Near Vision Correction With Presbyond Laser Eye Surgery
Finding it harder to read menus, messages or labels without reading glasses? Presbyopia is a normal age-related change in near focus. Learn about near-vision correction options, including glasses, contact lenses, laser monovision and lens-based surgery.
What is presbyopia?
Many people first notice changes in their near vision from around the age of 40. You may start holding your phone further away, need brighter light to read or find yourself searching for reading glasses more often.
This is usually caused by presbyopia, a natural part of ageing in which the lens inside the eye becomes less flexible and gradually loses some of its ability to focus on close objects.
When you are younger, the natural lens inside the eye changes shape to focus from distance to near. With age, the lens becomes firmer and less flexible, making close focus increasingly difficult.
Presbyopia is different from hyperopia (far-sightedness). Hyperopia is a refractive error caused by the optical shape of the eye, while presbyopia is an age-related change in focusing ability. A person can have presbyopia together with myopia, hyperopia or astigmatism.
Presbyopia cannot be prevented by eye exercises or lifestyle changes, but there are several ways to improve near vision. The most appropriate option depends on your age, prescription, eye health, lifestyle and whether your natural lens is still clear or has developed cataract.
Common signs of presbyopia
- Needing to hold reading material further away
- Difficulty reading small print or phone text
- Needing brighter light for close work
- Eye strain or tired eyes during reading
- Headaches after prolonged near tasks
- Increasing dependence on reading glasses
Near vision correction options
There is no single best treatment for presbyopia. Some people prefer simple reading glasses, while others want to reduce their dependence on glasses through contact lenses or surgery.
Reading, progressive and multifocal glasses
Glasses remain the simplest and most common way to manage presbyopia. Depending on your distance prescription and lifestyle, options may include reading glasses, bifocals or progressive/multifocal lenses.
Using reading glasses does not make the eyes weaker or cause presbyopia to progress faster.
Contact lenses
Some people use multifocal contact lenses or a monovision contact-lens strategy, where one eye is corrected mainly for distance and the other for nearer tasks. Contact lenses can also be useful for trialling whether you are comfortable with monovision before considering surgery.
Laser monovision or blended-vision correction
For selected patients, laser vision correction can be planned so that one eye provides stronger distance focus and the other provides more near focus. The brain combines information from both eyes to provide a wider functional range of vision.
Not everyone adapts comfortably to monovision. Depth perception, contrast and night vision can be affected in some people, so suitability should be assessed carefully and a contact-lens trial may be recommended.
Lens-based near vision correction
Lens-based surgery replaces the eye's natural lens with an artificial intraocular lens (IOL). This is routinely performed when cataract affects vision and can also be considered as refractive lens exchange in selected patients without significant cataract.
The lens strategy can be tailored to visual goals and may involve monofocal lenses, monovision, multifocal or trifocal lenses, extended-depth-of-focus (EDOF) lenses, and toric lenses where astigmatism also needs correction.
Cataract surgery and near vision
If cataract is contributing to your vision problems, cataract surgery may be the more appropriate pathway rather than corneal laser surgery. Your surgeon can discuss IOL options designed to balance distance, intermediate and near-vision goals.
Near vision correction options at a glance
| Option | Surgery? | Potential advantage | Important consideration |
|---|---|---|---|
| Reading/progressive glasses | No | Simple and adjustable | Requires glasses for near or multiple distances |
| Multifocal contacts | No | Can provide near and distance vision | Comfort and visual quality vary |
| Monovision contacts | No | Useful trial before surgery | Not everyone adapts to unequal focus |
| Laser monovision | Yes | May reduce reading-glasses dependence | Corneal suitability and monovision tolerance required |
| Lens-based surgery | Yes | Can address lens ageing/cataract and refractive error | Intraocular surgery with lens-specific trade-offs |
Which near vision option is right for me?
The choice is not based on age alone. A comprehensive eye assessment should consider:
- your distance and near prescription
- whether you have myopia, hyperopia or astigmatism
- corneal shape and thickness
- dry-eye and ocular-surface health
- whether cataract is present
- retinal and optic-nerve health
- your occupation and screen use
- how important night driving, depth perception and fine near work are to you
- your willingness to accept glasses for some tasks
For many patients, the best starting point is to understand the cause of the near-vision problem and then compare the realistic benefits and trade-offs of each option.
Can near vision surgery get rid of reading glasses?
Surgery may reduce dependence on reading glasses, but it cannot guarantee complete or lifelong spectacle independence. Some patients may still prefer glasses for very small print, prolonged reading, low-light tasks or certain distances.
Vision can also change over time. Presbyopia continues to progress through mid-life, and cataracts or other eye conditions can develop later.
Risks and limitations of surgical near vision correction
All surgery has potential risks. The risks depend on whether treatment involves the cornea or the lens.
Possible considerations can include:
- dry eye, glare, haloes or fluctuating vision after corneal laser treatment
- under- or over-correction and the possible need for further correction
- reduced tolerance of monovision, including changes in depth perception or night vision
- infection or inflammation
- lens-surgery risks such as retinal problems, pressure changes or lens-specific visual side effects
- continued need for glasses for some tasks
Your ophthalmologist should explain the risks, expected benefits and alternatives that apply to your eyes before you decide whether to proceed.
Book a near vision assessment
If reading glasses are becoming more important in your daily life, an assessment can determine whether the change is due to presbyopia alone or whether cataract, dry eye or another eye condition is also contributing.
The personalEYES team can discuss glasses-free and glasses-reducing options based on your prescription, eye health and visual priorities.
Book an assessment online or call personalEYES on 1300 68 3937.
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