Vision correction after the age of 40
After the age of 40, your eyesight changes differently than before. You may still see well in the distance, but it becomes increasingly difficult to read up close, use your phone, or work without glasses. This is most often presbyopia, which is a natural age-related process.
If this sounds familiar, it is worth checking how to prevent it.
Do you recognise yourself in any of these situations?
Many of our patients over the age of 40 come to us with very similar stories. Maybe yours sounds familiar, too.
You have several pairs of glasses, but not the one you actually need
Presbyond or RLE can reduce the need to switch between glasses.
You're holding your phone further and further away to read the message
This is a classic symptom of presbyopia, which can often be completely eliminated.
Reading menus in restaurants has become problematic
After correction, you return to reading without reaching out a hand and searching for light.
You don't know whether at your age laser surgery or RLE is still an option
Age is not a contraindication – that is decided by the test result, not the date of birth.
Laser vision correction
Presbyopia – why reading glasses are not everything?
After the age of 40, the natural lens of the eye gradually loses its elasticity. It becomes increasingly difficult for the eye to „focus” on close distances. You start holding your phone further away, need brighter light, or find yourself reaching for your reading glasses more often.
How does eyesight change with age?
20-39 years old
Jeśli występuje wada wzroku, zwykle dotyczy ona dali, bliży lub astigmatism.
40-50 years old
Presbyopia develops – difficulty with reading and near vision.
50+ years
Presbyopia can progress, and some people develop the initial symptoms of cataracts.
What is presbyopia?
Prezbiopia, czyli starczowzroczność, to naturalny proces związany z wiekiem — nie jest to choroba ani wada wzroku w klasycznym rozumieniu. Z czasem naturalna soczewka oka stopniowo traci elastyczność i coraz trudniej "ustawia ostrość" na bliskich odległościach. W praktyce objawia się to tak, że zaczynasz odsuwać telefon lub książkę dalej od oczu, potrzebujesz mocniejszego światła do czytania, a oczy szybciej się męczą przy pracy z bliska — np. przy komputerze czy podczas czytania drobnego druku.
Presbyopia usually appears after the age of 40 and affects practically everyone — including people who previously had very good eyesight or already wore glasses for another reason (short-sightedness, long-sightedness, astigmatism). This is an important distinction: presbyopia can occur on its own or overlap with an existing vision defect, and the latter happens very frequently.
Can presbyopia be treated with laser surgery?
Tak, choć warto od razu sprecyzować, na czym to leczenie polega. Prezbiopii nie da się "cofnąć" – żaden laser nie przywróci naturalnej soczewce jej elastyczności. Klasyczne zabiegi laserowe korygujące krótkowzroczność, nadwzroczność czy astygmatyzm (np. FemtoLASIK, SMILE Pro) same w sobie nie leczą prezbiopii – poprawiają widzenie do dali, ale nie rozwiązują problemu z bliska.
To this end, methods designed specifically for presbyopia have been created, such as PRESBYOND® (oparty na technologii FemtoLASIK). Zasada działania: laser koryguje oboje oczu nieco inaczej - jedno wspiera głównie widzenie do dali, drugie widzenie z bliska i z odległości pośrednich. Mózg uczy się łączyć te dwa obrazy w jeden, płynny zakres widzenia (tzw. Laser Blended Vision). Dzięki temu można ograniczyć zależność od okularów do czytania, pracy przy komputerze i codziennych czynności – choć u części pacjentów okulary do bardzo drobnego druku lub słabego światła mogą być nadal potrzebne.
An important caveat worth maintaining in communication: the PRESBYOND® effect requires adaptation — the brain and eyes learn the new vision system gradually, sometimes over several weeks or months, and during this time fluctuations in acuity or greater eye fatigue may occur. This is a normal part of the process, not a complication.
For patients whose corneal condition, lens status or degree of presbyopia rules out a laser procedure, a non-laser alternative remains – refractive lens exchange (RLE), which solves the problem differently: by replacing the natural lens with an artificial one.
Contraindications to laser eye surgery after the age of 40
Qualification for treatment laserowego po 40. roku życia jest bardziej złożona niż u młodszych pacjentów, ponieważ trzeba ocenić nie tylko wadę wzroku, ale też stan soczewki i ryzyko zaćmy. Zabieg laserowy (w tym PRESBYOND®) może nie być wskazany, jeśli występuje:
- cataract – even in the early stages, because the laser corrects the cornea and does not solve the problem of the clouding lens,
- too thin a cornea or its incorrect shape,
- stożek rogówki lub jego podejrzenie,
- nasilony dry eye disease,
- active eye infections,
- unstable visual impairment,
- pregnancy and breastfeeding,
- some general diseases (e.g.
- poorly controlled diabetes, selected autoimmune diseases),
- lack of tolerance for the difference in vision between the eyes – this is particularly important with methods such as PRESBYOND®, which intentionally differentiate the function of the two eyes.
If any of these factors occur, it does not mean the end of correction possibilities – usually it means that a different method, e.g. RLE rather than laser, will be a better solution. Therefore, the qualification assessment always provides the final answer, not age in itself.
Rodzaje korekcji wzroku - którą metodę wybrać powyżej 40 roku życia?
In the 40+ age group, there are several methods to choose from, differing in their mechanism of action and the specific problem they solve best:
Laser methods:
- PRESBYOND® - for people with presbyopia, often combined with myopia, hyperopia or astigmatism. It corrects vision at several distances simultaneously.
- FemtoLASIK — a proven method for correcting distance vision defects; in patients with mild or early presbyopia, it may be sufficient on its own.
- SMILE Pro — a minimally invasive laser method, mainly for myopia and astigmatism, when presbyopia is not yet advanced.
- PRK Standard / EBK Standard — surface procedures, a solution for patients with thinner corneas who are not eligible for FemtoLASIK or SMILE Pro.
Non-laser method:
RLE (refractive lens exchange) — when the cornea is too thin for laser surgery, the refractive error is large, presbyopia is advanced, or the first symptoms of cataracts appear. Additional benefit: it eliminates the risk of cataracts in the operated eye in the future.
Key message to maintain in this section: the choice of method is not something the patient decides on their own before the appointment — this is the result of the qualification process, which assesses the cornea, the lens, the stability of the defect, and the patient's lifestyle.
Laser correction
Presbyopia – laser specifically for presbyopia
PRESBYOND® to technologia laserowa stworzona z myślą o pacjentach z prezbiopią. Działa inaczej niż standardowa laser vision correction, ponieważ nie skupia się wyłącznie na widzeniu w dal. Jej celem jest poprawa widzenia na różnych odległościach — do dali, bliży i odległości pośrednich.
What is the PRESBYOND® procedure?
In practice, this means greater freedom in everyday situations: reading messages on your phone, working at a computer, driving a car or watching television.
Benefits of PRESBYOND®
- Correction of presbyopia is often simultaneous with short-sightedness, long-sightedness and astigmatism.
- Recovery trwa zwykle kilka dni i wracasz do swoich aktywności z lepszą ostrością widzenia.
- Freedom from glasses in everyday life.
Adaptacja do widzenia po PRESBYOND® może wymagać czasu. Mózg uczy się korzystać z nowego ustawienia oczu, dlatego pełny komfort widzenia oceniany jest stopniowo - podczas kontroli po zabiegu.
Non-laser vision correction
RLE – when a laser is not the best option
Refractive lens exchange, or RLE, is an eye procedure in which the natural lens of the eye is replaced with an artificial lens. It is not laser eye surgery, but for many patients over 40 to 50 years of age, it can be an effective method of improving vision.
When should RLE be used instead of laser eye surgery?
RLE may be a better solution when the cornea is too thin for laser surgery, the vision defect is too large, presbyopia is advanced, or the first symptoms of cataracts appear.
This is a method that works on a different structure of the eye than a laser. The laser reshapes the cornea, while RLE replaces the lens – which is why it can solve problems that standard laser correction cannot fix well enough.
What can RLE provide?
- Improve distance, near and intermediate vision
- Reduce or eliminate the need to wear multiple pairs of glasses.
- Eliminuje ryzyko zaćmy w operowanym oku - sztuczna soczewka nie mętnieje, tak jak naturalna.
- Trwały efekt - wszczepiona soeczewka nie starzeje się
RLE jest podobne technicznie do operacji zaćmy, ale wykonywane z innego powodu - nie tylko po to, by usunąć zmętniałą soczewkę, ale także po to, by skorygować wadę wzroku i poprawić komfort widzenia.
Vision correction methods
Najbardziej odpowiednią dla Ciebie metodę laserowej korekcji dobiera lekarz po kwalifikacji i konsultacji.
Powyżej 40 lat PRESBYOND®
Advanced presbyopia treatment method. The femtoseccond laser precisely creates a thin corneal flap of individually planned thickness and shape.
- Return to work: 1-2 days
- Wady: do -8,0 D, +2,0 D, astygmatyzm 2,0 D
Largest correction range FemtoLASIK
Recommended for standard defects. The laser creates a thin flap in the cornea under which the tissue is modelled. High precision, fast healing and minimal discomfort.
- Return to work: 1-2 days
- Disadvantages: up to -13.0 D and +6.0 D
Najnowocześniejsza technologia SMILE Pro
The most advanced method. The laser creates a microlens inside the cornea through a 2-3 mm incision. Minimal invasiveness
- Return to work: 1 day
- Defects: up to -10.0 D, +4.0 D, astigmatism up to 5.0 D
Dla wrażliwych rogówek EBK
Modern surface method without cutting, combining the advantages of PRK and Epi-LASIK. Gentle removal of the corneal epithelium with precise laser treatment of the surface.
- Return to work: 3-4 days
- Disadvantages: up to -6.0 D
Assessment
Are you eligible and for which method?
After the age of 40, assessment is particularly important because it is necessary to evaluate not only the visual defect, but also the cornea, the crystalline lens, and the degree of presbyopia. Therefore, the answer to the question „laser or RLE?” is provided by a detailed examination.
Candidate for laser eye surgery
- Your eyesight defect is beginning to become unstable
- The cornea has an appropriate thickness and shape
- Presbyopia is early or moderate
- You don't have cataracts
- The general condition of the eyes allows for laser surgery
Candidate for the RLE
- You have a thin cornea
- Your eyesight is very poor
- Presbyopia is more advanced
- The first symptoms of cataracts are appearing
- You want to correct your vision for several distances at the same time
Potrzebna dodatkowa ocena
- Uncontrolled glaucoma
- Active eye diseases
- Some autoimmune diseases
- Untreated diabetes
- Eye inflammation or other medical contraindications
Qualification
From assessment to a life without glasses
After the age of 40, assessment is particularly important because it is necessary to evaluate not only the visual defect, but also the cornea, the crystalline lens, and the degree of presbyopia. Therefore, the answer to the question „laser or RLE?” is provided by a detailed examination.
Assessment
We examine the cornea, lens, vision defect and general eye condition. The doctor assesses whether laser surgery, PRESBYOND® or RLE will be the better solution. This is the most important stage of the entire process.
This is where the decision on the method is made.
Procedure
The procedure is performed under local anaesthesia. In the case of laser methods, the procedure involves the cornea. In the case of RLE, the doctor replaces the natural lens with an artificial one – each eye is operated on separately.
First few days
Following laser treatment, vision improvement can appear quickly, although stabilisation takes longer. After RLE, the brain needs time to get used to working with the artificial lens, especially if it is multifocal. In the first few days, you may experience fluctuations in acuity, greater sensitivity to light, or eye strain. This is part of the adaptation and healing process.
Months 1-3
CORRECTION OVER 40 YEARS OF AGE
Obawy pacjentów po 40 roku życia - odpowiadamy
We have gathered the most frequent questions and doubts that patients bring to their qualification assessment.
Do I need to know which method to choose before the appointment?
Can presbyopia be stopped?
Is it still possible to have vision correction after the age of 60?
How long does recovery take after a lens replacement?
What is the difference between Presbyond and a standard laser?
Can I have laser eye surgery if I wear reading glasses?
Do I need to know which method to choose before the appointment?
Can presbyopia be stopped?
Is it still possible to have vision correction after the age of 60?
How long does recovery take after a lens replacement?
What is the difference between Presbyond and a standard laser?
Can I have laser eye surgery if I wear reading glasses?
Meet our specialists
Meet the team behind your care
Dorota Chomińska-Dorn, MD
Eye specialist, ophthalmic surgeon
Anna Jurska-Jaśko, MD, PhD
Eye specialist, ophthalmic surgeon
Jagoda Sarnowska-Tumminello, MD
Ophthalmology specialist, FEBO
Aleksandra Trzeciak, MD
Eye specialist, ophthalmic surgeon
Judyta Aniśko-Słomińska, MD, PhD
Eye specialist, ophthalmic surgeon
Patient feedback
Hear from patients who no longer need glasses
Price list
up to one month after surgery - free
over one month to one year - PLN 150
over one year - PLN 250
We offer flexible payment instalments
Learn more about the financing details
FAQ
We will answer all your concerns.
Do I need to know which method to choose before the appointment?
No. That is the job of the doctor and the diagnostic team. Your role is to describe how you see, what glasses you use, and what you expect from the procedure. We choose the method after examinations.
Can presbyopia be stopped?
Natural ageing of the crystalline lens cannot be stopped, but its effects can be corrected. Presbyond and RLE are methods that can help reduce dependence on reading glasses.
Is it still possible to have vision correction after the age of 60?
Yes, but the method depends on the condition of the eye. In patients over 60, RLE or cataract surgery with the selection of a lens is more frequently considered, as the natural lens may already be losing its transparency.
The most important thing is the qualification assessment — it will show whether correction is possible and which method will be the best.
How long does recovery take after a lens replacement?
Initial improvement in vision can happen quickly, but full adaptation to the new lens usually takes a few weeks. The brain learns to use the new way of seeing, especially with multifocal lenses.
During this time, fluctuations in sharpness, haloes around lights or increased sensitivity to light may occur. They usually gradually decrease.
What is the difference between PRESBYOND® and a standard laser?
Standard laser eye surgery most commonly corrects distance vision. PRESBYOND® is designed for people with presbyopia – it is intended to improve vision at multiple distances, including close up.
Thanks to this, they can reduce the need to wear reading glasses.
Can I have laser eye surgery if I wear reading glasses?
Yes, but standard laser eye surgery will not always be the best choice. Reading glasses usually mean presbyopia, which is age-related long-sightedness. In that case, the doctor assesses whether Presbyond, another laser method or RLE will be better.
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