Progressive Lens Dysfunction

Progressive Lens Dysfunction (PLD) - also known as Dysfunctional Lens Syndrome - is used to describe the progression of conditions associated with an aging crystalline lens. In PLD, there is an increasing loss of function of the natural lens inside your eye whereby the lens stiffens and also loses its clarity. Progressive Lens Dysfunction occurs in three stages:

Stage 1

The first stage of PLD generally occurs in your 40s and involves the elasticity of the crystalline lens. The crystalline lens is a transparent structure that curves outwardly on its two optical surfaces. Along with the cornea, this lens helps to refract light to be focused on the retina. A young and healthy crystalline lens is rounded, so it is capable of working like a magnifying lens. This allows us to see near objects clearly. When we need to see at a distance, muscles in our eye pull on the lens to flatten it out, which allows us to see far objects with clarity. This is known as accommodation.

As we get older, the lens loses its elasticity. The muscles are able to flatten the lens in order to see at a distance, but the lens is no longer able to snap back into its rounded shape to see clearly up close. The flexibility of the lens deteriorates at a steady pace our whole lives, but most don’t notice it until we reach our 40s. This condition is known as presbyopia. The loss of accommodation eventually requires us to wear reading glasses.

Innovative and life-changing, Laser PresbyVisionTM is the most effective solution available to help reduce your need for reading glasses. This quick and painless procedure corrects your refractive error and reshapes the cornea to compensate for the poor accommodation.

Stage 2

As we age into our 50s and 60s, not only does the lens become less flexible, but it also develops higher-order aberrations (HOAs). When HOAs are located in the lens, they’re called spherical aberrations, which are small irregularities or imperfections that contribute to decreased functional vision and poor nighttime vision, especially due to bright lights when driving at night.

The best treatment at this stage of PLD is Lens PresbyVisionTM, a procedure also known as a Refractive Lens Exchange (RLE ). An RLE removes the dysfunctional lens and replaces it with a new synthetic one known as an intraocular lens. This procedure offers a full range of benefits because it eliminates the problems associated with HOAs and can also substantially restore a patient’s ability to see both near and far without the need for reading glasses or bifocals. Correcting PLD with an RLE completely eliminates the risk of developing a cataract in the future.

Stage 3

By your 70s, PLD enters the final stage whereby the opacity of the lens becomes so cloudy that it is considered a cataract . While some cataracts can be caused by trauma, the condition is usually associated with aging. In fact, more than half of North Americans who reach the age of 80 have cataracts or have had cataract surgery.

There are several symptoms associated with cataracts, including cloudy or blurred vision, faded appearance of colours, glare or halos around lights and poor night vision. If cataracts are left untreated for a long time, complete loss of vision can occur during final stages.

The treatment for a cataract is similar to that of stage 2 PLD whereby the dysfunctional lens is replaced with Refractive Lens Exchange (RLE). It’s one of the safest, most effective and most common surgical procedures in medicine. At this stage, the treatment for cataracts is considered medically necessary.


For more information on PLD and the treatments available, book a free consultation today.

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