# Presbyopia

> Citation bundle for Presbyopia on The Treatment Registry.
> URL: https://thetreatmentregistry.com/conditions/refractive-presbyopia
> Bundle URL: https://thetreatmentregistry.com/api/citations/conditions/refractive-presbyopia

## Description

Age-related loss of the lens's ability to focus on near objects, typically presenting in the 40-50 age range. Distinct from refractive errors of childhood and young adulthood (myopia, hyperopia, astigmatism). Treatment options range from reading glasses and contact lenses through to refractive lens exchange (RLE) and corneal procedures.

## Treatment ladder

### conservative

- **Reading glasses or progressive lenses** — Optical correction for near vision. Lowest cost, reversible, no surgical risk. The default choice unless the patient has a specific reason to seek a surgical solution.
- **Monovision contact lenses** — One eye corrected for distance, the other for near. Most patients adapt but some experience reduced depth perception. Trial with contact lenses is the standard pre-surgical assessment.

### procedural

- **Multifocal contact lenses** — Contact lenses incorporating multiple focal zones. Higher cost than monofocal lenses; not all patients tolerate the optical compromise.

### surgical

- **Refractive Lens Exchange** — Clear lens extraction with implantation of a monofocal, multifocal, or extended depth-of-focus IOL. Permanent and prevents future cataract. Carries the small risks of any intraocular surgery and the optical compromises of any multifocal IOL.
- **Premium intraocular lens at cataract surgery** — If presbyopia coexists with early cataract, treating both at once with a multifocal or extended depth-of-focus IOL can address both conditions in one operation. Patient suitability is the gating question.

## Related procedures

- https://thetreatmentregistry.com/procedures/refractive-lens-exchange
- https://thetreatmentregistry.com/procedures/premium-iol

## Sources

- [WHO Surgical Safety Checklist](https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery) — World Health Organization (accessed 2026-05-09)