Presbyopia and Refractive Surgery: Restoring Near Vision
- The Straits Eye Centre
- Sep 20
- 4 min read
Introduction: The Inevitable Near-Vision Change
From your 40s onwards, you may notice yourself holding books, phones, or menus further away to see clearly. This is presbyopia, an age-related condition where the natural lens of the eye loses flexibility, making it harder to focus on near objects.
While common and natural, presbyopia affects work, reading, and daily convenience. Solutions range from glasses to advanced refractive surgeries that can reduce dependence on corrective eyewear.
What Is Presbyopia?
Presbyopia is not caused by the shape of the cornea like myopia or hyperopia, but by the natural aging of the eye’s lens. The lens stiffens and loses its ability to change shape (accommodate), limiting near focus.
Causes and Risk Factors
Natural aging process, usually noticeable after age 40.
Family history of early presbyopia.
Eye conditions such as diabetes or cardiovascular disease may accelerate onset.
Certain medications affecting focusing ability.
Symptoms of Presbyopia
Difficulty reading small print.
Holding objects further away to see clearly.
Eye strain or headaches after near tasks.
Needing brighter light for reading.
Complications if Untreated
Daily inconvenience and frustration.
Reduced work efficiency, especially with reading-heavy tasks.
Possible eye strain leading to headaches.
Diagnosis
Near vision testing using reading charts.
Refraction tests to determine prescription.
Comprehensive eye exam to rule out other eye conditions like cataracts or glaucoma.
Correction Options for Presbyopia
Glasses
Reading glasses or progressive lenses.
Convenient and safe option for many patients.
Contact Lenses
Multifocal lenses for both near and distance correction.
Monovision lenses (one eye corrected for near, the other for distance).
Refractive Surgery Options for Presbyopia
For suitable adults seeking reduced dependence on glasses:
PRK: Surface laser reshaping to modify corneal focus.
SMILE: Laser procedure, though less common for presbyopia-specific correction.
ICL: Implantable lenses for patients with high refractive errors.
Lens replacement surgery (PresbyLASIK or multifocal IOLs): Removes the aging lens and replaces it with a multifocal implant, often combined with cataract surgery.
Lifestyle and Prevention
Use proper lighting when reading.
Take regular breaks during near work.
Schedule annual eye checks after 40.
Frequently Asked Questions
1. Is presbyopia the same as hyperopia (long-sightedness)?
No. Hyperopia is caused by the eyeball shape and can occur at any age. Presbyopia is age-related lens stiffening.
2. At what age does presbyopia usually start?
Most people notice symptoms between ages 40–45, with progression until the mid-60s.
3. Can refractive surgery permanently fix presbyopia?
Surgery can reduce dependence on glasses, but some patients may still need reading aids in certain situations.
4. Which surgery is best for presbyopia?
Options include PRK, ICL, or lens replacement surgery. Suitability depends on your prescription, eye health, and lifestyle.
5. Is lens replacement surgery the same as cataract surgery?
Yes, both involve replacing the natural lens, but for presbyopia, this is done electively before cataracts develop.
6. Can presbyopia worsen over time?
Yes, it typically progresses until about age 65, after which it stabilises.
7. Are multifocal contact lenses effective for presbyopia?
Yes, they are a non-surgical option and allow both near and distance vision correction.
8. Should everyone with presbyopia get surgery?
Not necessarily. Many people manage well with glasses or contact lenses. Surgery is best for those seeking long-term reduction in dependence on eyewear.
Meet Our Specialists
At The Straits Eye Centre, your vision care is in the hands of a dedicated team of experienced ophthalmologists. Each of our doctors brings unique expertise and a shared commitment to delivering thorough, patient-focused care for all ages. Whether you need advanced cataract surgery, paediatric eye management, or treatment for complex eye conditions, our team works together to provide the same attentive care we would want for our own families.
Dr Jayant V Iyer
Senior Consultant & Medical Director
Special interest: Cataract, Glaucoma, General Ophthalmology With specialist training in Singapore and the UK, Dr Jayant V Iyer has served as Head of Department at Sengkang General Hospital and Senior Consultant at Tan Tock Seng Hospital. He is committed to delivering safe, precise surgical care with clear communication at every stage.
Dr Jason Lee
Senior Consultant & Medical Director
Special interest: Oculoplastics, General Ophthalmology, Myopia, Cataract, Diabetic Retinopathy Dr Jason Lee has extensive training in eyelid, orbital, and tear system surgery, with fellowships completed in Taiwan and China. Previously a Senior Consultant at Khoo Teck Puat Hospital, he co-founded The Vision Mission, a non-profit bringing sustainable eye care to communities in Asia.
Cost, Medisave, and Insurance
Many procedures at The Straits Eye Centre are eligible for Medisave claims under MOH guidelines, and certain insurance plans may cover part or all of your treatment costs. Our patient care team will guide you through eligibility, claim limits, and paperwork, so you can focus on your recovery. For more details, refer to our Medisave & Insurance Guide.
Secure Your Appointment at The Straits Eye Centre
at Parkway East Hospital
Your vision health deserves timely and professional attention. Book your appointment now at our Parkway East Hospital clinic and take the first step towards clearer, healthier sight.
