What changes after 40
The natural lens inside the eye slowly loses its ability to change focus, a change called presbyopia. Phones, menus and labels need to move further away, and reading glasses usually arrive somewhere in your mid-forties. It happens to people who never needed glasses too, and to people who had laser years ago.
Your options by age
| Age | What is usually discussed |
|---|---|
| 40 to 45 | Laser for distance, knowing reading glasses will come; or blended vision |
| 45 to 50 | Blended vision or monovision with laser; an implantable lens in some cases |
| 50 and over | Lens replacement, often with a multifocal lens or blended vision; laser if the lens is healthy and the aim is distance only |
Blended vision and monovision
One eye is set for distance and the other a little nearer, so together you see far and near. With blended vision the difference is smaller and the brain blends the two. Many people adjust within a few weeks; some never do, which is why it is often tried with contact lenses first.
Why lens replacement becomes the better fit
From about 50 the natural lens is often starting to cloud as well as stiffen. Replacing it deals with the focusing problem and the start of a cataract in one operation, and the new lens can be chosen to reduce reading glasses. It costs €2,900 to €3,700 per eye, against €800 to €2,600 for laser.
Who should be careful
- Anyone under 18. Laser eye treatment is for adults, and most clinics want you a little older, once the prescription has settled.
- Anyone whose prescription changed in the last year. Wait until it has held steady.
- Pregnancy and breastfeeding, when hormones can change the prescription. Wait until things have settled.
- Keratoconus, or a cornea the scans show is too thin or irregular for laser.
- Uncontrolled diabetes, or an autoimmune condition or medicine that affects healing, without extra assessment first.
- Early cataract, glaucoma or macular problems, which change what is possible.
Questions people ask
Am I too old for laser eye surgery?
There is no fixed upper age. Over 45, the question is less your age than the state of your natural lens, which the assessment checks.
Will laser get rid of my reading glasses?
Only with blended vision or monovision. Standard laser for distance leaves you needing reading glasses once presbyopia arrives.
Is lens replacement worth it at 55?
For many people in their fifties it is the option that deals with both distance and reading, and it takes away the lens that would later cloud. An assessment tells you whether your eyes suit it.