“After the correction of a negative dioptric value, I now seem to have age-related farsightedness.” — What is this really about?

This problem affects people over the age of 40-45 and results from presbyopia. While patients undergoing the laser vision correction procedure due to hyperopia (plus dioptric values) already use additional reading glasses, those with myopia (minus values) usually do not have them yet. Why do shortsighted people have problems with reading following the laser vision correction surgery?

What is presbyopia?

Presbyopia is a progressive physiological process that affects everyone over the age of 40-45. It manifests itself through difficulty seeing clearly at a short distance. What is re-sponsible for this is the natural intraocular lens, which gradually loses its elasticity over time. It leads to the weakening of the accommodation ability, i.e. the ability to focus vision on close objects.

Myopia and the correction of presbyopia

Hyperopic patients (wearing glasses or contact lenses with plus dioptric values) or those wi-thout any refractive error notice the symptoms related to the development of presbyopia much earlier than those with myopia. Why? The reason behind this is that the minus refraction error to some extent compensates for the close vision defect.

A short-sighted person with presbyopia who uses glasses with the value of more than -2 diop-tres may realise with age that they see better when they read without the glasses.

Why may we need reading glasses after laser vision correction?

First of all, the laser vision correction surgery does not contribute to the development of hyperopia and the need for reading glasses. After the entire defect is corrected, the patient can see as clearly as with the best-fitted glasses. The difference is that the correction ap-plied to the eye is permanent, so it cannot be removed like glasses or lenses at any time for close-range reading. In consequence, the patient needs to use reading glasses with a plus value.

Another way to correct myopia and presbyopia is to achieve the sa-called monovision. It gives the non-dominant eye better vision at close range. They are corrected to such a de-gree that the remaining vision defect is between -0.75 and -1.5 dioptres. At the same time, the dominant eye is corrected for distance vision, which means that the refractive error in this eye is completely corrected. As a result, the patient will have clear binocular vision at all distances, without using glasses.

However, it needs to be born in mind that presbyopia is a progressive physiological process, which means that the effect of the correction procedure will only be temporary. How long it is going to last depends on the patient’s individual features and the pace at which their body ages.

If the patient is uncertain as to how they are going to see following the laser vision cor-rection surgery, a visual simulation with the use of contact lenses can be conducted du-ring the preliminary qualifying examination to predict the surgery outcome. The patient will wear contact lenses of the values by which the correction will be performed during the pro-cedure. In this way, the patient will be able to check whether the anticipated results will be satisfactory for them or not.

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