A plan by age
Ages 40–55
Readers or varifocals. Near vision starts to fade, so the plan has to cover reading as well as distance.
The options
Reading has to be part of the plan
From the mid-forties, the lens stops focusing up close. Correcting only distance leaves reading blurry. If laser was done younger, a later touch-up for reading is often possible.
Laser, planned for both distances
Blended laser
LASIK or PRK, chosen from the cornea. One eye is set for distance and the other for near. That balance is shown with a contact lens trial before any surgery. On the WaveLight suite, treatment can run from −12 to +6, and astigmatism up to 6 dioptres.
Suits
Reading starting to fail, or someone who had LASIK younger and now needs help up close. Some people in varifocals are not laser candidates.
Recovery
LASIK usually settles in one to six days. PRK with Streamlight keeps a bandage lens in for four to six days, and clear vision takes about four to six weeks.
When varifocals are not a laser problem
Customised lens exchange
The natural lens is removed and replaced with an implant. The target can be distance, near, a blend of the two, or a multifocal or extended-depth lens when the eye allows it. The choice is made after the measurements, not from this page.
Suits
Varifocals, or a prescription that laser should not treat. The operation is the same as cataract surgery, so that eye will not need a cataract operation later.
Recovery
Usual activities in two or three days. Vision is usually stable in three to six weeks. Glasses can still be part of the result, and that is agreed before surgery.
A higher prescription, lens still clear
Phakic lens implant
A lens sits in front of the natural lens when laser is not suitable. It can correct distance. It does not stop presbyopia, so reading glasses from about 40 are still part of the picture. It also does not prevent cataract. If a cataract later needs surgery, this implant has to come out first.
Suits
Moderate to high short-sight, long-sight, or astigmatism, in an eye that should not be lasered and still has a clear natural lens.
Recovery
Usual activities in two or three days. Vision can take several weeks to settle. One eye is done at a time, with at least a week between them.
Another age