Presbyopia, or near vision impairment, is a condition that develops after the age of 40. The term “presbyopia” comes from Greek and means “aging eye.” As we age, the eye’s lens gradually loses its ability to accommodate, and most people eventually need glasses for reading or close-up tasks. This is not a disease but a normal part of aging, similar to graying hair.

Since it is age-related, presbyopia affects everyone. However, people with myopia can see close objects without glasses. In some cases, people who develop cataracts may notice an improvement in their near vision.

People with no vision problems (who have “zero” prescription) gradually experience difficulty reading small text after the age of 40, leading to the need for reading glasses. However, since aging affects everyone differently, the onset and severity of presbyopia vary from person to person. Hyperopic individuals tend to need reading glasses at an earlier age, while myopic individuals already wear glasses for distance vision and often remove them to read as they reach presbyopic age. However, this does not mean they do not have presbyopia.

Some people are born with naturally different prescriptions in each eye—one eye is “zero,” while the other has some degree of myopia. This is called congenital monovision, where one eye sees better at a distance while the other sees better up close. Because they have lived with this condition since birth, they can see both near and far without glasses and experience no discomfort.

Another age-related condition is cataracts. Certain types of cataracts, particularly nuclear cataracts, can cause myopia, reducing the need for reading glasses. However, in such cases, distance vision is compromised.

The simplest solution is reading glasses. People who already wear glasses for distance vision may use two separate pairs of glasses or multifocal lenses that correct both near and far vision. Another option is specialized presbyopia contact lenses. However, as people age, contact lenses become harder to use due to reduced tear production, and high-prescription reading lenses may interfere with distance vision. For those who do not want glasses or contact lenses, surgery with trifocal or EDOF (extended depth-of-focus) intraocular lenses—commonly known as “smart lenses”—is an option.

In recent years, many vision problems have been treated with laser surgery. Various surgical procedures are also available for presbyopia, but they are not suitable for everyone. Your doctor will determine whether you are a candidate.

• Monovision Surgery: People with one naturally myopic eye can manage without reading glasses. By performing LASIK surgery to induce mild myopia in one eye, the need for reading glasses can be minimized. This is a safe and well-established method.
• Trifocal, Multifocal, or EDOF Intraocular Lenses: These surgeries are especially beneficial for individuals with high hyperopia. Trifocal, multifocal, or EDOF (smart) lenses provide both near and distance vision.

Some other methods exist but are not recommended by our hospital:

• CK (Conductive Keratoplasty): Uses radiofrequency waves to modify the cornea for near vision. Currently, this method is not advised.
• PresbyLASIK: A LASIK-based procedure that reshapes the cornea for near vision. Since it is irreversible, it is not suitable for everyone.
• Intracor: Uses a femtosecond laser (Technolas Femtech) to reshape layers within the cornea. It has limited applications and is not a preferred method.
• PresbyLens: A laser-created opening in the cornea where a thin ring is placed. This technique is still in clinical trials and has not yet been approved.
• KAMRA Inlay: A thin inlay is placed within the cornea using a femtosecond laser. It is applied to patients aged 45–65 and can reduce the need for reading glasses. However, it is not suitable for professionals who rely on close-up vision and is not recommended at our hospital.

You may find a lot of information in newspapers, on television, or online. However, none of these sources can replace a consultation with an eye specialist experienced in these procedures.