Pesmen

(MONEY Magazine) – Nothing says "middle-aged" (or, worse, "candidate for an early retirement package") like a pair of reading glasses dangling from your neck. Mid-life vision loss--the biomarker known as presbyopia--touches virtually everyone between the ages of 40 and 50. Yet it still feels like a personal assault on that ageless 30-year-old staring back at you in the mirror. Or squinting back, more likely. You can stretch that teeny-print profit and loss statement out only so far (to arm's length), click the laptop's view/zoom feature only so many times.

But three recent innovations can help youthify aging eyes. Each has advantages (beyond being hipper than Dad's bifocals) as well as drawbacks (we are talking about--ick!--eyeball surgery). And if your insurance won't cover them, your flexible spending account often will.

Laser Surgery

No longer the new kid on the eye-chart block, Lasik has corrected 7 million sets of vision-afflicted eyeballs in the U.S. since its approval by the Food and Drug Administration in 1998. Noted for its painless cutting into and reshaping of the cornea (using a keratome blade and ultraviolet light), Lasik treats standard refractive errors--nearsightedness and farsightedness--to allow patients to ditch their glasses or contacts. Nowadays a growing cadre of eye surgeons is using the Lasik technique to treat presbyopia.

WHAT IT IS A laser surgery variant of monovision glasses or contacts. Example: One's dominant eye (the one you use while focusing snapshots) is corrected for distance vision, while the nondominant eye is treated for near vision.

WHAT IT'S NOT Crystal clear, at first. Monovision can be blurry; it takes some getting used to, whether in glasses, contacts or surgically altered eyes.

ICK FACTOR Moderate to high, though complication rates are well below 1%

COST $750 per eye to $3,000 per eye (with software that helps doctors more precisely map fields of vision)


Lens Implants

For over 30 years, surgeons have carefully sliced open the eyes of cataract patients and replaced their murky lenses with intraocular lens implants (IOLs). Now younger consumers, in search of glasses-free lives, want similar surgery for lesser ills.

WHAT IT IS An IOL is an artificial lens inserted into the eyeball, usually after the original lens has been extracted. One new IOL, the Verisyse lens, treats severe nearsightedness in people under 45 without removing the natural lens. Another, Crystalens, targets presbyopia, with the potential to restore lost focusing ability.

WHAT IT'S NOT For everybody. Occasional side effects include postoperative pain, blurring and halos.

ICK FACTOR High, although it's almost always safe

COST $3,600 to $5,000 per eye

COVERED BY INSURANCE? Not usually, and not fully. But Medicare last May began reimbursing some of the surgical costs for early cataract patients who opt for the latest IOLs. As Medicare goes, so (eventually) go many insurers.

Radio Waves

Medicrats call it radio-frequency conductive keratoplasty, or (thank goodness) just CK, and the FDA okayed its use for presbyopia in 2004. "CK is for people who see well at a distance but who just wear reading glasses--40% of the population," says Dr. Daniel Durrie, an eye surgeon in Overland Park, Kans. who studied the procedure for the feds.

WHAT IT IS An alternative to surgery that doesn't slice tissue. It changes focusing power by using radio-frequency energy to briefly heat and reshape the cornea--in less than three minutes.

WHAT IT'S NOT Forever. "As with prescriptions for reading glasses, consumers will be returning for refinements within three years," predicts Mitchell Campbell, CEO of Refractec, which holds the patent for an FDA-approved CK device.

ICK FACTOR Low. Campbell says 120,000 CKs have been logged worldwide "without a single sight-threatening event." Wow. But most of the 800 U.S. docs trained in CK have been doing it for less than two years.

COST $1,500 to $2,000 per eye

COVERED BY INSURANCE? Not yet. But you may want to wait--and see.