Presbyopia
What is presbyopia?
Presbyopia affects virtually everyone over the age of 40–45 years. It is associated with a progressive decline in near vision and is caused by age-related changes in the eye’s crystalline lens, which gradually loses its ability to focus on nearby objects.
Although current technology cannot restore the eye’s natural accommodative function after the crystalline lens has been replaced with an intraocular lens, it offers a range of effective treatment options that can significantly improve near vision and reduce dependence on glasses. The most appropriate approach is tailored to each patient’s visual needs, lifestyle, and expectations.
Causes of Presbyopia
Presbyopia is primarily due to the natural ageing process of the crystalline lens, which gradually becomes stiffer and less elastic with age. At the same time, the ciliary muscle—the mechanism that helps the lens change shape—gradually becomes less effective. Genetic and environmental factors may also play a role, particularly in the onset and severity of symptoms. These include prolonged near work, extended screen use, and inadequate lighting.
Symptoms of Presbyopia
The primary symptom of presbyopia is blurred near vision. Initially, symptoms are often more noticeable in dim lighting or when performing prolonged near tasks, such as reading a map in the car at night. It often causes headache, eye strain, and a feeling of tired or heavy eyes. Many patients also report an improvement in other non-specific ocular symptoms, such as tearing and redness, after appropriate correction of their presbyopia.
Diagnosis of Presbyopia
Presbyopia is diagnosed through a comprehensive ophthalmic examination.
The specialist ophthalmologist evaluates:
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the refractive error (presence of myopia, hyperopia, or astigmatism)
- the lens’s accommodative ability
- the functional impact of presbyopia on daily life
- the presence of other conditions, such as dry eye or early-stage cataracts, which may exacerbate symptoms.
Treatment of Presbyopia
Presbyopia is effectively treated with a range of treatment options, tailored to each patient’s age, visual needs, occupation, and lifestyle.
Presbyopia Glasses
- Single-vision reading glasses
- Bifocal glasses
- Progressive (multifocal) glasses, providing a smooth transition between distance, intermediate, and near vision
Contact Lenses
Refractive Laser Surgery
PRELEX — Refractive Lens Exchange & Premium Intraocular Lenses
PRELEX provides a permanent solution for presbyopia while simultaneously correcting coexisting refractive errors. Because the natural crystalline lens is replaced with an artificial intraocular lens, cataracts cannot develop in the future.
Careful selection of the most appropriate premium intraocular lens is the key factor in achieving the best possible visual outcome.
Since 2021, Athens Vision has been using a pilot galenic formulation in selected patients with presbyopia, particularly following refractive laser surgery for myopia or hyperopia, with encouraging clinical results.
Athens Vision closely monitors developments in this field and will offer these treatments to appropriately selected patients as soon as they receive EMA approval.
Prevention of Presbyopia
- regular eye examinations after the age of 40
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adequate lighting when reading or working
- frequent breaks during prolonged screen use (20-20-20 rule)
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timely correction of refractive errors to reduce eye strain and visual fatigue during near work.
Laser Treatment for Presbyopia
At Athens Vision, we offer a range of laser vision correction procedures tailored to each patient’s individual visual needs and lifestyle.
Modern laser refractive surgery is a well-established, safe, and effective treatment option for appropriately selected patients.
In the third decade of the 21st century, refractive surgery has established itself as a permanent, safe, and cost-effective solution for nearly all refractive errors (myopia, astigmatism, hyperopia, and selected cases of presbyopia).
The millions of patients who have been freed from their glasses through laser surgery are tangible proof of the value of refractive surgery in treating myopia, astigmatism, hyperopia, and selected cases of presbyopia.
Read more here.
Frequently Asked Questions
We can help you decide whether correcting your myopia, astigmatism, hyperopia, or presbyopia is the best option for you.
In general:
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You must be at least 18 years of age (an exception is made for procedures performed to gain admission to a military academy/ security forces/fire department/naval academies, etc. In such cases, the decision to perform the procedure is individualized, and social and professional factors are taken into account in the final decision to perform (or not) of an invasive procedure before reaching the age of legal majority, which requires parental consent)
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to be in good overall health,
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stable vision over the past year
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You must not have any chronic conditions affecting the cornea, the retina, or other eye diseases
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If you are a woman, this treatment is contraindicated during pregnancy and while breastfeeding.
Of course, to determine whether you are a suitable candidate for myopia correction, you will need to undergo a comprehensive preoperative evaluation, which includes a series of tests:
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Full History
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Complete Refractive Examination
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Goldmann Tonometry
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Comprehensive Fundus Examination (Optic Nerve, Macula, Periphery)
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Refraction (Visual Acuity Test)
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Automated Keratometry
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Ammeter
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Examination Under a Slit Lamp
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Measurement of the Mesoptic Diameter of the Pupil
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Eye Movement
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Circular Refraction
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Tear Film Measurement (Schirmer Test)
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Corneal Topography
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Topography of the Anterior and Posterior Corneal Surfaces – Scheimpflug
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Pachymetry
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Measurement of Ocular Inertia & IOP with the Ocular Response Analyzer (Assessment of the mechanical properties of the cornea)
Presbyopia and hyperopia are both refractive errors that cause blurred near vision. However, they have different underlying causes. Presbyopia occurs when the eye’s lens loses its elasticity. Hyperopia occurs when the eyeball is too short or the cornea is too flat.
Yes, and it’s very common. Myopia means that your eyes naturally focus too much, resulting in clear near vision but blurry distance vision. However, if you’re nearsighted and over 40, you’ll still experience symptoms of presbyopia even when wearing your glasses or contact lenses. Your eye doctor can adjust your lens prescription to correct both presbyopia and nearsightedness.
Doctors who specialize in this condition
ANASTASIOS CHARONIS
Gerasimos Kopsinis
Theodoros Filippopoulos
Maria Zozolou
Georgia Kosti