Presbyopia can concern everybody aged 40 or more. It is caused by an increasing hardening of the crystalline lens that results in a decrease in accommodation power (capacity to focus at near distances). It evolves in a predictable way and generally no longer progresses after 70. People with normal sight require reading glasses after about 40 or 45 years of age. Farsighted persons then require both reading glasses and glasses to see distant objects clearly, whereas nearsighted persons may simply take off their glasses to read.

Presbyopia can be corrected in principle, for instance with multifocal implants or the procedure called Monovision. In Monovision, one eye (usually the dominant one) is corrected for distant vision and the other (e.g. non-dominant) for near vision. In order to test how well the patient tolerates this type of vision, a temporary set of contact lenses is used to simulate vision as it would be after an operation.

Presbyopia is caused by the loss of elasticity of the crystalline lens: in all people over 45, the lens is no longer able to adjust to different distances.

As a rule presbyopia is compensated by wearing reading glasses. There is also the possibility to use bifocal or multifocal glasses, with which one sees distant objects clearly when looking straight ahead, and close-up objects clearly when looking down (newspaper). But glasses present the disadvantages of any rigid system, they may restrict the mobility and the field of vision of a person.

There is also the possibility to correct presbyopia using refractive surgery (laser, implant).

Correction by laser: monovision in case of presbyopia

In about 60% of all cases the eyes can be modified surgically so that objects at a distance are seen clearly by the dominant eye and close-up objects clearly by the other eye (so called monovision). The brain automatically adapts to the object that the patient fixes at the moment, so that it appears sharp.
The German poet Goethe was born with one myopic and one hyperopic eye, and therefore could see well near and far throughout his life, without glasses. Monovision is therefore also called "Goethe-Blick" (Goethe look) in German.

However, total independence from reading glasses is not achieved in all cases. Under certain circumstances, it is necessary to fall back on reading glasses, for instance for small print or in twilight conditions.

If you decide to have your presbyopia corrected by a surgical operation, we must first check if you will be able to cope with monovision à la Goethe. This can be ascertained by using special contact lenses that you will be asked to wear over a period of several days in your usual surroundings. Only in this way is it possible to determine whether your visual requirements can be satisfied without glasses.

For this evaluation, our specialists and an extensive range of optimally tolerated trial lenses are at your disposal, and thus even seeing in old age can become an exciting event.

Implants: natural visual comfort with multifocal implants

In these procedures, the natural (crystalline) lens is replaced by an artificial lens. Up to now it was possible to achieve clear vision for one range of distances only. In most cases, the power of the lens was chosen so that the patient saw well at a distance but needed glasses to see close-up objects clearly.

Multifocal lenses have several focal points, hence the name multifocal. There are two main focal points, one for distant vision and one for near vision.

A preliminary examination will allow us to ascertain whether your eyes could benefit from a multifocal artificial lens.