It is often mistakenly called ‘long sight’ but presbyopia is caused by the eye’s natural lens losing its ability to focus and the focusing muscles becoming weaker. Those who wear glasses or contact lenses already for short or long sight will require additional vision correction as presbyopia develops, usually in the form of bifocal or multifocal (progressive, Varilux, varifocal) glasses.
It is very important to understand that presbyopia affects us all, whether or not you have had laser eye surgery to correct your distance vision. Therefore, once you reach your mid- to late-40s, it is highly likely that you WILL require reading glasses – even former RAF pilots, for example, will need reading glasses from their mid-40s onwards.
A small number of prospective laser eye patients of presbyopic age choose not to have laser eye surgery, believing that they’ll simply end up swapping one pair of glasses for another. This is understandable – however, most prefer to have clear distance vision and accept the need for reading glasses along with all normally-sighted people of their age.
If you are short-sighted, it is possible to correct the dominant eye fully for good distance vision and partially correct the non-dominant eye to leave some residual short-sightedness to help with reading vision. This strategy is known as ‘mono’ or ‘blended’ vision and provides freedom from spectacles most of the time. Many patients have already, very successfully, used the blended vision / monovision strategy with their contact lenses. If not, we would always advise a contact lens trial period intended to simulate the ‘mono’ or ‘blended’ vision effect before their laser surgery.
There is another solution to help with your reading addition – multifocal intraocular lens implants or IOLs. They are given the name ‘multi’-focal as they aid distance, intermediate and close reading vision (to a degree). They are premium correcting lens implants which are not available on the NHS and have become popular in recent years for the treatment of presbyopia. These lenses can usually be well tolerated and can give reasonably good distance and close vision, with a greater depth of focus than monofocal (‘mono’ focal – singular correction for distance only). However, this is sometimes at the expense of image quality. Glare and haloes may be troublesome. We would not recommend multifocal IOLs for professional drivers, those who drive frequently at night or those with very exacting visual requirements.