Oculase Articles

Presbyopia treatment: Laser vision correction and refractive lens exchange

Mr Tariq Ayoub - 23 May 2022

Laser vision correction and refractive lens exchange (RLE) are treatment options for presbyopia. Read our article to learn more about these and other treatments available.



Presbyopia is an age-related condition and occurs due to a decrease in the elasticity of the muscles in the eye. If you have presbyopia, you gradually lose your ability to focus on close-up objects.

Watch Mr Tariq Ayoub, our Consultant Ophthalmologist, explain what presbyopia is in more detail.

Signs of presbyopia

  • Squinting
  • Eyestrain
  • Light sensitivity
  • Glare from lights
  • Difficulty reading small text
  • Doing close work makes you tired
  • Struggling to focus on or see objects close to you
  • Needing brighter lights for reading and close work

Your optometrist or ophthalmologist will diagnose presbyopia after assessing your vision and eye health.


Presbyopia treatment options

There are various treatment options to aid your near vision. Glasses and contact lenses are popular options though surgery can offer a more permanent solution.


Non-surgical treatments for presbyopia

  • Eyedrops
  • Glasses
  • Contact lenses


Surgical treatments for presbyopia

  • Refractive surgery, such as LASIK, LASEK, and PRK
  • Refractive lens exchange (RLE)
  • Corneal inlays/ implants

Keep reading to learn more about laser vision correction (laser eye surgery) and refractive lens exchange as treatments for presbyopia.


Laser eye treatment for presbyopia

We have a few laser eye treatments for presbyopia: 

  • LASIK (laser-assisted in situ keratomileusis)
  • LASEK (laser-assisted subepithelial keratectomy)
  • Trans-PRK (photorefractive keratectomy)



LASIK is the most common laser eye surgery. For presbyopia, blended-monovision LASIK or presbyLASIK is used to correct presbyopia. 

In blended-monovision LASIK, we correct the dominant eye for distance vision and the non-dominant eye for near while providing multifocality for intermediate vision. Watch Jo describe her experience of LASIK with monovision for presbyopia in her patient testimonial.

Learn more about the risks and benefits of LASIK here: What are the benefits of LASIK laser eye surgery?

Presbyopia treatment

LASEK and Trans-PRK

During LASIK, we use two lasers, whereas LASEK only involves one. LASEK might be a better choice if you have a thin cornea. It may also be more suitable if you have a medical condition that makes laser eye surgery more challenging.

LASIK involves creating a flap to access your cornea, but we don’t create a flap with LASEK or Trans-PRK. Trans-PRK (No touch LASEK) and LASEK are similar procedures that involve applying a laser to the corneal surface. 

With LASEK, we use diluted alcohol to soften the epithelium and remove it. However, with Trans-PRK, we remove the epithelium with the laser, as well as use it to reshape the cornea. At Oculase, we use trans-PRK rather than LASEK. Learn more about PRK: Photorefractive Keratectomy (PRK) Laser Eye Surgery: What you need to know.

Hear how Trans-PRK with monovision helped this Oculase patient: Patricia, Royal College, Trans-PRK with Monovision for Presbyopia.


Refractive lens exchange (RLE) for presbyopia

Refractive lens exchange (RLE) involves replacing your natural crystalline lens with an advanced technology intraocular lens (IOL). RLE surgery not only corrects your presbyopia but also treats any cataracts you would develop later in life. 

The HD vision lenses we use are long-lasting and are made to stay in your eye for the rest of your life. There are a few different types of lenses we can offer, though our ophthalmologist will explain this to you in more detail.

Similar to LASIK, we can correct distance vision in one eye and near in the other (premium monofocal lenses), or we can insert lenses that enhance your distance and near vision (multifocal lenses). We can also combine RLE with laser vision correction to correct any remaining refractive error.

Book an appointment with one of our ophthalmologists to go over the treatment options for presbyopia. During your appointment, we can discuss the benefits and risks of each option.

Learn more about the RLE procedure, and its risks and benefits in our blog: Refractive Lens Exchange surgery: What is the process?


Laser vision correction vs. refractive lens exchange

While refractive lens exchange is more invasive than laser vision correction, RLE corrects all refractive error presbyopia and treats any future cataracts, unlike laser vision correction. While both presbyopia treatments are effective, refractive lens exchange may be more suitable if you are above the age of 50. 

Laser vision correction with blended monovision is a very effective presbyopia treatment, but as the eye ages, presbyopia progresses, and cataracts develop, laser correction may be rendered less effective. It is therefore important to cover the pros and cons of each at your appointment. Our ophthalmologist can give you a realistic expectation of how each surgery can help you achieve glasses independence.


Preparing for your appointment

If you have a presbyopia diagnosis and want to explore the possibility of surgical treatment, speak to our ophthalmologist. At your appointment, we can discuss your suitability for each treatment. Our ophthalmologist can make a recommendation based on your prescription, eye health, general health, lifestyle, and goals.

It can be useful to arrive with a list of questions you’d like to ask, so you know you won’t forget anything. This is a good time to cover any specific concerns you have. We also recommend bringing a list of any medical conditions you have and any medications you are taking. In your appointment, we will talk about your general health as well as your family health history.


Book an appointment

Presbyopia treatment can restore your ability to focus on close up objects and help you enjoy reading again. You can also experience freedom from glasses or contact lenses.

Our expert ophthalmologist can guide you through your options and recommend the most suitable one for you.

Book an appointment today to discuss your options and start your treatment plan.

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About the author

Mr Tariq Ayoub
Mr Tariq Ayoub, Consultant Ophthalmologist

Mr Ayoub has been rated as one of the top eye surgeons in the UK. He is a Consultant Ophthalmic Surgeon with Imperial College Healthcare NHS Trust in London, one of the largest NHS trusts in England. He is also the Lead for the Emergency Department at Western Eye Hospital, as part of the Imperial College Trust.

Mr Ayoub completed his Ophthalmology training at the prestigious London School of Ophthalmology, namely at Moorfields Eye Hospital and Royal Free Hospital. During his career, he has received many prestigious awards from national and international organisations for his work in the field of ophthalmology.

His clinical interests include treatment for cataracts, vision correction, corneal disease, eye-lid disorders, trauma, and general ophthalmology. Mr Ayoub prides himself on the high quality of his work. With his extensive experience, he can holistically manage complex eye conditions to deliver the best care for his patients.

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