What is Presbyopia?Author: Dr. William Tullo
July 19, 2013
Presbyopia is the gradual worsening of close-up vision. It is part of the natural aging process and affects most of us, usually beginning around age 40.
While LASIK surgery is an excellent option to correct nearsightedness (myopia), farsightedness (hyperopia) and astigmatism—all of which can be caused by the shape of the eyes—LASIK eye surgery is not effective in treating presbyopia, which is caused by the natural thickening and hardening of the eye’s lens.
If you have had—or plan to have—laser eye surgery, you should know that you might develop presbyopia as you age, and that you may eventually need eye glasses for reading or other close work.
Symptoms of presbyopia
If you experience any of the following symptoms and are around 40 years old, consider talking to your eye doctor about presbyopia:
Difficulty reading books or magazines, using the computer, doing needlework or performing other up-close tasks
A need to hold reading material at arm’s length to read clearly
- Frequent headaches or eye strain
Nonsurgical treatment options
The good news is that presbyopia is easily—and, many times, inexpensively—corrected. Some popular nonsurgical treatments include these:
Nonprescription reading glasses (sometimes called “readers”), found at most drugstores
Higher-quality prescription reading glasses available from your eye doctor
Bifocal, trifocal or progressive multifocal glasses, which have two or more prescriptions per lens for distance, intermediate and near vision
Monovision contact lenses, which offer different prescriptions for each eye: one for distance vision and one for close-up vision (this can take some getting used to)
- Multifocal contacts lenses, which work like bifocal or progressive multifocal glasses by providing two or more different prescriptions per lens for distance, intermediate and near vision
People who have undergone LASIK eye surgery may opt for either reading glasses or special post-surgery contact lenses to correct their presbyopia without additional surgery.
Surgical treatment options
If you’re not interested in wearing reading glasses or contacts to treat your presbyopia, surgical eye treatment options are available, including these:
Monovision LASIK, which corrects one eye for distance vision and leaves the other eye for near vision. Some people may have difficulty adjusting to monovision, and their depth perception may be affected.
- Refractive lens exchange, which is similar to cataract surgery, in which the eye’s natural lens is replaced with an artificial one.
There are also some promising new surgical treatment options on the horizon, including these:
KAMRA™ inlay, in which the eye receives an implant smaller than a contact lens, which allows for comfortable, natural near vision. This inlay was recently approved by Health Canada but is still under U.S. FDA investigation. This means that KAMRA™ is not currently available for sale in the United States.
- Multifocal LASIK, or presbyLASIK, which uses a laser to create multiple separate treatment regions, or “zones.” This allows for near, intermediate and far vision in each eye. This form of LASIK is used in several other countries but has not been approved by the U.S. FDA.
Having presbyopia, or knowing that you likely will experience it to some degree as you age, shouldn’t discourage you from choosing LASIK surgery now—especially if you are in your 20s or 30s. It is still possible to enjoy many years of improved vision without the aid of eye glasses or contacts. Even as age-related vision issues such as presbyopia occur, you can still have the advantage of clear distance vision after laser eye surgery, even if you need inexpensive reading glasses.
Talk to your eye doctor and LASIK surgeon about your options for correcting presbyopia, so you can make the choice that is best for you and your lifestyle.