Presbyopia and its Treatment

Presbiyopi ve Tedavisi

Presbyopia is the loss of the lens's ability to change the focus of the eye through adaptation, in which the eye muscles change the shape of the lens. Presbyopia starts in the early years of the forties and everyone is affected.

Same as in hypermetropia the focal point of the light rays from nearby objects remains at the back of the retina and is out of focus. The reason for this in hypermetropia is that the eyeball is shorter than normal. The reason for this in presbyopia is that the old lens becomes harder and the flexibility is reduced. This allows the focal point to come in front of the retina; it makes it more difficult or improbable to bend sharply to the light rays needed to achieve compliance.

When you're tired, it can be hard to read at night or in low light. Presbyopia occurs regardless of how your vision disorder is

The first sign of presbyopia is the need to remove objects while reading. In later times, this blurred vision is further increased and pain in the forehead, temple area. Focusing the eye on objects as close as possible brings about other problems over time. After reading, it may be difficult to temporarily see distant objects clearly, because distant objects also require alignment to focus.

Presbyopia's only solution is mostly optical correction (reading glasses). Persons with corrective lenses for myopia; they need double focus glasses (the upper part is for distant sight and the lower part is for short sight) or they use two separate glasses.

Due to the deterioration of presbyopia, prescriptions written by the end of the 60’s often change. As for these ages, the presbyopia becomes stable. From the age of 60-65, the focus of the eye actually stops because the lens loses its elasticity; at this stage, the relative becomes completely dependent on the glasses. However, those who are myopia take their far away glasses while they are close to the eye, and they can see more easily when doing their close work.

What are the Symptoms of Presbyopia?

Presbyopia patients have difficulty in seeing objects when they bring them closer than 50 cm. Therefore, they can see the objects by removing. In later times, if the short sight is still distorted, it may be accompanied by headache in the forehead and temple area.

How to Treat Presbyopia?

There are many treatment methods on this subject in the world. These treatment methods have advantages and disadvantages compared to theirs. Intraocular multifocal lens operations and presbyond laser treatments which are accepted as the most reliable method for the treatment of presbyopia are successfully applied in our hospital.

1. Treatment with glasses

  • Bifocal Glasses
  • Multifocal (progressive) glasses

2. Treatment of Contact Lens

Multifocal contact lenses: Patients who are eligible for lenses receive successful results when using these lenses. However, there may be problems in use due to decrease in tear quality in patients over age of 40.

Mono-vision with contact lenses (leaving one eye as myopia): Whether you are eligible for this treatment or not, your initial examination may be obvious.

3. Surgical Treatment

There are 3 places that may be applied by surgical intervention.

a. Cornea

  • Presbyond Treatment
  • Monovision Excimer Laser Treatment

b. Lens

  • Multifocal Lenses / Trifocal Lenses
  • Adaptive Lenses

An option for patients with presbyopia (near vision difficulty)

In the aging eye, the problem of adaptation in close eyes begins at about 45 years of age. By using the PRESBYOND Laser Compliance Area method, it is possible to solve this adaptation problem with refractive surgical approach; a good vision can be achieved at far distant, middle and close distances. It provides the possibility of visual acuity by using corneal refractive surgery which provides highly sensitive intervention and by providing depth of visual field. Spheric aberration which is found naturally in the eye and the scope of the individual laser intervention is expanded in many respects to include more people than conventional monovision laser method.

Discover the Benefits of Personalized Treatment of the PRESBYOND Laser Compliance Area


Before the refractive surgery with the PRESBYOND Laser Compliance Area, the interference is performed by taking into consideration the " wavefront data" in the eye of the person.

All Distances

With the PRESBYOND Laser Compatibility Area, a clear vision is aimed at near, middle and far distances without any concessions.


Many patients may start reading on the same day.

A wide range of patients may benefit from the PRESBYOND Laser Compliance Area.

  • Myopia
  • Hypermetropia
  • Astigmatism and even
  • Presbyopic patients who need only short-sighted glasses
  • PRESBYOND Laser Compatibility Area

One step ahead of conventional monovision

It is similar to conventional monovision with laser treatment in terms of workflow. However, it is one step ahead in terms of the results, especially when it is customized.

PRESBYOND Laser Compatibility Area

It is the next step in perfection of eye treatment that is physiologically optimized for presbyopic patients and achieved in eye treatment. As in the case of conventional monovision, the dominant eye is made almost zero for far sight, while the non-dominant eye is left as mild as -1.5D myopic for near vision. This micro-monovision strategy is supported by a method that increases the depth of field by creating a continuous refraction in the entire optic region of the cornea. The PRESBYOND Laser Compliance Area is definitely a customised treatment that takes into account the functional age and preoperative spherical aberrations of the eye. As a result, two images of short and far sight for each patient are combined in an individual way; we call it as Adaptation Area.

Unique Compliance Area

The Compliance Area makes it easy for the brain to combine images from both eyes. This is an important advantage over conventional monovision. In addition to excellent near and far vision, patients with the PRESBYOND Laser Compliance Area experience very good visual acuity and contrast sensitivity at mid-distance. They fit very quickly and many are happy that they no more have to wear glasses.

That's why most patients with a PRESBYOND Laser Compliance Area tolerate this (up to 97% 1)

Conventional Monovision

In conventional monovision treatment methods (both surgical and contact lens), the dominant eye is brought to almost zero number. Non-dominant eyes are usually myopic up to -3.0D and the correction is done for near vision. This method aims to provide the most ideal for short and far vision. After the process, the brain deals with two different images, which are made at different levels of correction.

Scientific studies have shown that only 59-67% of patients can successfully combine both images in order to achieve a clear image at short and far distances. Those who tolerate this method remain with an uncorrected gap called "Fuzzy Area" at medium distance. In addition to fuzzy images, side effects such as contrast sensitivity and reduced vision may occur. It also takes a long time to get used to perceiving both images as a single image.

Conventional monovision is a method with concessions. It is not a viable option for a group of patients.

PRESBYOND Laser Compatibility Area Customized

In general, conventional monovision methods use standard ablation profiles. The PRESBYOND Laser Compatibility Area includes a customised application for each eye due to increased depth of area.

Customized Ablation

The PRESBYOND Laser Compatibility Area is a unique customised approach to treating presbyopic patients. In order to provide depth of area to each eye, pre-operative wavefront data is included in the process to be calculated by means of a customised calculation. Thus, a separate personal nomogram is created for each eye to achieve the most ideal target. The monovision part of the procedure is adjusted pre-operatively considering the patient's tolerance. In addition, different optic zones are selected by taking into consideration the patient's pupil size.

Increasing Medium-Elder Age Group

The PRESBYOND Laser Compatibility Area, a laser method suitable for age-lost accommodation, is ideal for meeting the needs of patients between the ages of 40 and 60. This method also requires minimal interference to remove presbyopia.

Known Method

The LASIK treatment first appeared in 1990 and began to be accepted and applied in 1999 in the United States. The PRESBYOND Laser Compatibility Area method also uses the LASIK process, which has been used for many years. The treatment planning of both eyes in the PRESBYOND Laser Compliance Area is performed by ZEISS's CRS-Master® program and the MEL 90 Excimer Laser platform.

All Distances

In terms of purely visual results, the PRESBYOND Laser Compatibility Area provides a clear view of all distances, ie, near, middle and far, relative to conventional monovision. Even better is that almost all patients become free from wearing reading glasses.

Superior Visual Acuity

Since customized treatment is provided for each individual, the PRESBYOND Laser Compliance Area provides excellent visual acuity for short and far vision. In contrast to conventional monovision methods, the PRESBYOND Laser Compatibility Area also provides a good view of the middle distance within the Compliance Area. Clinical studies show that functional vision is preserved and that there is almost no loss of contrast sensitivity. At the same time, side effects such as the appearance of more than one image with one eye are almost completely destroyed.

Totally Natural Approach

The PRESBYOND Laser Compatibility Area is a physiological solution and is a method that allows the use of two eyes at the same time for the treatment of presbyopic patients.

Applicable to a Large Range of Patient Group

The PRESBYOND Laser Compatibility Area is an effective and proven method for treating patients using glasses with -8.0 D to +2.0 D, including presbyopic patients who do not wear goggles and have astigmatism (up to 2.0 D cylinders).


The characteristic that distinguishes the PRESBYOND Laser Compliance Area technique is that the patient immediately perceives the visual positive effect. 1-4,6

Suitable for Many Patients

A significant advantage of treatment with the PRESBYOND Laser Compliance Area is that it is more acceptable than conventional monovision by more patients. The PRESBYOND Laser Compatibility Area is effective in treating presbyopia-related disorders up to 97% ansiyon1, whereas in conventional monovision this figure is 59-67%. Patients with astigmatism and no need for far glasses may be treated. Indeed, it has potentially far more success potential than any comparable method.