Methods of presbyopia correction

Presbyopia is a vision defect which affects the ability to sharpen the image when looking closely - e.g. when reading a book, texting someone on the phone or working in front of a computer screen with a small font, especially in low light. The first symptoms become noticeable between the ages of 40 and 50. It develops gradually. Presbyopia is a common phenomenon that affects everyone, regardless of whether they previously had any vision problems or not.

What causes presbyopia

Inside the eye there is a natural, flexible lens that changes in shape, providing a clear image when we switch from distance vision to close range vision or the other way round. This process is called accommodation, and our eyes perform it automatically.

At the early stages of life, the lens is flexible and elastic, but its flexibility disappears over time. This leads to a loss of the accommodation ability, which results in our inability to see clearly up close.

Methods of presbyopia correction

Uncorrected presbyopia may lead to visual fatigue or headaches when looking at close objects or reading. Nowadays, there are several methods of correcting presbyopia and if the method is selected correctly, we will enjoy good vision regardless of the distance.

Non-surgical methods

- Reading glasses – the most basic form of presbyopia correction, available practically everywhere. Glasses with a ‘plus’ value (in the range from +0.5 to +3.5 dioptres) can even be purchased in a drugstore – if they are urgently needed for temporary use, and not for work. As presbyopia progresses, we can buy new, more powerful glasses at an optical salon.

- Progressive glasses (both for distance and close-up vision) – a more expensive alternative for those whose presbyopia is combined with a refractive error and who do not consider wearing two different pairs of glasses convenient. Progressive glasses should be prescribed by a specialist.

- Progressive (multifocal) contact lenses – Thanks to technological progress the range of lenses correcting presbyopia is becoming wider. Multifocal lenses guarantee a smooth change of optical power, which allows for clear vision at all distances. They can be a good solution for drivers.

The advantage of the lenses is primarily the fact that they are invisible and are perfect for both everyday life and free time. If your vision deteriorates, it is easier to order lenses with a different power than to buy completely new glasses.

It should be noted that contact lenses can also correct presbyopia itself – i.e. they will have zero value for distance vision and they will only correct close-up vision. It is most advisable to select lenses with the help of a specialist.

Surgical methods

- Laser vision correction (so-called monovision) – The least invasive surgical method. It involves reshaping the front part of the cornea using a cold laser beam to enable sharp vision. Monovision is only performed in patients who also have a vision defect that is corrected with lenses/glasses on a daily basis.

This results in better vision of the non-dominant eye at close range (the remaining defect is between -0.75 and -1.5 dioptres), while the dominant eye is corrected in such a way that it better adjusted to look into the distance (the defect is corrected completely). You should remember that laser correction of vision defects is for life, but in the case of presbyopia it is only a temporary solution.

- Phakic lens implant – It involves implantation of a second artificial lens (multifocal implant) inside the eye, which will correct both distance and close-up vision. The implant, unlike standard contact lenses, does not require daily replacement. The treatment also has the advantage of being a reversible procedure. The lens usually remains in place until cataract develops (in the elderly), which makes it a better solution for slightly younger patients.

- Refractive lens removal – It involves the removal of the natural intraocular lens and replacing it with a multifocal implant for the correction of both distance and close-up vision. This procedure is performed only once - with the implanted lens permanently remaining in the eye. This treatment is recommended to elderly patients, especially if apart from a vision defect and presbyopia they also have developed cataract.

Of the above-mentioned surgical methods, at the ArtLife Ophthalmological Centre we only perform laser vision correction procedures using the monovision method (at the request of a patient with presbyopia and vision defects). More information about the monovision correction method is available on our website and in our article.
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