As we get older, it is normal for our eyes to change. One common change is called presbyopia – it makes it harder to see things up close, such as when reading.
Even though people often start using reading glasses, presbyopia is not a disease or vision defect. It is simply a natural part of aging. Over time, the lens inside the eye becomes less flexible, so it can no longer easily adjust focus between near and far objects.
Everyone does. It does not matter if you have had perfect vision your entire life or if you already wear glasses or contact lenses. If your eye still has its natural lens, it will eventually become less flexible.
Most people begin noticing changes around age 40 to 45 (and even earlier when you are farsighted). By age 65, the lens has usually become fully stiff.
Using contact lenses, we can exploit the fact that if you have two eyes, you have two optical systems to work with in these eyes; one eye receives a contact lens that is focused for distance; the other is focused for near.
A single lens corrects near and far. One optical zone focuses a sharp image from near objects on the retina; another optical zone focuses a sharp image of objects that are far away on the retina. This comes with a cost: reduced contrast sensitivity.
If you can tolerate monovision with contact lenses (one eye “tuned” to near, the other to far), then you can make these adjustments in the cornea with an excimer laser, meaning that contact lenses are no longer necessary.
Whatever the contact lenses can do, the excimer laser can do too (and with micron-level precision too) – and this also applies to multifocality. If a patient tolerates multifocal contact lenses, then they can tolerate multifocal optics created with the laser.
Rather than wait for a cataract to develop (as a natural consequence of aging) before removing the lens and replacing it with an artificial intraocular lens, it’s possible to replace both lenses early and simultaneously correct the eye for both near and distance vision.
These are small rings that are introduced into the cornea with the help of a femtosecond laser – it acts by helping exclude light that comes in from far away, and significantly improves near vision in the eye it’s implanted in (at the cost of reduced contrast sensitivity).
The best method for your eyes depends on your individual measurements, which we carefully check during your pre-surgery exam. After that, we’ll go over the results together and explain which option is right for you.
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