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presbyopia old eyes

When should you have surgery for presbyopia? Age and symptoms

By March 28, 2022No Comments

Presbyopia or old eyes is a universal defect that develops from the age of 40-50 and involves physiological insufficiency of accommodation associated with the aging of the eye’s crystalline lens that does not allow focusing at different distances. However, when should you have surgery for presbyopia?  Just like with wrinkles and other parts of our body, the crystalline lens, provides approximately one-third of the focusing power of the eye, is becoming more rigid, harder, and the ability it had to focus on things is being lost. It is not a condition, but a natural process that cannot be prevented and that will affect all of us at some point. In this article, we will discuss the main symptoms of old eyes, at what age surgery is recommended, the types of surgeries available to correct the defect, our patients’ opinions as well as the results you should expect from the surgery.

What are the symptoms of presbyopia?

To know when surgery for presbyopia is required, first of all it is important to be aware of some of the possible symptoms. The patient starts by needing more light, then closer objects start to look further away, texts move away followed by some symptoms such as pain, stinging, itching, tearing. All this causes the patient to start seeing poorly up close, to stretch out their hand, etc., until he/she needs to make an appointment with the ophthalmologist. These are some of the main symptoms experienced by patients with old eyes:

  • Difficulty focusing on close-up objects  This is the main symptom of presbyopia, which occurs when the lens becomes less flexible, it can no longer change shape to focus on close-up images. There are eye problems that share this symptom, so we recommend making an appointment with an ophthalmologist.
  • Inability to read things up close:  Losing the ability to read at close range is another indicator of old eyes, and is directly related to the previous symptom. Unable to focus properly on letters. It is common for people to start stretching out their arm.
  • Headaches:  Constantly having to strain to focus on close-up objects can cause headaches, which are quite common in people with old eyes.
  • Natural tasks become more difficult:  Due to the ageing of the crystalline lens, you start to have problems carrying out precise and meticulous manual work. For example, embroidery, graphic design, tattoos, among others. In other words, jobs where it is necessary to focus on specific points for prolonged periods of time.
  • Increased discomfort when working at the computer:  Multiple studies have been published on the impact of prolonged exposure to bright screens. In this regard, regular computer workload can lead to dry eyes brought about by blinking less.
  • Blurry vision:  The main feature of this indicator is the loss of visual acuity, causing objects to appear blurry and opaque. It should be noted that this symptom may be a consequence of other eye or body conditions. When detected, it is important to make an appointment with an ophthalmologist to get to the source of the problem.
  • Need for more light:  Because the eye’s natural focus is affected by biological wear and tear, needing better lighting is quite common. So, as we get older, there is a need for well-lit spaces so we can see properly.
  • Decreased visual acuity at night: If someone in their forties starts having problems seeing in the evening and at night, they may have old eyes. This is in direct response to the decrease in natural light, a situation that accentuates the limited functioning of the crystalline lens.


When do the first symptoms of presbyopia develop?

It depends on the person, but presbyopia usually develops after the age of 40-45.. When should I undergo surgery for presbyopia? From this point onwards, you should see an ophthalmologist to assess your specific case. Young or adolescent patients do not have this defect because, as mentioned above, it is due to the ageing of the crystalline lens. However, there is another defect that is similar to presbyopia: eyestrain.

Old eyes in adolescents and young adults: eyestrain

As mentioned above, young people and teenagers do not get old eyes, but there are conditions with symptoms similar to presbyopia, known as asthenopia or eyestrain. Farsightedness is, also sometimes confused with old eyes. People with hyperopia have a refractive defect that prevents the correct focusing of the image on the retina and therefore perceive images, especially close-up images, as blurred.

What causes eyestrain?

Several studies have been carried out by ophthalmological institutions that have concluded that one of the main sources is prolonged exposure to luminous screens. Whether it be TVs, mobiles, tablets, consoles or computers. Prolonged use of luminous screens and doing work that requires focusing on things close up can cause headaches, and dry eyes due to blinking less when performing these tasks, which can be rather annoying.

Differences between eyestrain and old eyes

There are several differences between old eyes or presbyopia and eyestrain, although at Clínica Rahhal we always advise you to see a specialist to check your particular case. Some of these factors are: 

  • Symptoms of old eyes vs. eyestrain: although they are different conditions, the symptoms in both are often the same. However, eyestrain can aggravate the symptoms of old eyes.  Even so, there are differences that mainly focus on the origin, the age at which it develops and the possible treatment.
  • Population affected:eyestrain, or asthenopia, affects most people regardless of age. However, presbyopia affects middle-aged people (between 40-50 years old).
  • Causes:eyestrain is caused by environmental factors and habits, whereas old eyes is the result of a biological process. The most obvious difference between the two is that eyestrain is temporary and can be easily eradicated, whereas presbyopia is permanent and can only be treated through surgery.
  • Common discomforts:in both conditions there are a number of recurring discomforts such as dryness, a gritty or burning feeling, stinging and itching. Headaches are also common, as well as redness and swelling of the eyes and eyelids.

How is presbyopia corrected? Surgery for old eyes

Presbyopia is usually corrected by replacing the crystalline lens with another lens. These lenses, also known as trifocal lenses, allow vision correction at all distances.

“There is a type of presbyopia correction called MONOVISION in which the vision in your dominant eye is corrected for distance vision, while your other eye is intentionally left somewhat nearsighted to allow you to see close objects.

Dr. Alonso. Ophthalmologist.

Presbyopia correction techniques

At Clínica Rahhal, our patients always ask us, apart from when they should undergo surgery for presbyopia, how the different lenses and techniques used to correct presbyopia differ, as well as their characteristics. We will look at the main techniques used, but here is some more information about surgery for presbyopia or old eyes should you want more information on the surgery itself as well as the postoperative period. There are 2 main techniques

Intraocular lenses (pseudophakic lenses)

It is a procedure in which the crystalline lens that has lost its focusing ability is replaced by a trifocal artificial lens.. It is currently the most commonly performed procedure.

Laser surgery to correct presbyopia

The SUPRACOR® laser is the treatment for old eyes (presbyopia) performed by shining an Excimer laser on both eyes to modify the thickness of the cornea and thereby change its grading. With this technique, it is possible to treat distance and near vision in both eyes.

When should you have surgery for presbyopia? Recommended age

In order for the patient to be considered a candidate for the surgery for old eyes, he/she must meet some requirements, the main ones being:

  • Have a good corneal surface.
  • Have suitable parameters for this type of surgery, for which some more specific tests such as topography and aberrometry are required.
  • Have healthy eyes, with the eye examination ruling out retinal pathology, among others.

Can I have surgery if I have had myopia surgery?

Yes, like everything else in medicine, as long as it meets the inclusion criteria for surgery, which are the same as those mentioned above.  

When should I undergo surgery for presbyopia?Is surgery for presbyopia the same as cataract surgery?

The surgery for old eyes involves replacing the natural crystalline lens with another lens, exactly the same as is done when a patient has a cataract. Although they are not caused by the same thing, as presbyopia develops when the lens loses its ability to accommodate and cataracts are caused by progressive opacification of the lens, the technique used to correct both defects is the same. Furthermore,when a patient has surgery for presbyopia, he/she will not develop cataracts in the future. 

How can I prevent presbyopia?

Old eyes is a visual defect that develops biologically and is linked to age, which is why it is not possible to prevent it. The only solution is to treat it when it develops. At Clínica Rahhal, we always recommend regular eye examinations, especially after the age of 40, which is when this defect starts to develop, in order to be able to monitor how it is developing and look into possible treatments.

Is it worthwhile to undergo surgery for old eyes? Opinions presbyopia surgery

To answer this question, we compiled some of the real testimonials from our patients after undergoing surgery for presbyopia.  Here is an article should you want to read more opinions about presbyopia or old eyes surgery from patients who have undergone surgery at Clínica Rahhal de Valencia.

“I have been wearing glasses since I was very young. Today, thanks to the ophthalmologists at Clínica Rahhal, I no longer have to wear them”.

José Miguel Carbonell

“The trifocal lens surgery was a success. The recovery process went very quickly and I couldn’t be happier with the results. I wish I had had the surgery earlier. Many thanks to the whole team.

Pablo Albert

Presbyopia surgery price

The cost of presbyopia surgery with a trifocal lens is approximately €2,300 per eye (these prices are very similar throughout the ophthalmological community). This price includes the costs of visits, check-ups, the preliminary evaluation, materials and the surgery itself.  At Clínica Rahhal, you can finance our treatments, letting you pay for them comfortably and so that price is never a problem when it comes to improving your health and quality of life. Here you can check the presbyopia surgery prices in our clinic in more detail.  [rahhal_presbyopia_calculator]

Make an appointment

If you have detected any of the symptoms we have mentioned in this article or you would like information on when to have presbyopia or old eyes surgery, you can make an appointment at Clínica Oftalmológica Rahhal so that our expert medical team can assess your specific case. You can call us on +34 960462121 or provide us with your details in the form below and we will get in touch with you as soon as possible to give you more information or arrange an appointment with one of our specialists.

    Advice and conclusions

    We may often experience symptoms that may seem like symptoms of old eyes, but which may also be indicators of other visual defects, such as eyestrain, hyperopia, keratitis or dry eye syndrome, among others.  It is therefore of the utmost importance that you see a specialist ophthalmologist to assess your case and check whether your symptoms are caused by presbyopia or could be due to a different condition.  Today, presbyopia correction is an extremely straightforward procedure with a high success rate. Patients agree that their quality of life improves significantly post-procedure.

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