Presbyopia treatment in London

What is presbyopia?

Presbyopia is the gradual, age-related loss of the eye’s ability to focus up close. The natural lens becomes less flexible, so it can no longer change focus as easily between distant objects and nearby print. It commonly becomes noticeable in the forties.

You may hold your phone farther away, need brighter light or find small print tiring. It can affect people who have never worn glasses, as well as those who are short- or long-sighted. Presbyopia can develop while the lens is still clear; cataract is clouding of that lens.

Reading glasses, varifocals and suitable contact lenses can help. Surgery is an elective alternative for selected patients, following an assessment of eye health and visual priorities.

What are the treatment options for presbyopia?

If your natural lens is cloudy, cataract surgery may address both cataract and presbyopia. If cataract is not the main reason for treatment, explore refractive lens exchange, also called lens replacement surgery. If there are no significant lens changes, PRESBYOND laser blended vision may be another option after specialist assessment.

PRESBYOND laser blended vision

If your natural lenses remain clear, with no significant cataract or other lens changes affecting vision, PRESBYOND may be considered as an alternative to lens replacement. It is a LASIK-based laser treatment that reshapes the cornea, the clear front surface of the eye, while leaving the natural lens in place.

The treatment increases the range of focus and usually plans one eye more for distance and the other more for near vision. The aim is for the two eyes to work together across everyday distances, reducing reliance on reading glasses.

A clear lens alone does not establish suitability. Assessment also considers your prescription, corneal shape and thickness, eye-surface health and how comfortably you tolerate the planned balance between the eyes.

Presbyopia correction with trifocal lens implants

During cataract surgery or refractive lens exchange, the natural lens is replaced with an artificial intraocular lens (IOL). A trifocal implant directs light into three main focal ranges: near for reading, intermediate for screens and distance for activities such as looking across a room.

These three “sweet spots” can substantially reduce dependence on spectacles. Useful vision may extend between them, but clarity varies with distance, lighting, the lens selected and your eyes. With Clareon PanOptix, the intended near and intermediate distances are approximately 40 cm and 60 cm.

Balance greater freedom with optical trade-offs.

Reading glasses may still help for small print, dim lighting or tasks requiring extra clarity. Halos, glare, starbursts and reduced contrast can occur, particularly at night. Symptoms can persist, and some people find them troublesome.

Corneal or retinal disease, dry eye, previous laser vision correction and important night-driving needs can affect suitability. A monofocal or EDOF lens may provide a better balance for some eyes. EDOF lenses mainly support distance and intermediate vision; reading glasses should be expected and computer glasses may also be needed.

Lens replacement also carries surgical risks. Discuss the benefits, alternatives and individual risks before deciding. Compare all lens options and read about visual effects and adaptation.

Presbyopia treatment: your questions

Your vision correction consultation in London

George Voyatzis FRCOphth is a Consultant Ophthalmic Surgeon at Moorfields Eye Hospital and Moorfields Private. Consultations take place at Moorfields Private, New Cavendish Street in Marylebone, and the Moorfields Private Outpatient Centre on Bath Street in the City Road area.

Your assessment, measurements and visual priorities guide the treatment discussion. View the London consultation locations and meet the practice team. Please confirm your appointment location when booking.

Realistic expectations

Most people are very happy with their vision following surgery. Although every effort is made to achieve the best possible visual outcome, I cannot guarantee that you will be satisfied with your vision following surgery.