Presbyopia — Quick Answers
- What is presbyopia and at what age does it appear? Presbyopia is a natural process associated with the aging of the eye, resulting from the progressive stiffening of the lens and weakening of accommodation ability; the first difficulties usually appear after the age of 40, with the greatest intensity occurring between 40 and 55 years of age.
- How much does presbyopia surgery cost? PresbyMAX (laser, pair of eyes) costs PLN 15,000, refractive lens exchange with a premium implant costs PLN 11,000 per eye, and the qualification examination costs PLN 400; prices are identical in Warsaw and Krakow, and installment payments are available.
- What is monovision? Monovision involves each eye undergoing a different correction – one is prepared for distance vision, and the other for near vision; it can be achieved with contact lenses, laser correction, or intraocular lens implants.
- Can presbyopia be reversed? It is not possible to restore lens elasticity with drops or exercises, but its effects can be permanently corrected with a laser, a biological Allotex TransForm implant, or by replacing the lens with a multifocal or EDOF implant.
- Where is presbyopia treatment performed? The procedure is performed at both SwissLaser clinics – the same surgeon, the same technology, and the same prices at both locations.
Presbyopia
Warsaw · Krakow · Vienna · Zurich
The restaurant menu moves further and further from your eyes, messages on your phone are read at arm’s length, and in dim light, small print blurs together. This is how presbyopia most often begins — and it is not a disease, but a natural process that affects everyone after the age of 40. The good news: it can now be effectively corrected — with glasses, contact lenses, laser methods, or lens implants.
Definition: Presbyopia is the progressive, age-related loss of elasticity of the eye’s natural lens, through which the eye gradually loses its ability to see sharply up close.
SwissLaser in numbers: over 25,000 procedures performed by the chief surgeon · clinics in Krakow, Warsaw, Vienna, and Zurich · Google: 5.0 (169 reviews, Krakow) and 4.9 (256 reviews, Warsaw)
Which method at what age? Comparison
| Method | Optimal age / situation | Price |
| PresbyMAX | 40–55 years, multifocal corneal profile | PLN 15,000 for a pair of eyes |
| Allotex TransForm™ | 45–65 years, fully reversible biological implant – unique in Poland | individual valuation |
| Monovision | 40+, after successful simulation with contact lenses | according to method (e.g., FemtoLASIK PLN 11,000/pair) |
| Lens Exchange (RLE) | 55+ or early cataract; trifocal/EDOF lenses | PLN 11,000 per eye |
What is presbyopia?
Meanwhile, human vision naturally deteriorates after the age of 40, and this has nothing to do with potential defects such as myopia, hyperopia (farsightedness), or astigmatism. Moreover: it also appears in people who have never been diagnosed with any vision defect.
Presbyopia is associated with the progressive stiffening of the lens and the weakening ability of the eye’s accommodation (the accommodative muscles become weaker). These changes cannot be prevented – they result from the natural wear and tear of our body. Even the healthiest lifestyle will not prevent them.
It is worth adding that some diseases, such as diabetes, or taking antihistamines or antidepressants, can accelerate the development of presbyopia.
It is estimated that by 2020, the number of people struggling with presbyopia worldwide will reach approximately 1.3 billion. This is a problem that is easy to diagnose and possible to correct. Therefore, it is worth seeking the help of a specialist.
“Arms too short,” or the farsighted person reading a newspaper
The first symptoms of presbyopia are impossible not to feel: accommodation disorders are experienced as significant discomfort. This initial stage of lens stiffening occurs in jumps, and at some point, the process slows down and becomes less rapid.
Every two to three years, there is a loss of a quarter or half a diopter of near vision correction. We then joke that our arms are too short for reading – meaning we cannot move the text far enough from our eyes to see it clearly – and we refer to ourselves as farsighted.
But in reality, it doesn’t necessarily have to be “ordinary” farsightedness (hyperopia), or it’s not just about that. It’s evolving presbyopia, also known as age-related farsightedness or senile farsightedness.
Symptoms of presbyopia
- inability to read text up close – the smaller the letters, the greater the difficulty (SMS, footnote in a book, restaurant menu, text on a computer monitor)
- headache and eye strain when looking up close
- difficulty with eye accommodation during the so-called “twilight hour” (when dusk falls or just after it has fallen)
It is important to be aware that after the age of 35, our vision, regardless of previously diagnosed defects, begins to deteriorate. Presbyopia is most often diagnosed after the age of 40, with its greatest intensity occurring between 40 and 55 years of age.
Around the age of 60 (some believe between 65 and 70), this process stops.
How to check if it’s the beginning of presbyopia?
Let’s focus on reading text up close, and then quickly look into the distance – for example, at a window, a picture, or a television. If shifting our gaze to distance vision takes a few seconds (until we see a sharp image again), we should consult an ophthalmologist.
Presbyopia is easily corrected with glasses, but if you lead an active lifestyle, it is worth looking for other solutions.
Presbyopia Correction
Reading glasses
If symptoms of presbyopia appeared in a person diagnosed with a vision defect, until recently they had to get two pairs of glasses – the first adequate for their defect and the second for reading.
Then bifocal glasses appeared, which have two powers built-in – in the main area (when looking straight ahead) power for distance vision, and in its lower segment – higher power to facilitate reading. However, the transition from one area to another is very unnatural for the eye, it occurs abruptly, and not every patient was able to get used to wearing bifocal glasses. So progressive glasses were created. Thanks to progressive glasses, the change in corrective value on the lens surface occurs smoothly, not abruptly. The upper part of the corrective lens is used for seeing distant objects, below it, its power increases in such a way as to see intermediate distances sharply (from a few meters to several tens of centimeters). The lower area is used for reading and looking at distances below half a meter. In progressive glasses, lenses correcting other vision defects can also be included.
Presbyopia Correction
Two pairs, bifocal lenses, and progressive lenses
If symptoms of presbyopia appeared in a person diagnosed with myopia, until recently they had to get two pairs of glasses – the first adequate for their vision defect and the second for reading. Then bifocal lenses appeared, which have two powers built-in – in the main area (when looking straight ahead) power for distance vision, and in its lower segment – higher power to facilitate reading.
However, the transition from one area to another is very unnatural for the eye, it occurs abruptly, and not every patient was able to get used to wearing bifocal glasses. So progressive lenses were created.
Thanks to progressive lenses, the change in corrective value on the lens surface occurs smoothly, not abruptly. The upper part of the lens is used for seeing distant objects, below it, its power increases in such a way as to see intermediate distances sharply (from a few meters to several tens of centimeters).
The lower area is used for reading and looking at distances below half a meter. In progressive glasses, lenses with vision correction can be included.
Presbyopia Correction
Contact lenses
Multifocal contact lenses are very effective in presbyopia correction. They are multifocal, enabling vision both at a distance and up close. Multifocal lenses look the same as other contact lenses, but they are designed to enable vision regardless of distance. The center of the lens has a different light refraction than the periphery, which allows for clear perception of objects at most distances.
It is worth noting, however, that the adaptation period for comfortable wearing of multifocal contact lenses can be quite long, and for people with anisometropia (a different defect in each eye), adaptation can not only be significantly difficult but often even impossible and may require a trial-and-error approach.
Presbyopia Correction
Monovision
Monovision can be performed in various ways: with contact lenses, through ophthalmic laser correction, or with intraocular lens implants.
Monovision is a vision correction method used to alleviate the effects of presbyopia, which involves each eye undergoing a different correction to prepare one eye for distance vision and the other for near vision.
In short: one myopic and one hyperopic eye are artificially created.
Laser Correction
Laser Vision Correction for Presbyopia
Depending on whether presbyopia is the only eye dysfunction or if it is accompanied by other vision defects, the patient has the following laser correction methods to choose from:
- without another vision defect – /Femto-LASIK/Monovision PresbyMAX/ lens exchange, phakic lens
- hyperopia/myopia +3 to -5 Femto-LASIK/Monovision PresbyMAX/LASIK for presbyopia,
- all vision defects – lens exchange with mono- or multifocal and EDOF implants
LASIK
(laser assisted in situ keratomileusis): a two-stage technique; the cornea is incised with a scalpel (microkeratome), and then the inner corneal surface is reshaped to properly focus the image on the retina.
Femto-LASIK
(All-Laser-LASIK): Thanks to a precise femtosecond laser, the surgeon makes an incision in the cornea, creating a thin flap 0.1 mm thick. An excimer laser is then used to reshape the exposed cornea for a few seconds, after which the flap is closed back; it attaches and forms a protective barrier for the cornea. This method allows for multifocal correction and monovision.
LENS EXCHANGE
Also known as refractive lens exchange, it can be performed using various, individually matched lenses. The following are used in the treatment of presbyopia:
- Latest generation multifocal lenses (trifocal lenses, EDOF, for near and distance vision, and intermediate area);
- Monofocal lenses (also known as “enhancing lenses,” often used in cataract surgery);
- Toric lenses (for astigmatism correction);
- Toric trifocal lenses (correct presbyopia and astigmatism);
- PHAKIC lenses implanted additionally to the natural lens.
Presbyopia Treatment – Step by Step
Before the procedure – preliminary examinations
At the beginning of the first visit, we conduct a comprehensive anamnesis. We record not only previous illnesses, surgeries performed, and medications taken by the patient, but also explain what is particularly bothersome in the case of presbyopia and what correction methods are available. We provide comprehensive information on various presbyopia correction options.
Full eye examination
Next, we thoroughly examine the eyes. We determine the exact visual acuity and the precise degree of presbyopia. We examine the retina and measure intraocular pressure. These examinations serve to determine if other eye diseases are present. In the next step, we measure the eye and perform optical biometry, considered the most precise method for measuring the axial length and partial segments of the eyeball. We also record the corneal curvature – this is done completely non-invasively using a laser that measures along the eye’s axis. This method is completely safe and eliminates measurement errors that occur with ultrasound measurement.
Corneal examination
To achieve optimal presbyopia correction, a precise corneal map is created. Using corneal tomography, the anterior and posterior walls and their thickness are precisely measured. This examination serves to determine all anatomical properties of the cornea. Based on such a “map,” the refractive power of the eye, which plays a very important role during correction surgery, is determined.
We also offer another painless examination of the anterior corneal wall – optical coherence tomography of the anterior segment of the eye. The examination is non-contact and can be compared to an ultrasound examination, but instead of sound, laser light is used.
Wavefront examination
Next, a wavefront examination is performed. A light beam is sent into the eye, focused precisely on the retina. From this point, the wavefront of light spreads through the lens and cornea. This method can precisely determine where laser treatment is required to optimize visual acuity.
Important for the preliminary examination
Soft contact lenses should not be worn for one week, and hard contact lenses for three weeks before the examination.
During the examination, eye drops are used to dilate the pupils. This causes higher light sensitivity, so you should not drive or operate machinery for two to three hours after the examination.
Scheduling an appointment
After the preliminary examination, it is discussed whether ophthalmic laser surgery is appropriate in a given case. The patient is informed about the course of the operation, risks and side effects, and further treatment.
If the patient decides on presbyopia correction, we jointly determine the ideal appointment date. Contact lenses can be worn again up to two days before the operation.
Day of surgery
On the day of surgery, you should come with a companion. On this day, no creams, powders, makeup, mascara, aftershave, or other substances applied to the face should be used. This is important to prevent eye infections. You can eat and drink normally. Final questions are clarified. Patients also receive medications and instructions for their use after surgery. Before we begin, we schedule a follow-up appointment for the next morning. The procedure itself is very quick – it only takes 10-20 minutes and causes no pain.
After the procedure
After eye correction, the patient receives protective glasses and can go home with their companion. They may experience symptoms such as: watery eyes, slight burning, or a feeling of a foreign body. On this day, the eyes should be kept closed as much as possible (except, for example, when going to the toilet or eating). Avoid watching TV, reading, working on a computer, using smartphones, etc. The eyelids press on the cornea, which accelerates its healing. To prevent boredom, you can listen to an audiobook or music. Otherwise, remain calm.
Protective glasses should also be worn at night to prevent accidental eye injury. Avoid rubbing and pressing the eyes in the first few days after surgery. After laser surgery, makeup should be avoided for two weeks to prevent eye infection. After lens exchange, the “no makeup” rule applies for four weeks. For two weeks, do not bathe in a tub, go to a spa or sauna, or shower with your face directly in the stream of water. For two weeks, drafts, smoky, windy, and dusty rooms should also be avoided. This also applies to physical exertion.
Patients receive an eye drop schedule and two types of drops (corticosteroid and antibiotic drops). The schedule indicates when and with which medications the eyes should be instilled.
On the day after the operation, you should come for the next scheduled appointment. Usually, on this day, patients have no complaints and regain about 90% of their vision. The next examination is planned for the following month.
Summary
Several methods for permanent presbyopia correction are available. All procedures can be performed on an outpatient basis and are painless for the patient.
Monovision is a suitable method for older individuals who cope well with distance and near vision (a simulation using contact lenses is performed before the operation).
Lens exchange is necessary if laser correction is not an option, the patient is over 50 years old, and their natural lens is already slightly clouded (early cataract).
In the case of refractive lens exchange, the natural lens is removed using computer-controlled ultrasound and replaced with an appropriate artificial lens.
At SwissLaser, we use multifocal lenses (trifocal lenses) that allow for good near and distance vision and perfectly cover the area between near and distance vision (intermediate area).
Just a few days after the operation, the patient regains good vision and no longer needs to wear glasses.
If residual vision defects still exist after lens exchange, they can usually be corrected with laser treatment.
Expert Comment
“For presbyopia, there isn’t one best method – there is the best method for a specific patient. For a fifty-year-old with a clear lens, I usually suggest laser or Allotex; for a sixty-year-old with early cataracts – immediate lens exchange. About 1,000 of my patients underwent PresbyMAX; another thousand consultations resulted in a different recommendation, because that’s what the diagnostics showed.”
Dr. med. Victor Derhartunian, FEBO, FWCRS – approx. 1,000 PresbyMAX patients
Frequently Asked Questions (FAQ)
What is presbyopia and at what age does it appear?
Presbyopia is a natural process associated with the aging of the eye – the progressive stiffening of the lens and weakening of accommodation ability. The first difficulties with reading up close, using a smartphone, or working on a computer usually appear after the age of 40, with the greatest intensity occurring between 40 and 55 years of age. Presbyopia also affects people who have never had any vision defect, and it cannot be prevented even with the healthiest lifestyle.
What permanent presbyopia correction methods does SwissLaser offer?
Depending on whether presbyopia occurs alone or is accompanied by other vision defects, laser methods – PresbyMAX, Femto-LASIK with monovision, or Allotex TransForm – and lens surgery: refractive lens exchange with mono- or multifocal and EDOF implants are available. All procedures are performed on an outpatient basis and are painless for the patient. The appropriate method is selected during the qualification examination.
What is monovision?
Monovision involves each eye undergoing a different correction – one is prepared for distance vision, and the other for near vision. It can be achieved with contact lenses, laser correction, or intraocular lens implants. Before the operation, a simulation using contact lenses is performed to check if the patient tolerates this type of vision well.
When is lens exchange recommended for presbyopia instead of laser?
Lens exchange is indicated when laser correction is not an option, the patient is over 50 years old, and their natural lens is already slightly clouded (early cataract). At SwissLaser, we use trifocal and EDOF lenses, which provide good near, distance, and intermediate vision. Just a few days after the operation, the patient regains good vision, and any residual defects can usually be refined with a laser.
How much does presbyopia surgery cost using the lens exchange method?
Refractive lens exchange with a Premium implant (spherical, toric, or Customized) costs PLN 11,000 per eye and is performed at our clinics in Warsaw and Krakow. The procedure is not reimbursed by the NFZ (National Health Fund), but we offer installment payments through Santander Consumer Bank. The qualification examination costs PLN 400.
How to prepare for the qualification examination before presbyopia correction?
Before the examination, soft contact lenses should not be worn for one week, and hard lenses for three weeks. During the visit, we perform a full eye examination: visual acuity, retina, intraocular pressure, optical biometry, corneal tomography, and wavefront examination. Since pupil-dilating drops are used, driving should be avoided for two to three hours after the examination.
What are the first symptoms of presbyopia?
Pushing text away at arm’s length, needing brighter light for reading, eye strain and headache when working up close, blurry letters when shifting gaze from distance to near. It usually starts between 40 and 45 years of age, earlier in hyperopic individuals, later in myopic individuals.
Does presbyopia worsen?
Yes – the eye’s lens gradually loses elasticity, which is why the power of reading glasses increases until approximately 60–65 years of age, and then stabilizes. This is a natural process, not a disease; laser correction or lens exchange stops it in the sense that the implant does not age further.
Can presbyopia be reversed?
It is not possible to restore lens elasticity with drops or exercises. However, its effects can be permanently corrected: with a laser (PresbyMAX, monovision), a biological Allotex TransForm implant, or by replacing the lens with a multifocal or EDOF implant – this last method simultaneously addresses future cataracts.
How much does presbyopia surgery cost?
PresbyMAX (laser, pair of eyes) PLN 15,000; refractive lens exchange with a premium implant PLN 11,000 per eye; Allotex TransForm – individual valuation; qualification examination PLN 400. Prices are identical in Warsaw and Krakow, installment payments are available.
Farsightedness after 40 and presbyopia – are they the same?
No. Farsightedness (hyperopia) is an eye structural defect, present from childhood and long masked by accommodation. Presbyopia is the loss of lens elasticity with age. After the age of 40, both overlap, which is why hyperopic individuals experience presbyopia earlier and more intensely.
Sources
- Wolffsohn JS, Davies LN. Presbyopia: effectiveness of correction strategies. Prog Retin Eye Res 2019;68:124–143. doi:10.1016/j.preteyeres.2018.09.004
- Fricke TR, Tahhan N, Resnikoff S et al. Global prevalence of presbyopia and vision impairment from uncorrected presbyopia: systematic review, meta-analysis, and modeling. Ophthalmology 2018;125(10):1492–1499. doi:10.1016/j.ophtha.2018.04.013
- Uthoff D, Pölzl M, Hepper D, Holland D. A new method of cornea modulation with excimer laser for simultaneous correction of presbyopia and ametropia. Graefes Arch Clin Exp Ophthalmol 2012;250(11):1649–1661. doi:10.1007/s00417-012-1948-1
- Alió JL, Plaza-Puche AB, Férnandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: an overview. Surv Ophthalmol 2017;62(5):611–634. doi:10.1016/j.survophthal.2017.03.004
- Evans BJW. Monovision: a review. Ophthalmic Physiol Opt 2007;27(5):417–439. doi:10.1111/j.1475-1313.2007.00488.x
- Jacob S, Kumar DA, Agarwal A, Agarwal A, Aravind R, Saijimol AI. Preliminary evidence of successful near vision enhancement with a new technique: PrEsbyopic Allogenic Refractive Lenticule (PEARL) corneal inlay using a SMILE lenticule. J Refract Surg 2017;33(4):224–229. doi:10.3928/1081597X-20170111-03
Our Patients’ Opinions
Google rating: Warsaw 4,8 (reviews: 258) · Krakow 5,0 (reviews: 171). All reviews, unedited and unselected, can be read directly on Google: Warsaw · Krakow.
Related Topics
- Allotex TransForm™ – the only biological implant in Poland correcting presbyopia
- prices for presbyopia correction procedures
- monovision – one eye for distance, one for near
Related Topics
- PresbyMAX, EDOF lenses, or lens exchange? – method comparison
- Presbyopia Treatment in Warsaw – PresbyMAX and EDOF lenses
- Presbyopia Treatment in Krakow – consultation and procedure
Presbyopia and Laser Vision Correction
Content fact-checked by Dr. med. univ. (Vienna) Victor Derhartunian, FEBO, FWCRS – refractive surgery specialist. Last verified: October 2, 2026.
Where we perform this procedure
We perform the procedure in both our clinics – the same surgeon, the same technology, and the same prices. Choose a location to see details, directions, and opening hours:
Presbyopia Treatment in Warsaw
ul. Kolejowa 1, 01-217 Warsaw · tel. +48 22 120 16 90
Presbyopia Treatment in Krakow
ul. Kluczborska 15/U3, 31-271 Krakow · tel. +48 12 383 33 60
Decision
Three paths — and why age alone is not decisive
After the age of 50, all three paths remain open. Which one suits you depends less on your birth year and more on what you rule out for yourself: one person doesn’t want an invasive procedure, another doesn’t want a method where values might still change, a third doesn’t want donor tissue. Therefore, we decide together during the qualification examination, not according to a fixed scheme.
All three paths require stable vision defects and a healthy eye condition. What is suitable for you will only be revealed by measurements.
