Presbyopia/Eye Strain


Presbyopia and eye strain are related to the ageing process and mean that it is difficult to see things close up. Presbyopia is caused by the loss of flexibility in the eye’s natural crystalline lens decreasing the ability to focus clearly on close-up objects. Its appearance is related to age (generally from the age of 40-45) and the condition gradually increases until the age of 60-65. Presbyopia equally affects those suffering from short-sightedness, long-sightedness and/or astigmatism as much as it does those who have no history of eye defects. However, it does appear first in those who are long-sighted.

Treating Presbyopia

When the condition appears, it’s necessary to use glasses to focus on close-up objects. The following are all efficient treatments for the correction of eye strain:

  • Laser treatment
  • Intraocular lens (IOL) treatment
  • Laser and IOL treatment both correct long and short-sightedness without the need for glasses.

Laser treatment for Presbyopia

The procedure for treating Presbyopia with an Excimer laser is a type of refractive corneal surgery similar to the LASIK operation for correcting short-sightedness, long-sightedness and/or astigmatism. As with the LASIK treatment, this laser procedure also requires the surgeon to peel back a fine flap of corneal tissue. An incision is then made into the cornea using the Excimer laser and finally the flap is replaced without the need for any stitching.

Laser presbyopia treatment is particularly recommended for those patients who have not yet developed cataracts and who, as well as having presbyopia, have refractive defects that prevent them from seeing objects far away. These defects will also be corrected by the laser in the same procedure. There are two types of presbyopia laser surgery that exist:

  • Monovision or blended vision: the distance vision of the dominant eye is corrected while the other eye is made mildly short sighted. After the operation itself patients must carefully follow their doctor’s instructions while they adapt to the changes in their vision.
  • Presbylasik: Here the laser modifies the curvature of the cornea in order to obtain a multifocal effect. This allows the patient to see clearly at all distances in both eyes. Unlike traditional LASIK treatment, which corrects either short or long-sightedness, Presbylasik improves vision at all distances.

Presbyopia laser surgery is carried out using a local topical anaesthetic (drops) meaning that the patient will not feel any pain. The procedure lasts only a few minutes and following a brief stay at the clinic and an initial post-operative check, the patient can be discharged and leave the clinic by themselves. The postoperative healing process, recovery of vision and risks of presbyopia laser surgery are the same as those associated with LASIK surgery to correct short-sightedness, long-sightedness and/or astigmatism.

Treating Presbyopia with Intraocular Lenses (IOLs)

This IOL insertion technique consists of replacing the eye’s natural crystalline lens with an artificial multifocal or trifocal lens which will allow the patient to have clear vision at all distances without the need for glasses. As well as correcting presbyopia, these multifocal and trifocal lenses also correct any pre-existing short-sightedness, long-sightedness and/or astigmatism.

This IOL technique to treat presbyopia is ideal for patients who have started developing cataracts, are over 60 years old, or whose refractive defect for distance vision is too severe for it to be corrected using laser surgery.

IOL presbyopia surgery is similar to treatment for cataracts as with both procedures the eye’s crystalline lens is removed using phacoemulsification (ultrasound) and an artificial IOL is inserted in place of the natural crystalline lens. This is all carried out by making a microincision in the cornea which doesn’t require any stitches. The procedure lasts just a few minutes and is carried out using a local anaesthetic. There’s no need for the patient to stay overnight at the hospital and after an initial post-operative check the patient can return home by themselves. IOL presbyopia surgery has exactly the same postoperative healing process, recovery of sight and risks as cataract surgery.

Patients who have had these lenses inserted will not require cataract surgery in the future because the eye’s natural crystalline lens has already been removed (remember that cataracts is caused by this lens losing its transparency and becoming cloudy).

In some cases, it’s possible to use a combination of IOL and laser techniques to correct presbyopia that cannot be cured using just one of these procedures.