I have trouble reading but otherwise see pretty well far away.

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Presbyopia (Reading Problems) Nearsightedness

Refers to the natural decrease in the eyes’ ability to see up close as we get older. The first symptoms people with presbyopia typically notice are difficulty reading fine print, particularly in low light conditions, and blurred vision close-up, and momentarily blurred vision when transitioning from a far or near object (and vice versa). Even a patient with perfect vision (Emmetropia) all their life will require glasses to help them read, usually at some point in the early to mid forties.

Presbyopia starts to become noticeable usually at around age 40 and it affects everyone. Nearsighted people (with Myopia) can usually remove their glasses, hold the print up close, and read without glasses or have bifocals put in their distance glasses. Slightly farsighted people (with Hyperopia) will initially just need glasses to read but as they get older, they will need them for near and far. Moderately or severely farsighted people will already be wearing glasses for distance but will now need either bifocals or two separate pairs of glasses. Normal sighted people (called Emmetropia) who have never needed glasses typically will begin to need them in order to read small print. Presbyopia gets worse as we get older and thus patients require changes in reading power every few years. If you are near age 40 or older, your laser eye surgeon should discuss Presbyopia with you and explain your options to minimize this annoying decrease in your near (reading) vision.

Presbyopia Video: Surgical Procedures to reduce the symptoms

*Conductive Keratoplasty or CK and monovision LASIK are the only two procedures approved by the FDA for treating Presbyopia, although this does not mean PRK cannot be utilized. Although neither Conductive Keratoplasty (CK) nor laser vision monovision (LASIK or PRK) “cure” Presbyopia, both procedures can reduce the need for reading glasses for every day activities like reading a menu or looking at a cell phone.

With “monovision” (or “blended vision”) laser eye surgery, one eye is focused better for reading while the other eye is focused primarily for distance. This is a common option for patients over the age of 40 who are considering laser vision surgery to correct their nearsightedness or farsightedness, with or without astigmatism. Monovision is also an option for patients who have always had natural excellent distance vision (Emmetropia) and desire to be able to read without glasses.

The only FDA-approved procedure for the correction of Presbyopia in emmetropic eyes (normal eyes requiring no glasses) is Conductive Keratoplasty (CK) where radio-frequency energy is applied to 8 spots in the cornea to refocus one eye for a reading focus. The CK procedure results in a milder form of monovision than the typical laser procedure and it is often better tolerated by the patient because the CK eye is not usually as blurred for distance as it would be with laser induced monovision. However, not all patients are comfortable with mono or blended vision and it is best to have this demonstrated with either contact lenses or glasses before choosing this option.

Although not FDA-approved, PRK is considered an “off label” use of the FDA-approved lasers. In fact, many refractive eye surgeons have used PRK and LASIK (which has now approved by the FDA) in both nearsighted and farsighted eyes to create monovision, with one eye focused for distance and the other focused for near vision.

Laser eye surgery may not always be the best option so it is important to find an experienced eye surgeon like the ones in the Trusted LASIK Surgeons Directory, most of whom perform a variety of refractive surgery procedures to give patients a more complete range of options. To learn more about these vision correction surgical treatments for Presbyopia, please clink on the links below:

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