What Is Presbyopia?
Presbyopia is a term used to describe a type of farsightedness (hyperopia) that develops with age. Individuals with presbyopia find it difficult to see objects close to them clearly, due to tissues within the eye becoming stiffer and less flexible.
Inside the eye is a clear lens which changes shape to focus light onto the retina at the back of the eye to enable you to see. This lens is soft and elastic in young age, allowing you to focus on objects at both near and far distances. In older age however, the lens gradually becomes harder meaning it cannot change shape easily. This ineffective lens causes light to be focused behind the retina, making your near vision blurry. As a consequence it becomes more difficult to carry out close-up tasks such as reading and writing.
Presbyopia generally starts to appear around the age of 40 years old, with an estimated 1.7 billion people around the world suffering from the condition. Since it occurs as part of the natural aging process, its development cannot be prevented or reversed.
There are a number of symptoms that individuals with presbyopia typically experience, the most common being:
- Difficulty reading small print, particularly in low light conditions
- Eyestrain or headaches when carrying out close-up tasks
- Blurred vision at near distances
- Holding reading materials at arm’s length to see them clearly
If you notice any of these symptoms, it is important that you make an appointment to visit an eye specialist as soon as possible. They will be able to conduct a full examination of your eyes to determine whether you have presbyopia.
How Is Presbyopia Treated?
Treatment for presbyopia can be classified into two types: non-surgical treatments and surgical treatments. Non-surgical treatments such as glasses are the most common correction for presbyopia, but surgical options are available as an alternative if you do not want to wear corrective lenses.
- Prescription glasses: these will typically be bifocal lenses, which enable you to see clearly at both near and far distances. Progressive addition lenses may also be prescribed. Like bifocal lenses, they allow you to focus at varying distances but provide a smoother transition between near and far distances. Alternatively, you may be given reading glasses that just help you to see at near distance. Unlike bifocal and progressive addition lenses which are worn all the time, reading glasses only need to be worn for close-up tasks.
- Contact lenses: these are often multifocal contact lenses, which provide you with sharp vision at near, far and intermediate distances. Another type of contact lens is monovision, in which one eye wears a lens for focusing at near distance, while the other eye wears a lens for focusing at far distance. Monovision works by training the brain to favour one eye for near vision and one eye for distance vision, therefore allowing you to see clearly at varying focal points.
Surgical options are available for anyone that does not want to depend on contact lenses or glasses for everyday activities. These treatments include:
- Corneal Inlay: also known as an intracorneal implant, this is inserted into the centre of the cornea in the non-dominant eye. Smaller than regular contact lenses, these disc-shaped devices are made from a synthetic material and work by focusing light onto the retina to allow you to see clearly at both near and far distances.
- Conductive Keratoplasty (CK): this minimally invasive procedure uses a handheld device that transmits radio waves onto specific points on your eye’s cornea to change its shape, improving your near distance vision. CK is typically only performed on one eye in order to maintain far distance vision in the other eye.
- Monovision LASIK: a small flap is made in the cornea of the eye using a handheld instrument called a microkeratome. This flap is then peeled back to reveal the corneal tissue below, in which a laser is used to change the shape of the cornea. This procedure is only performed on the non-dominant eye to make it slightly near-sighted in order to improve close-up vision, while the dominant eye is left untreated. This allows one eye to see clearly at near distance, while the other eye can see well at far distance.
- Multifocal LASIK: also known as presbyLASIK surgery, this procedure is similar to that of multifocal LASIK surgery in which a corneal flap is created and a laser is used to reshape the cornea. While the cornea is reshaped to improve just near distance vision during monovision LASIK surgery, during multifocal LASIK surgery the cornea is reshaped to improve vision at varying distances. A laser is used to create different zones for near, far and intermediate distance vision on the cornea. The brain then decides which zone it uses to see most clearly, depending on whether you are looking at objects close-up or far away.
- Refractive Lens Exchange (RLE): this is an invasive procedure whereby the eye’s natural lens is removed and replaced with an artificial lens known as an intraocular lens (IOL). This lens allows you to focus at varying distances, by correcting your near distance vision and enhancing your far distance vision.
Your eye specialist will be able to advise you on which type of surgery will be most appropriate for you to correct your presbyopia during your consultation.
Presbyopia Treatment Cost
The cost comparison table below provides you with an estimate of how much you should expect to pay for the different types of treatment for presbyopia. Depending on the type of treatment you have, the price can vary from just £20 up to £2,795.
|Type Of Treatment||Price Per Eye|
|Prescription Glasses||From £69|
|Contact Lenses||From £20|
|Corneal Inlay||From £2500|
|Conductive Keratoplasty||From £1000|
|Monovision LASIK||From £1795|
|Multifocal LASIK||From £2095|
|Refractive Lens Exchange||From £2795|
As you can see, surgical treatments are a lot more expensive than non-surgical treatment options. This is because surgery is a one-off procedure that provides a long-term solution for presbyopia correction, whereas prescription glasses and contact lenses will need to be re-purchased regularly. Surgery also requires the use of expensive specialist equipment and a fully qualified ophthalmic surgeon to carry out the procedure, which drives up the cost.
Make sure you know what is included in the price you are quoted, as some clinics do charge extra for essential services such as aftercare and follow-up appointments. This could mean that the overall cost of your treatment is more than you initially anticipated.
Is Finance Available?
There are a lot of eye surgery clinics around the UK that have finance options available for surgical presbyopia treatments. They do this to make the payments more manageable for those that cannot afford a lump sum upfront.
These finance agreements typically require you need to pay an upfront deposit, followed by monthly instalments for an agreed period of time. There will be an APR rate placed on this, which will generally increase the longer the repayment period is.
There are a number of different factors you should consider before entering into a finance agreement:
- Make sure that you can make the monthly repayments by choosing an instalment plan that is within your budget and schedule. If you miss a repayment, it could impact your credit score making it harder to enter into financial deals in the future.
- Make sure you are fully aware of the APR rate and the affect that this can have on the total amount you pay back to the clinic. The higher the APR rate, the more money you will owe.
- Determine exactly what is included in the agreement, as there can sometimes be hidden costs. Make sure you fully understand its terms and conditions.
To find out more about getting presbyopia treatment on finance, visit our eye surgery cost guide.
Can I Get Treatment For Presbyopia On The NHS?
Presbyopia treatment is not available on the NHS. This is because there are successful non-surgical solutions available for presbyopia correction, such as wearing contact lenses or glasses. Eye surgery is only available on the NHS for conditions that can lead to a complete loss of vision without treatment, such as cataracts.