As people age, the internal lens system of the eye becomes less capable of focusing on objects up close or it is possible to say that the natural lens of the eye has lost its ability to “zoom”. The lens of the eye loses its elasticity and the individual is no longer able to read, drive or perform other tasks requiring nearsightedness without the aid of glasses. A result of that people having to hold things farther away to read or a dependence on reading glasses or bifocals.

This process, called presbyopia, is a natural part of aging, and affects nearly everyone over the age of 40, including those who have never before worn glasses or contact lenses as well as those that do.

The word presbyopia comes from the Greek word presbys, meaning “elder” or “old man”, and Latin root -opia, meaning “eye”

The lens of the young eye changes its shape easily, allowing you to focus on the objects both close and near.  From the age of 40, the lens starts to become more rigid.  Because the lens can’t change shape as easily as it once did, it is more difficult to read at close range. You can also have presbyopia in combination with myopia, hyperopia or astigmatism.

Presbyopia is a normal part of the aging process. As the body matures, the normally soft, flexible lens becomes hard and has difficulty focusing on close objects. Reading vision becomes blurred and difficult. Bifocals and reading glasses, which aid the eye in focusing on close objects, are used to treat presbyopia.

Since the laser has no effect on the lens of the eye and cannot improve vision due to presbyopia, people who have had LASIK and have or develop presbyopia will need reading glasses for small print. But there are some good ways to correct your vision with surgery for presbyopia.

When, as a result of physiological changes occurring between the ages of 40 and 45, the near point of vision of the emmetropic eye recedes to a distance of more than 22 cm (9 inches), then that person has acquired presbyopian status. It is our considered opinion that presbyopia is more than a physiological state, that it transends the mere effects of age and, indeed, is worthy to be included within the term “status”.

What are symptoms of presbyopia?
Some symptoms of presbyopia include the tendency to hold reading material at arm’s length, blurred vision at normal reading distance and eye fatigue along with headaches when attempting to do close work.

What causes presbyopia?
Presbyopia is an age-related loss of flexibility of the lens inside the eye. This is different from astigmatism, nearsightedness and farsightedness, which are related to the shape of the eyeball and occur early in life. When the lens becomes hardened and less elastic, the eye has a harder time focusing up close.

Presbyopia treatment
Many options exist to correct your vision if you are Presbyopic. From glasses, to contact lenses, to surgery, or some combination of the three, you can have clear vision for whatever tasks you are doing. You may be surprised by the number of ways could be customized as a solution for you if you have specific needs beyond what the standard options correct. There are many new technologies that make it easier than ever, particularly the new digitally-surfaced progressive lenses.

Monovision LASIK surgery treats presbyopia by correcting one eye for long distance vision and the other eye for near vision. This procedure offers presbyopic and pre-presbyopic patients the ability to retain near and distance vision after surgery with little or no reliance on glasses or contact lenses. If you are over fifty and you choose to have traditional, rather than M-LASIK, you’ll probably still need reading glasses after surgery.

The concept of using one eye for close vision and one for distance is not new. It dates back as far as 1720, when Baron Philip Von Stosch invented the monocle. In more modern times, using different eyes for different vision has been done successfully for several decades, using contact lenses. Monovision as a form of LASIK surgery is the most recent development in presbyopia treatment, taking advantage of the fact that each of us has a dominant eye, much as we have a dominant hand.

Monovision LASIK was performed off-label for many years, meaning that it had not received official FDA approval as an approach to correcting presbyopia. However, this changed on July 12, 2007, when the FDA officially approved the surgery as a treatment for presbyopia. While this is an ambitious type of laser eye surgery, requiring careful patient selection and counseling, Monovision LASIK can offer excellent visual outcomes for both distance and close vision, and may be especially attractive to those hoping to never have to wear granny glasses!

Because not everyone can adjust to this new way of seeing, many doctors recommend you wear special monovision contact lenses for at least a week before committing to surgery. Monovision LASIK is a permanent operation to the cornea, and you want to be sure it will work for you before you commit to it.