Top 5 Presbyopia Treatment Options

If you are over 40 and squinting to read this page without any form of visual assistance, chances are you may be developing presbyopia. Presbyopia is also known as age-related long-sightedness or more commonly, a loss of your near vision due to age.

If you have presbyopia, you are not alone. It affects more than one billion people worldwide. While its effects are not usually as severe as cataracts, glaucoma, or macular degeneration, it can make everyday activities such as reading, using your mobile phone, working on a computer, or completing close-up tasks much more difficult.

If you’ve started noticing these changes, a comprehensive eye assessment can help identify the cause of your symptoms and determine which treatment options may be suitable for your eyes. At Envision Eye Centre in Sydney, our experienced team can discuss your vision, lifestyle, and goals to help you make an informed decision about your care.

Presbyopia is caused by the natural lens inside the eye becoming less flexible over time. As the lens stiffens, it becomes harder to focus on objects up close. There are a number of short- and long-term treatment options available. The most appropriate option will depend on your eye health, vision needs, lifestyle preferences, and personal circumstances.

1. Over the counter reading glasses

The simplest and most common solution for Presbyopia is reading glasses. Often these can be bought over the counter at a chemist or even service station. These generally have magnifications from +1.00 up to around +3.00. These can help overcome the early stages of Presbyopia and will usually worn only when needing to perform activities that need better near vision.

Pros of over-the-counter reading glasses

• Cost – Over the counter glasses can be bought from almost anywhere and are very affordable as a quick fix to see things up close.
• Easily replaced – if you lose or break over the counter glasses you can get a new pair without too much time, trouble or expense. In fact, you could have multiple in different locations for convenience.

Cons of over-the-counter reading glasses

• Suitability of glasses unproven – if you need a specific magnification or different magnification for each eye or have astigmatism, then over the counter reading glasses generally won’t work so well.
• Absence of an eye exam – Presbyopia is a deterioration of vision quality. It is a very good idea to get a prescription to measure your vision deterioration over time. It also allows for other age-related eye conditions to be monitored.

2. Prescription reading glasses

Prescription reading glasses may be required if you’re not able to get the right vision quality from what’s available in over-the-counter glasses. These are prescribed by your eye doctor.

Pros of prescription reading glasses

• Customised lenses – Apart from being prescribed to the precise magnification for each of your eyes, the lenses can be designed to cater for near and far vision allowing you to wear the glasses all time if you wish.
• Customised frames – choosing from a range of frame designs and colours vs the standard options most often available with over-the-counter varieties.

Cons of prescription reading glasses

• Cost – Prescription glasses will cost a bit more than over the counter glasses and if style is important the costs could increase. Given Presbyopia will get worse, you may need to replace your glass lenses every few years.
• Wearing glasses – While this is not unique to just prescription glasses, many people want to be free of glasses as it impacts them in performing certain sports and activities, or simply how they look.

3. Contact lenses

To avoid the need for glasses, contact lenses have provided a popular alternative and specific presbyopia contact lenses can be prescribed to overcome the deterioration in near vision as you age.

Pros of contact lenses

• No visible glasses – If you don’t like wearing glasses or they get in the way during certain sports then have contact lenses as an alternative.

Cons of contact lenses

• Maintaining supply – carrying contact lenses and keeping a stock of contact lenses and solution on hand, particularly when travelling can be a hassle.
• Wearing contact lenses – putting in contact lenses (and taking them out) is a bit of an adjustment for many. And, the act of putting contact lenses in itself requires a degree of near vision!

4. Monovision LASIK

This surgical procedure is a form of laser eye surgery that makes a refractive correction to the cornea of the dominant eye to allow for distance vision and an adjustment to the other eye to assist near vision. The brain then adjusts its reliance on each eye based on the type of vision required.

Pros of Monovision LASIK

• No glasses or contacts – The intention of Monovision LASIK is to remove the need to wear glasses although in some circumstances glasses may still be needed for some people to get greater clarity in certain situations.
• Less invasive – LASIK involves laser surgery on the cornea surface on the outer of the eye. This is a quick painless procedure with a quicker recovery than more invasive procedures.

Cons of Monovision LASIK

• Adaptation – many people adapt well to monovision, but others do not. A trial is performed using contact lenses prior to surgery to see how you adapt.
• Compromise – Overall, monovison is a compromise on both distance and near vision and a certain amount of depth perception is lost. So, jobs or sports where depth perception is vital may rule out monovision as a treatment for some people.

5. Refractive Lens Exchange

Given the cause of presbyopia is to do with the natural lens of the eye, a Refractive Lens Exchange (RLE) replaces this lens with an artificial lens. This is the most direct treatment to overcome the loss of near vision. When combined with a tri-focal replacement lens you may dispense the need for glasses and as an added bonus, avoid cataract surgery later in life.

Pros of Refractive Lens Exchange

• Visual outcomes – 90% of patients obtain 20:20 vision.¹
• Safe and common procedure – a Refractive Lens Exchangeis identical to cataract surgery, the most common of all eye procedures.
• No cataracts in later life – As a Refractive Lens Exchange replaces the lens of the eye, this removes the need for almost inevitable cataract surgery later in life

1. Based on outcomes at Envison Eye Centre for cataract surgery

Cons of Refractive Lens Exchange

• Invasive procedure – despite being a very common procedure, an RLE is the most invasive of presbyopia treatments requiring a slightly longer recovery.
• Cost – A Refractive Lens Exchange is not covered by Medicare in Australia (unless you have also been diagnosed with cataracts).

A summary of your options

Ready to discuss your presbyopia treatment options?

If you’re finding it harder to read, use your phone, or focus on close-up tasks, you don’t have to simply accept it as part of ageing. A comprehensive eye assessment can help determine the cause of your symptoms and whether treatments such as reading glasses, contact lenses, Monovision LASIK, or Refractive Lens Exchange may be suitable for you.

Book a consultation with Envision Eye Centre in Sydney to discuss your options with an experienced ophthalmologist.