Presbyopia is the normal age-related loss of the ability to focus on close objects. It gradually affects most individuals over 40 years who will then require reading or varifocal glasses to see clearly at all distances. Book a consultation today and discover your treatment options.
In addition to any refractive errors that our eyes may have e.g. myopia, hyperopia and / or astigmatism, as we age the natural crystalline lens inside our eye loses flexibility. This is because the lens has lens protein added to it continuously throughout life making it gradually denser and stiffer or sclerotic. When we are younger the ciliary muscles in the eye change the shape of the lens to a rounder shape which increases the focal power and allows us to see objects close to. As we age, the ciliary muscles continue to work normally but the lens is less able to change shape and we lose the additional power needed to see objects near us.
Although for many people presbyopia is considered a nuisance or normal part of ageing, the symptoms of presbyopia are often considered more inconvenient nowadays because of our dependence on visual proximity for devices like smartphones and watches and the use of laptops and tablets. Symptoms can reduce confidence particularly at work or socially and needing several pairs of glasses can limit visual freedom for recreational activities and hobbies.
A common misconception is that the use of reading glasses can speed up presbyopia but this is not the case as frustrating as it may be. The ciliary muscles don’t lose their strength throughout life but the natural elasticity of the lens cannot be recovered once lost. Most people start with off-the-shelf magnifiers or ready reading glasses even if they have otherwise normal vision but these can prove inconvenient or easily lost! Progressive or varifocal lenses are more convenient but may cause peripheral distortion in vision or be inconvenient in restricted spaces or when looking down e.g. walking downstairs. For these reasons other solutions are often sought.
Multifocal contact lenses or contact lenses set for different distances for each eye are commonly used to treat presbyopia. Contact lenses powered for different focal lengths provide a type of vision called monovision, a forerunner of laser blended vision when it is replicated through laser vision correction (see illustration of blur and blend zone on PRESBYOND® page). Although contact lenses can give good visual quality, vision can be affected by movement of lens with blinking and as we age, our production of high quality, natural tears is reduced making the eyes less well lubricated. This can in turn lead to lenses drying out with a reduction in visual quality and comfort. Contact lenses are generally a safe way to correct vision but complications include long term intolerance, dry eye and contact lens related infections. It is important not to wear contact lenses around water as most water is not sterile or germ-free and although rare, infections can be sight-threatening.
There are several options for correcting Presbyopia surgically and we can guide you through the choices to determine which might be the best for you. Each section is accompanied by FAQ’s but if you do have questions that are not answered or wish to learn more, please download a brochure or contact us directly through our Contact Us page.
If you are still able to accommodate and do not have any changes to the natural lens of your eye, PRESBYOND® Laser Blended Vision is an excellent choice to maintain a natural visual range. A non-invasive laser vision correction procedure, it is performed on an out-patient basis in our laser suite, is not painful and takes around 5-10 minutes to complete per eye. Your visit to the hospital would take around 2-3 hours.
Visit the treatment page to learn more: PRESBYOND® Laser Blended Vision
If you have early lens change but have not yet developed cataract, have a high spectacle correction or a cornea that will not support laser vision correction, Lens Replacement Surgery or Refractive Lens Exchange (RLE) may be a good option. In this procedure the natural crystalline lens of the eye is replaced with an artificial lens. This lens can be chosen with a variety of different focal lengths and properties to suit your visual requirements. Trifocal lenses such as PanOptix® or Zeiss AT LISA tri will provide the widest range of focal points whilst lenses such as TECNIS Symfony® are optimized for a ‘distance dominant’ lifestyle. Surgery typically takes place under local anaesthetic and takes around 15 minutes to complete. Allow around 4 hours for your visit to the hospital.
To learn more about RLE and read our FAQ’s please visit the treatment page: Lens Replacement Surgery or Refractive Lens Exchange
If you have been told by your optician that you have cataract even at an early stage, or you are aware that despite wearing glasses or contact lenses you may not be seeing as clearly as you have in the past, you may benefit from cataract or refractive cataract surgery. These procedures address the primary problem in your visual system which is loss of transparency and visual quality of your natural crystalline lens. A comprehensive eye examination will be performed to exclude any other cause of visual loss and to determine which replacement lens might suit you best. Refractive cataract surgery refers to the use of lenses which can add functionality to monofocal lenses, either to address astigmatism or multifocality. Depending on your examination, lifestyle and preferences we can make some recommendations as to which type of lens may suit you best. Cataract surgery takes place at Nuffield Health Wessex or Spire Hospital Southampton as a day case procedure, typically under local anesthetic.
To learn more about cataract surgery please visit the treatment page: Cataract and Refractive Cataract Surgery
No, presbyopia is a slowly progressive natural ageing change of the lens in the eye.
The onset of presbyopia is usually in the 40’s slowly increasing until the 70’s. Most people will start with a + 1.00D ‘add’ (see ‘Your Vision / Prescription Explained’) with a final correction of + 3.00D which provides a focal distance of 33cm comfortable for reading or close visual tasks.
Yes! Here are some of the ways you can look after your eyes. They will not slow down presbyopia but will help you make the most of your vision:
Provided your eyes are healthy and you are not developing a medical eye condition the human visual system requires more light as we age. The pupils of the eye become smaller and the lens of the eye becomes thicker, transmitting less light and scattering more light reducing contrast and reducing the saturation of colours. Brighter light is needed to see to the same degree even if our vision is focused correctly.
No. This is one of the myths of presbyopia. Exercise, activity and flexibility are beneficial for our general health but cannot prevent the onset or slow down the progression of presbyopia.
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