Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 07/09/17 6:45 PM
For quite a while, the holy grail of refractive surgery has been a way to fix the loss of near vision that comes with age. More specifically, it’s been to accomplish that goal while maintaining excellent distance vision. Perhaps you’re part of the huge segment of the population who lived with effortless near and distance vision for four decades and then, in a cruel twist of fate, lost your ability to focus on anything closer than arms length. It’s a terrible fall from the top. And I say that without a hint of sarcasm. The people I meet in clinic who’ve worn glasses since childhood are excited to get out of them. The people I meet in clinic who’ve worn glasses since they turned 42 want to throw their glasses into a volcano. They remember having perfect eyes. It’s a lot harder to lose an ability than to never know what it was like to have it.
In a coincidence frustrating to ophthalmologists and patients alike, the folks who most want their eyes fixed have a vision problem that happens to be the hardest to fix. Restoring near vision without causing problems for distance vision is really challenging. It’s because refractive surgery has gotten really good at fixing prescriptions, but the loss of near vision isn’t a prescription problem. It’s an autofocus problem. Turns out, it’s insanely difficult to match the ease and precision of autofocusing found in a young eye’s natural lens. It’s not that we’ve got it mostly figured out and it needs a little tweaking. We’re not even close.
So for years the research and development segment of refractive surgery has been trying to come up with a workaround to enable easy near and distance vision. LASIK works, and while some of my happiest LASIK patients are those who got it to fix their near vision, few would describe it as easy. Life changing? Yes. Worthwhile? Definitely. Easy? Not at first, for many of them. Unless you’re in the lucky bunch for whom neuroadaptation was immediate and unnoticeable, there’s a mental investment involved in having easy near and distance vision. While the ability to see everything without glasses is there from day one, the ability to do it without ever thinking “I can see this, but it feels different” is something most people learn over the first few months.
This is why the Raindrop is such a welcome addition to our world. The change in near vision compared to the change in distance vision is huge. To put it in different terms, you give up a couple cents of distance vision to gain a couple dollars of near vision. This matters if you’re someone who really likes their distance vision, while your near vision makes you angry and sad. Easy distance and near vision is a more reachable goal than we’ve had available until now. Here’s how the Raindrop inlay can help: it allows you to easily read a menu and maintain your ability to easily see across the restaurant. To cover my bases in case you’d rather stay at home, it can also help you easily read a book and easily see the TV across the living room.
Since most of us care more about our sight than scientific specifications, I’ve left the explanation of what Raindrop is until here at the end. Only us diehards are still reading by now. The Raindrop is a tiny little hydrogel disc that looks a lot like a contact lens made to fit a hamster. It’s 2mm in diameter and about half the thickness of a human hair. A 10-minute procedure places it under a LASIK flap in just one eye, where it causes an ever-so-slight change in the curve of the cornea. In doing so, it dramatically increases the depth of focus so that distance vision is slightly decreased (e.g. to around 20/30) and near vision is largely increased (e.g. to allow the ability to read fine print). Because the other eye is untouched, the overall distance vision is maintained. Near vision, however, is transformed from impossible to easy.
There’s more to it than that, but ironically you can’t read the fine print without first getting the Raindrop procedure. No, not really. That’s just a line from my upcoming ophthalmology-based stand up comedy show. The details involved in whether or not you’d be a candidate for the Raindrop, as well as the risks and benefits for you specifically, should be saved for a consult with a refractive surgeon. It’s super important to work from your eyes to the answer on how to fix them, rather than start with an answer and try to fit the problem to it. The Raindrop is exciting though, because a lot of people are going to have a good answer to a problem that didn’t have a solution until now.