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Multifocal Lenses vs Monovision vs Presbyond: Which option is right for me?

To begin with, we’ll discuss what Presbyopia actually is.

Presbyopia is the loss of autofocus as we get older. It is caused by the loss of elasticity of the lens in your eyes and issues with your refraction. It’s unavoidable, as everyone ages, they will eventually start to cross paths with the issue. This usually occurs in middle and old ages (40+). Common symptoms of presbyopia are:

  • Blurred vision at normal distances i.e within arm’s reach
  • Eye strain
  • Headaches
  • Tiredness feeling when doing things that require near vision
  • The tendency of holding papers/books far away in the hope the words will be clearer

Thankfully, it’s easy to manage and correct.

So, what are your options?

There are multiple options that will help your presbyopia. These include multifocal lenses, monovision and Presbyond or, you can put up with your reading glasses.

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What are multifocal lenses?

Multifocal lenses enable you to have more than one prescription built into one. For example, if you are both short and long-sighted, multifocal lenses will blend the two. This can be used to assistant with the visual issue of presbyopia as it allows your eyes the ability to focus on objects at all distances, giving you freedom from varifocal glasses. This option is best suited for patients who are happy wearing their glasses and are not considering laser eye surgery such as Presbyond.

Multifocal lenses are used in patients who undergo the refractive lens exchange (RLE) procedure which is similar to cataract surgery. The only difference is that cataract surgery is performed to correct blurriness caused by a misty natural lens which is usually found in people who are ages 50+. With RLE, it is performed to reduce the need for glasses or contact lenses when, for example, reading or using a computer. However, they can give you glare and make driving at night difficult. There also may be a requirement to correct the surgery. This could involve repositioning or exchanging the lens if the desired outcome has not been achieved. Due to this, some patients decide to opt for Presbyond which we will discuss later on. My iClinic no longer offers multifocal lenses as Presbyond gives better results.

What is Monovision?

Monovision can be an option that corrects presbyopia as it reduces a person’s dependency on reading glasses for near-vision tasks such as reading. This compromise of depth perception and intermediate vision. People who consider having monovision will need to research into Clear Lens Extraction. This is a procedure where monovision can be obtained.  With monovision, the vision in your dominant eye is corrected for distance vision while the other is left near sighted to allow you to see objects up close. Despite this, both eyes still work together, allowing you to see clearly at any distance.

Adaptation to this technique is usually done well, to the point some patients are unable to tell which is eye is for which! Your doctor will demonstrate this option to you with a trial pair of contact lenses to see how your brain adapts to the change.

Here at My iClinic, we give you the option of a trial to give you an idea of what it actually looks like to see your everyday life with one eye set for distance and one set for near. By the end of this trial, most patients have a better idea of whether or not this is an option for them. If all is well, you can have surgical monovision correction which can be permanent and eliminates the need for contact lenses to achieve this vision. The downside of monovision is that some people find that it doesn’t provide adequate near vision to give them the freedom from reading glasses that they were hoping for which can lead to further expenses. Some patients find that they would rather pay once for treatment and have a long-lasting result.

What is Presbyond?

Presbyond is Laser Vision Correction that eliminates the need for reading glasses. During the procedure, the depth of field (where objects appear in focus) is increased in each eye so that there is a continuum from near through intermediate to distance where objects are perceived sharply without glasses or contacts. Patients can drive at night and can carry out their daily activities without being troubled by haloes or starbursts.

Presbyond has two main components. The first is the laser correction itself and the second is the brain relearning to use the new vision. This adaptation usually happens within a few weeks or months at the most. Most patients who have had Presbyond are glasses-free for all distances meaning they have more freedom; their natural vision is restored and can do all the things they loved to do without reaching for their glasses/contacts first!

How do you know which option is right for you?

All options require a period of adaptation for your brain to learn the new vision. If your consultant believes you may not be able to do, then readers may be your second option. If you find that you’re gradually getting more and more tired of being inconvenienced by wearing glasses and contacts, Presbyond may be the best option for you. Although it could be considered expensive, clinics such as My iClinic offer a 0% finance option, allowing patients to break down the cost of the procedure.

Contact My iClinic for a FREE Laser Suitability Test.

If you are still unsure if it is right for you, we also offer a FREE suitability test which tells us whether or not you are likely to be suitable for surgery!

About the experts

Mr John Bolger | Consultant Ophthalmologist / Clinic Director

FRCS DO FEBOS -CR

John Bolger is a Consultant Ophthalmologist and Clinic Director at My-iClinic. He specialises in ophthalmology, laser refractive surgery (SMILE, Presbyond, LASIK, PRK, PTK), refractive lens exchange (RLE), cataract surgery, glaucoma treatment and macular degeneration.

Over the course of his career, John Bolger has carried out over 35,000 cataract operations, 20 of which were for eye surgeons. He has also taught over 1500 young ophthalmologists worldwide as they begin their surgical careers.

Bolger has observed and played a part in the evolution of modern ophthalmology. He was one of the first surgeons to introduce microincision cataract surgery to the UK; he witnessed the advent of the femtosecond laser that is used in SMILE procedures and is seeing huge progress in the treatment of glaucoma and wet macular degeneration.

Remaining at the forefront of these advancements ensures that he is always providing his patients with the very best and latest treatments, whatever their condition.

In his free time, John Bolger enjoys flying helicopters, playing classical guitar, baking bread and pastries, and making fresh pasta.