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REFRACTORY PROBLEMS It’s said that Nero would look through an emerald to help focus on gladiator fights, and that’s thought to be one of the first inventions of eyeglasses. Simply, refractory problems like nearsightedness (when you can see only close things) or farsightedness (when you can see only far away things)—stem from that process where light comes in. The normal eye is a perfect sphere, where the cornea and lens focus light to form the image on the retina. In nearsighted people, the eye is too long from front to back, so when the light travels through, it doesn’t focus on the retina, but on the middle of the eye. Now, your vision can change for several reasons. For instance, you may notice worse vision in the morning—but that could stem from dehydration of the cornea, not from true refractory problems. Your eyes need to be well lubricated to focus; they stay lubricated through your three-layer tear supply and by blinking. With blinking (it’s a process in which the upper lid moves but the lower one doesn’t), your tear film is evenly distributed over the surface of the eye, particularly the cornea. (Winking does the same thing, but has a side effect of increasing your risk of sexual harassment suits.) In either case, the movement of your eyelids has the effect of spraying Windex on your windows. Dry eyes are a little like dry mouths; you produce fewer tears as you get older. Keeping well hydrated by drinking water can help, but you may need to use artificial tears as well.

Eyeglasses were certainly the first wave of treatment methods for refractory problems. Though they don’t cure vision problems, they address eye conditions in such a way to help you see a clearer picture. Nine out of ten people can improve their eyesight with a corrective form of treatment, like glasses (Ben Franklin invented the first bifocal). Later, contact lenses were developed. Essentially eyeglasses that you place on your eyeballs, contacts have evolved from large glass pieces that had to be removed with a small plunger to soft lenses that perfectly fit on the eyeball. New waves of contacts will become even more sophisticated—some lenses may detect levels of blood sugar, so diabetics will know when their blood sugar changes based on the color change of the lenses (yes, you would need a mirror).

Now, of course, we have many varieties of refractive surgery, like photorefractive keratectomy, Lasik, and others, which can permanently correct the refractory problem by reshaping the cornea back to perfect—so that the light focuses on the retina. Lasik has become a very fast and relatively precise process—one in which the eye is numbed, a corneal flap is lifted off the eye, then a computer calculates the amount of tissue that needs to be changed. Within seconds, light beams are sent to cut and reshape the cornea, which allows light to hit your cornea at a different angle so that your vision is improved. Of course, some people need corrective lenses at young ages, but eyes change with aging—even though the speed of that change varies, so some people never need glasses.

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