# Presbyopia

Source page: https://www.kudretgozistanbul.com/en/treatments/presbyopia

**Author:** Kudret Eye İstanbul | **Medical Approval:** Op. Dr. Mehmet Ali Özdil | **Date:** 2026-09-12

> **Summary:** Presbyopia is the age-related loss of clear near vision that follows the eye's lens becoming harder and less flexible, and it usually begins after the age of 40. It is managed with reading glasses or contact lenses, or corrected with intraocular lens treatment.

## Quick Facts
- **Typical Onset:** Around the age of 40
- **Operation Duration (lens treatment):** 15-20 minutes per eye
- **Recovery Time:** Back to daily life in 3-4 days, full recovery in 3-4 weeks
- **Anaesthesia Type:** Topical eye drops

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## What Is Presbyopia?
An eye condition in which the lens loses its flexibility with age, making it hard to focus on close objects. It appears in both eyes and progresses over time.

## Causes
- Ageing is the most common cause: lens proteins harden and the lens can no longer take the shape needed for near focus.
- Diabetes, hypertension, some rheumatic diseases and cataracts can accelerate its onset.

## Symptoms
- Difficulty reading, texting, sewing or other close work.
- Eye fatigue, itching, stinging and pain after close work.
- Eye muscle tension and headache from forcing near vision.
- Burning and watery eyes when reading or using a computer.
- Holding text at arm's length to read.
- Difficulty seeing close objects without good lighting.

## Diagnosis
A comprehensive eye examination, which may include:
- Visual acuity test at far and near distances.
- Refractive error test to detect myopia, hyperopia or astigmatism.
- Near vision test.
- Special tests of how the eye focuses and adapts, and a slit lamp check for cataract, glaucoma and macular degeneration.

## Treatment Options
- **Reading glasses:** The most common and simplest option.
- **Multifocal glasses:** Correct near and distance vision.
- **Bifocal or multifocal contact lenses:** Focus at different distances.
- **Intraocular lenses:** Monofocal lenses focus at one distance; bifocal and trifocal lenses focus at several. After the age of forty a multifocal or trifocal lens is usually recommended to restore near vision.
- **Laser (e.g. Presbyond):** Available, but because the prescription is quite likely to return within a few years, a lens is generally preferred at this age.

The choice depends on the patient's needs, lifestyle and examination.

### Intraocular Lens Types

| Lens type | How it works | Who it suits | Advantages | Considerations |
| :--- | :--- | :--- | :--- | :--- |
| **Monofocal** | Single focus, usually far | Cataract patients who accept reading glasses | Sharpest distance vision, least night glare, most affordable | Reading glasses still needed, limited intermediate vision |
| **Monofocal Toric** | Monofocal that also corrects astigmatism | Cataract patients with significant astigmatism | Corrects astigmatism in one go | Reading glasses still needed, precise positioning required |
| **Trifocal (Multifocal)** | Far, intermediate and near focus | Those wanting freedom from glasses who do little night driving | Glasses-free at every distance | Halos at night in the first 6 months, adaptation time |
| **Trifocal (Multifocal) Toric** | Trifocal that also corrects astigmatism | People with astigmatism who want to live without glasses | Complete solution in one operation | Halos at night in the first 6 months, extra charge for astigmatism correction |
| **EDOF** | Extended depth of focus from far to intermediate; near focus around 40 cm instead of 30 cm (about 10 cm further than a trifocal) | Those with previous laser surgery, wanting very sharp distance vision, or driving long at night | Very sharp far and intermediate, fewer halos than trifocal, phone and computer without glasses | Reading glasses may be needed for very small print |

## Price
The price varies with the underlying cause and the operation performed; the plan is set individually after a detailed examination.

## Understanding Your Prescription
A prescription is usually valid for two years.
- **Sphere (SPH):** Minus (−) means difficulty seeing far, plus (+) difficulty seeing near.
- **Cylinder (CYL):** Astigmatism correction; blank means none.
- **Axis:** Direction of astigmatism, between 0 and 180 degrees.
- **Addition (ADD):** Extra near power, usually needed after 40, usually the same for both eyes.
- **Prism:** Only for double vision or squint.

## About the Hospital
Over 24 years in eye care, three eye hospitals and a general hospital, specialist surgeons for each treatment, equipment for SMILE PRO, iLASIK and trifocal lenses, and lifetime aftercare including enhancement if ever needed.

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## Frequently Asked Questions (FAQs)

**Q: At what age does presbyopia begin?**
A: Usually around the age of 40, and it may worsen with age.

**Q: How do I recognise presbyopia?**
A: Not seeing close objects clearly, needing to squint while reading, and headaches.

**Q: Can presbyopia be treated?**
A: Yes, with glasses, contact lenses or multifocal lenses.

**Q: What is the most effective treatment?**
A: Glasses are the most common solution. After forty an intraocular lens (multifocal or trifocal) is usually recommended to restore near vision. Laser such as Presbyond exists, but the prescription is quite likely to return within a few years, so a lens is generally preferred. The examination decides.

**Q: Why does presbyopia occur?**
A: The lens loses flexibility and hardens with age, so it cannot focus clearly up close.

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## References
- What Is Presbyopia?, AAO
- Presbyopia, NEI
- Presbyopia Treatment, EyeWiki (AAO)