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Anagha is a very active woman. She runs every day, manages her home and her office beautifully. In some sense she is a super woman. All was going well for her until she started experiencing hazy vision for her reading related activities and headache after prolonged computer work. She was very confused as otherwise she felt very healthy. She came to me for an eye check-up and I informed her that everything was perfect. She just needed reading glasses. She was shocked and commented then how could everything be normal for her. Se was 44 years of age and poor her, she wasn’t aware of the normal age-related need for reading glasses. I explained about Presbyopia to her.
Presbyopia is the natural physiological weakening of the lens accommodative power which happens with age beyond 40. It is a process of aging of the eye wherein the lens loses its flexibility and is now unable to focus near objects.
Inability to read comfortably or needing to keep the material at an increased distance, are the main symptoms of presbyopia. Normally it starts after 40 years of age.
Near vision testing using different charts like Snellen’s near vision chart can pick this up.

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What are the TREATMENT options Available?

Optical Correction
Eye glasses with bifocal or progressive lenses/ Transition glasses would be the usual and most common resolution to these issues. If people do not prefer to wear glasses, they have the option of contact lenses. Refractive surgery for presbyopia is also available for people who do not wish for either glasses or contact lenses
Presbyopic Lasik

It is an advanced type of laser surgery which modifies the shape of the cornea creating different zones of power to see at various distances. The laser creates zones of power for far, near and intermediate vision. Your brain will adapt to select the zone needed to obtain clearest vision depending on where the object is located. This aims to give you clear vision and make you glass free for distance as well as near vision. However, it has the disadvantage of a poor quality of vision. Hence most surgeons don’t prefer this Lasik for presbyopia correction. A more preferred option s called mono-vision (presbyond) where one eye is corrected for near and the other is corrected for distance. It retains a good quality of vision compared to the other Lasik.

Other Options

There are also Lens bases procedure called refractive lens exchange with multifocal or trifocal IOL implant. This is a great option for patients who are above the age of 45-50 years and have early cataract changes as well. The choice of lens implantation can be based on the lifestyle requirements.
Surgical implantation of a presbyopic corneal inlays is another procedure which is not very popular due to the associated side-effects
So, all in all many options exist for people who are unable to see clearly for near objects. Glasses, contact lenses, Lasik, lens exchange with IOL implantation are some of the commonly preferred options. The choice may be dependent on patient’s lifestyle, preferences and the condition of the eye.

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Summary- Presbyopia is a common eye condition that affects people above the age of 40. Reading vision reduces and patients need to wear reading glasses or contact lenses. Those who don’t want to wear glasses can go for Lasik or lens replacement surgery.

About Dr. Neeraj Israni

Dr. Neeraj Israni is a Cataract and Refractive surgeon. He is trained from the best eye institutes of the country. He is a very diligent eye specialist and researcher. Other eye doctors appreciate him not just for his clinical skills but other skills like video making etc. He has won numerous national and international awards.


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