What Is Dysfunctional Lens Syndrome?

As you enter your 40s, your near vision begins to change. This is because the lenses in your eyes are aging, and it happens to everyone, even those who had LASIK earlier in life. LASIK fixes problems in the cornea, or outer layer of the eye, and not the lens itself. Changes to your near vision after age 40 are natural and part of the aging process. It is known as dysfunctional lens syndrome (DLS).

The Stages of Dysfunctional Lens Syndrome

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As you begin to experience the onset of DLS, the lens in your eye is undergoing a series of gradual changes. We categorize these changes into three stages:

Stage 1 DLS

Stage 1 is the beginning of DLS, and what is commonly referred to as presbyopia. In stage 1 DLS, the lens of your eye slowly begins to harden and lose its flexibility. This rigidness makes it difficult for you to focus on things up close, and is the reason you will start to need reading glasses or bifocals. This stage usually begins in the early to mid-40s.

During stage 1 DLS, your lens is still healthy and clear. There are multiple options available to help free you from your reliance on reading glasses or bifocals. Corneal inlays, such as the KAMRA Inlaycan be a good solution for active people in stage 1 DLS who have good distance vision but wish to reduce or eliminate their dependence on readers. Laser vision correction, such as LASIK in one eye, may also still be a viable option for some patients, allowing individuals to see near and far without depending on readers. One eye is used for distance vision and the other eye is used for near vision. When both eyes are open, the brain can chose to use distance corrected eye to see far away and the near corrected eye to see up close.

Stage 2 DLS

During stage 2 DLS, the lens of the eye has started the gradual process of yellowing. This affects the amount of light the lens can filter, which reduces the clarity of both your distance and near vision. Symptoms of stage 2 DLS most often begin in the late 40s to mid-50s.

During stage 2 DLS, we often recommend Refractive Lens Exchange (RLE) instead of laser vision correction, and replace the dysfunctional lens with a technologically advanced lens, called an IOL.

Stage 3 DLS  

Stage 3 DLS is also known as a cataract. A cataract occurs when the lens of your eye has become cloudy enough that it significantly impacts your vision. The cataracts must be treated to restore the quality of your sight.

The recommended treatment for cataracts, or stage 3 DLS, is laser cataract surgery. In the U.S., the average age for cataract surgery is 73.

What You Need to Know – Takeaways About DLS

middle aged couple reading jar at grocery store

  • Lens loses function over time
  • Lens stiffens
  • Lens loses clarity
  • Develops in three stages
  • Affects everyone eventually, even those who have had LASIK
  • Can be treated with various solutions so that you don’t have to depend on readers or bifocals

Did My LASIK Wear Off or Cause DLS?

LASIK is a permanent solution and does not wear off. LASIK corrects your vision by changing the shape of your cornea, which is the outer layer of your eye. This change to the cornea’s surface helps your eyes better focus light onto the retina (the back of your eye) for clear vision.

When you’re young, the lens inside your eye is extremely flexible and allows you to easily focus on objects up close. Over time, typically in your early 40s, your lens gradually loses its flexibility, making it difficult to focus on close objects. Your near vision starts to become blurry, caused by the decreased flexibility of your eye’s lens. This is a normal part of  the aging process that happens to everyone, even those who have never needed glasses before. DLS is not related to or caused by LASIK.

Find Out If You’re a Candidate

If you are suffering from DLS, the first step to minimizing your visual barriers is to discover which vision correction procedure is right for you. At Kugler Vision, we administer one of the most sophisticated exam and screening processes in the country and will consult with you on all treatment options available. Contact us at 402.558.2211 to schedule your consultation and take control of your vision.

Published by

Lance Kugler, MD

Lance Kugler, MD, is a specialist in LASIK and vision correction surgery and CEO of Kugler Vision. A proud Omaha native, he is passionate about improving lives through clear vision. Dr. Kugler serves on several national boards, and his practice is recognized internationally as a center of excellence. Dr. Kugler is one of the original founders of the Refractive Surgery Alliance, an international organization comprised of over 350 of the world’s leading vision correction surgeons; he also served as its first president. In 2019, Dr. Kugler was selected as a TEDx speaker, and delivered a talk in Omaha about the worldwide epidemic of nearsightedness and refractive solutions. Dr. Kugler is an Associate Professor of Refractive Surgery at the University of Nebraska Medical Center’s Truhlsen Eye Institute, has been published in many medical journals, and participates in numerous clinical studies to advance the field of vision correction surgery. Additionally, Dr. Kugler is proud to be a Board Certified Fellow of the World College of Refractive Surgery & Visual Sciences. Dr. Kugler and his wife are proud parents to five active kids. When he has a spare moment, he enjoys skiing, tennis, travel, and fine coffee.

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