LASIK and Presbyopia: what You Should Know

The most common eye problems in the United States are refractive errors. According to the National Eye Institute, approximately half of the U.S. population could benefit from proper refractive correction to treat conditions including hyperopia (farsightedness), myopia (nearsightedness), presbyopia and astigmatism.

More than 3.3 million Americans 40 years or older are either legally blind or have low vision, with the leading cause being age-related eye diseases.

What is Presbyopia?

Presbyopia is age-related and defined as the inability to view things clearly up close. The condition typically occurs in your 40s and worsens until about 65. The term itself comes from a Greek word meaning "old eye."

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Presbyopia is caused by a lack of elasticity in your lens. Your lens, which sits in the eye behind the colored iris, changes shape to focus light onto the retina in order to see objects held closely. As you age, the lens becomes more rigid and loses its ability to reshape thus making it harder to see, especially objects up close.

Presbyopia treatments

Unfortunately, there is no way to prevent or reverse the normal aging process which causes the condition.

Presbyopia can be corrected through treatments including reading glasses, bifocals or contact lenses and even surgery. Multifocal implants (bifocal or trifocal) can be implanted in the eye after removal of the clear natural lens or a cataract (a clouded lens). The multifocal implant allows for clear focus at distance and near. There is even future potential that presbyopia may be treated with eye drops in lieu of glasses.

"If a patient's goal is to get rid of glasses both at distance and at near, I perform mono-vision or mini mono-vision, which means I correct the dominant eye for distance and intentionally under-correct the non-dominant eye for near or almost near," says Dr. Yuna Rapoport, a board-certified ophthalmologist. "This minimizes the need for glasses at all distances. If a presbyopic patient does not care about wearing glasses at a particular distance, then I will correct the distance vision and the patient will still need to wear reading glasses."

If left untreated, not only does presbyopia negatively affect your vision, it can cause headaches and eye strain.

Presbyopia and LASIK

LASIK (laser-assisted in situ keratomileusis) is a popular eye surgery that can correct farsightedness, nearsightedness and astigmatism. However, the procedure doesn’t prevent presbyopia from occurring.

There is a technique used to treat presbyopia using the LASIK procedure called monovision. Most patients undergo a trial with either glasses or contact lenses to see if they can tolerate having one eye corrected for distance vision and one eye for near vision before going forward with the procedure.

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