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Correction of presbyopia

Learn about the indications for the procedure, its course and recommendations for patients, as well as contraindications to the procedure.

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Presbyopia (presbyopia) is a natural process of aging eyesight. With PresbyMAX® correction surgery , you can regain good vision without glasses.

Presbyopia (presbyopia) is a natural process of aging eyesight. It involves a decrease in the acuity of close-up vision. It affects almost every person over 40. year of age. Presbyopia is not a visual defect and should not be confused with hyperopia, although the symptoms as perceived by patients may seem similar. This process is irreversible, but thanks to the achievements of modern medicine, the effects of presbyopia can be successfully mitigated or corrected. For this purpose, special glasses or laser treatment are used.

When does presbyopia appear?

Symptoms of presbyopia most often appear between the ages of 40 and 45. Prolonged reading or working at the computer or reading labels on products becomes a problem. The text seems too small, we need to increase the distance to read the letters and sentences. So we naturally increase the distance between our eyes and the text. Often you can also see a change in the defect of vision. People who develop presbyopia, depending on the defect, may need to replace the lenses in their glasses or read without glasses, although this was once impossible.

First symptoms

People with farsightedness will be the first to notice the change, because in their case one of the coping mechanisms for refractive error is the use of eye accommodation. Myopic people, especially those with low myopia (up to about -3.0 D), may notice that they no longer need glasses for reading, that their defect is receding. It may even happen that they stop using glasses for a short time, after which they usually have to use focusing lenses.

As a result of weakening of the ciliary muscles and stiffening of the lens, people with presbyopia find it difficult to contract the muscles and convexity of the lens, and thus see objects clearly from a short distance. That’s why presbyopia is often called “short hand disease” or “too-short hand syndrome” because offsetting the text allows you to see a little better.

Symptoms of presbyopia:

Symptoms of presbyopia are not specific, they do not occur suddenly, they develop over time. Here are the most commonly observed:

  • Reduced visual acuity when looking at objects close by. Distant vision is not affected in any way, unless the person has a refractive defect occurring earlier than the onset of presbyopia symptoms.
  • problem with reading books, newspapers, labels, texts on computer or smartphone
  • Headaches or feelings of fatigue after prolonged reading or computer work requiring visual focus
  • Weakening of the muscles responsible for the eye’s accommodation, or eye attitude. Accommodating is the ability of the eye to adjust to see objects at different distances. Accommodations are made possible by changing the shape of the eye’s lens, which results in a change in its focal length and, as a result, the correct sharpening of images on the retina.

How to treat presbyopia?

Presbyopia is a condition that can be corrected with appropriate corrective measures. Here are some ways to treat presbyopia:

  • Glasses: the most common way to correct presbyopia is through glasses. The ophthalmologist will conduct an eye examination and determine the strength of the glasses needed to improve the vision of close objects. Presbyopia glasses differ from regular distance glasses because they have extra power in the lower part of the lenses to help improve vision of near objects.
  • Contact lenses: Those who prefer contact lenses can benefit from multifocal contact lenses. Such lenses have different zones with different powers, which allows both distance and close-up vision. However, it is necessary to customize the lenses and wear them comfortably.
  • Progressive lenses: progressive lenses are also an effective option for people with presbyopia. These are lenses that combine power for distance, intermediate and near vision, with no clear zoning. Progressive lenses allow you to smoothly adjust your vision according to distance.
  • Surgery: In some cases where glasses and contact lenses are not satisfactory, a surgical option such as cataract surgery or surgical correction of presbyopia may be considered. In cataract surgery, removing the cloudy lens of the eye can simultaneously correct presbyopia. There are also surgical techniques to correct presbyopia, such as laser technology or intraocular lens (ICL) replacement, which can be used in some patients.

 

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Will laser vision correction help treat presbyopia?

Laser vision correction, also known as laser refractive surgery, is a popular solution for correcting vision defects such as nearsightedness, farsightedness and astigmatism. However, laser vision correction is not usually used as the main solution for presbyopia.

Presbyopia is related to the loss of elasticity of the eye’s lens, not a defect in the shape of the cornea, which can be corrected with laser vision correction. However, state-of-the-art technology allows for laser vision correction in combination with presbyopia correction.

 

If a person suffering from presbyopia also has another visual defect, such as nearsightedness or farsightedness, and meets other eligibility criteria for laser vision correction, then a refractive surgeon may recommend this procedure. If this is the case, laser vision correction can help improve overall vision both near and far.

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Piotr Voigt

Corneal biomechanics specialist

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