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Age
Visual defect

A prebyopic eye

In a normal eye and before the age of presbyopia, the crystallin which is part of the optic lens found behind the iris changes form and strength during vision from far to near and vice versa. This elasticity is required to ensure that images are constantly focussed on the retina to maintain clear vision.
Presbyopia is not a refractive default. It is a gradual loss of strength and elasticity of the crystallin which then prevents images from being focussed effectively on the retina. This reduces the eyes capacity to focus on near objects and vision becomes more blurred over the years.
This condition affects all normal eyes as well as eyes where there is already an optical defect. In these cases the existing condition coupled with presbyopia results in a more exaggerated visual defect.
To surgically correct presbyopia, there is more than one solution and the preferred option will depend on the individual case. Surgery normally involves modifying the form and shape of the cornea with the Excimer laser or simply replacing the defective crystallin.
Changing the form of the cornea by laser can create a stabilised environment. Another technique consists of adapting one eye to focus on near objects and the other on far objects.
The option to remove the crystallin and to replace it with a multifocal implant also exists.
A large number of factors influence patient suitability for this option, including age, profession, the state of the eye and the choice to except potential visual compromise.

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