Presbyopia Treatments

Close Focus and Reading

In our modern, multi-tasking world, people are often challenged by viewing different items at different distances. We want perfect vision for all ranges — cell phones, computer monitors, tablets, newspapers, price tags, dashboard instruments, road signs, food on a dinner plate, sheet music, the channel guide on TV, night driving on the freeway, and in a movie theater.

If you’re over 45, you have probably noticed that your reading clarity is not what it used to be. If you are now having difficulty seeing your cell phone, computer monitor, restaurant menu or newspaper, you’re not alone. Everyone will eventually experience presbyopia, or the inability to focus on objects up close.

Reading glasses and bifocals are the most common answer, but there are other treatment options that allow Dr. Amir Moarefi and LA Sight to restore vision at all distances without glasses or contacts.



The human lens is made of protein; it’s transparent and very flexible when we’re young. The lens is surrounded by a circular muscle and when this muscle contracts, the lens changes its shape, enabling focus adjustment on objects up close, much like an auto-focus camera.

As we age, extra layers of protein that naturally develop cause the lens to become more rigid. As a result, we lose our ability to flex the lens when we shift our focus. This condition is called presbyopia, and is what causes the need for reading glasses or bifocals.

Since it is a condition of the lens and a natural part of the aging process, it affects everyone, usually at about 45 years of age. Normal glasses and contact wearers, people with perfect vision, and even people who received laser vision correction will all develop presbyopia at some point in their lifetime.

Loss of clarity at close range is a direct consequence of presbyopia. One of the oldest solutions is to use simple magnifying glasses if you don’t need any distance prescription. Alternatively, if a distance prescription is worn, then bifocals (a lens with two different focal properties, originally invented by Benjamin Franklin) will correct for the two different focal ranges, distance (upper section) and reading (lower section).

When reading about any proposed surgical option that tries to correct for loss of reading comfort, it’s important to understand that no corneal surgery can reverse or optically correct for loss of accommodation in the human lens. These and other surgical options can at best afford optical compromise solutions — they are imperfect treatments, but not a cure. Some of them are in our opinion “not quite ready for prime time”. We’ll still endeavor to describe them in this section.


If You Desire Near and Distance Vision

At present there’s a relatively short list of existing and emerging technology attempting to restore reading vision.

  • Reading Glasses or Bifocals – These are by far the most time-honored, cost-effective and prevalent solution available in the modern world. With the obvious limitation that glasses are required for reading.
  • Multifocal Contact Lenses – Although various types of multifocal soft contact lenses have been around for over 25 years, they have their limitations. Generally, even when fit by an expert, these are not highly successful long-term solutions. Part of the reason is optical (blur at distance when viewing through the reading portion of the lens and vice versa), part is functional (computer monitor viewing creates different visual demands than when looking down to read, etc.) and part is climate-related. In the Los Angeles area, which is hot, dry, dusty and sometimes smoggy, it’s difficult for most people of presbyopic age to comfortably tolerate contact lens wear for prolonged periods.
  • Monovision
  • Multifocal lens implant
  • Extended Depth of Focus (“EDOF”) lens implant
  • Apthera IC-8 Lens Implant
  • Clear Lens Exchange (cataract style surgery with IOL placement)



A popular solution for seeing without readers, monovision takes advantage of the brain’s natural tendency to rely on your dominant eye for distance vision, and your non-dominant eye for close up sight.

With monovision correction by LASIK, one eye is corrected for distance, and the other eye is adjusted for near-range vision. While this may seem awkward, many people adapt nicely and enjoy good viewing comfort at near and far distances.

Monovision has been used for years with contact lenses, and can be a great option for anyone looking to reduce their dependence on readers. It is not a perfect solution and it’s not for everyone, which is why we suggest trying monovision first with soft contact lenses. Monovision is an acceptable option for many (but not all!) individuals who desire to avoid reading and distance glasses. Like reading glasses and bifocals, it’s not a perfect solution to the optical challenges of presbyopia. With monovision, when driving at night, the near-focused eye will see blurry at distance, so driving comfort, depth perception and night viewing comfort can be diminished. Some who enjoy monovision do have a pair of eyeglasses they keep in the console of their car to correct the near eye for distance, which resolves these issues. Monovision is a compromise, and it is not for everybody. If a group of people try monovision correction in soft contact lenses, roughly 40% will like it. About 30% will feel uncomfortable or off-balance. The last 30% will have difficulty making a decision one way or the other. The best way to know if monovision will work for you is to try it in contact lenses. We find that satisfaction with monovision laser treatment is extremely high if people understand the limits of presbyopia and participate in the process of choosing whether or not to have monovision-style treatment.


Multifocal Lens Implants

Multifocal lens implants, also known as multifocal intraocular lenses (IOLs), are a remarkable advancement in ophthalmic surgery that addresses presbyopia and cataracts simultaneously. These innovative lenses provide individuals with the ability to see clearly at various distances, reducing or even eliminating the need for glasses or contact lenses for most daily activities.

Multifocal Lenses for Cataract Surgery Available at LA Sight Los Angeles, CA

Images of several types of multifocal IOLs

Multifocal lens implants work by Diffractive and Refractive Zones. Multifocal IOLs have specific zones within the lens that are designed to bend light in different ways. Diffractive zones split incoming light into multiple focal points, while refractive zones change the lens’s power, allowing for clear vision at varying distances. One of the key features of multifocal lens implants is their ability to leverage the brain’s natural adaptation mechanism. Over time, the brain learns to select the appropriate focal point for the given task, such as reading a book or looking at a distant object.


Benefits of multifocal lens implants include:

  • Reduced Dependence on Glasses: Multifocal IOLs aim to provide clear vision for both near and distant objects. While glasses may still be required for certain tasks, such as reading fine print in low light, the reliance on glasses is significantly reduced.
  • Enhanced Quality of Life: The freedom from constantly switching between reading glasses and distance glasses can greatly improve an individual’s quality of life. Activities like driving, watching TV, and using digital devices become more convenient and enjoyable.
  • Improved Independence: Multifocal IOLs are particularly beneficial for individuals who want to maintain an active lifestyle without the constant hassle of glasses or contact lenses. They can travel, participate in sports, and engage in outdoor activities with greater ease.
  • Presbyopia and Cataract Correction: Multifocal IOLs effectively address both presbyopia and cataracts in one surgical procedure. This eliminates the need for separate surgeries and enhances visual outcomes.

While multifocal lens implants offer significant advantages, they may not be suitable for everyone. Factors such as overall eye health, corneal conditions, and lifestyle preferences must be considered. It’s essential to consult with Dr. Amir Moarefi who can assess your unique needs and determine the most appropriate lens option for you.

Extended Depth of Focus (“EDOF”) Implants

Extended Depth of Focus (EDOF) lenses are a cutting-edge advancement in the world of vision correction. These lenses offer several significant benefits for individuals seeking to improve their visual acuity across a range of distances while minimizing the drawbacks associated with traditional multifocal lenses.

Key advantages of EDOF lenses:

  • Clear Vision at Multiple Distances: EDOF lenses are engineered to provide clear vision not only at a single fixed distance (e.g., near or far) but also across a broader spectrum of distances. This means you can enjoy improved vision for activities like reading, using digital devices, working on a computer, and even driving without the need for frequent adjustments or the inconvenience of switching between different pairs of glasses.
  • Enhanced Visual Quality: Compared to some traditional multifocal lenses, EDOF lenses often offer improved visual quality with minimal visual disturbances such as glare or halos around lights, which can be particularly bothersome during nighttime driving. The design of EDOF lenses helps reduce these optical aberrations, leading to a more comfortable and natural visual experience.
  • Reduced Dependence on Glasses: EDOF lenses aim to reduce the reliance on glasses for most daily activities. While you may still need reading glasses for very fine print or certain low-light conditions, EDOF lenses significantly minimize the need for both reading and distance glasses. This newfound independence can greatly enhance your quality of life and convenience.
  • Seamless Adaptation: Unlike monovision LASIK, where one eye is corrected for distance vision and the other for near vision, EDOF lenses provide a more seamless transition between distances. Your brain learns to naturally adjust to different distances, making the adaptation process smoother and more comfortable. EDOF lenses are an excellent choice for individuals with active lifestyles who engage in various activities. Whether you’re playing sports, traveling, or pursuing outdoor hobbies, EDOF lenses allow you to see clearly.

Extended Depth of Focus (EDOF) lenses represent a remarkable advancement in vision correction technology, offering a wide range of benefits that can significantly enhance your daily life. These lenses provide clear vision at multiple distances, reduce the need for glasses, and offer improved visual quality, making them a compelling choice for those seeking freedom from the limitations of traditional eyewear.

Alcon Vivity EDOF Lens Implant at LA Sight Los Angeles
Alcon Vivity EDOF Lens Implant
EDOF with Astigmatism Correction
An EDOF IOL containing astigmatism correction (identified by the three peripheral dots)

Apthera IC-8 Lens

A game changer in vision correction surgery, The Apthera IC-8 lens is an innovative intraocular lens (IOL) that has garnered attention for its ability to revolutionize the way people experience vision correction. This cutting-edge technology offers several distinct benefits that set it apart from traditional IOLs and make it an attractive choice for individuals seeking improved visual outcomes after cataract surgery or refractive lens exchange.

Notable advantages of the Apthera IC-8 lens include:

  • Extended Range of Vision: The hallmark feature of the Apthera IC-8 lens is its capacity to provide an extended range of vision. Unlike standard monofocal IOLs that primarily correct distance vision, the Apthera IC-8 lens is designed to enhance vision at various distances, including near, intermediate, and far. This means you can enjoy clear vision for a wide range of daily activities, such as reading, using digital devices, working at a computer, driving, and watching TV, with minimal reliance on glasses.
  • Reduced Dependence on Glasses: With the Apthera IC-8 lens, many patients experience a significant reduction in their dependence on glasses or contact lenses for both near and intermediate tasks. While you may still require glasses for very fine print or certain low-light conditions, the need for glasses is notably diminished, leading to increased convenience and improved quality of life.
  • Enhanced Visual Quality: The Apthera IC-8 lens employs advanced optics to provide excellent visual quality. Patients often report minimal visual disturbances such as glare, halos, or reduced contrast sensitivity, making it well-suited for nighttime driving and low-light conditions. This improved visual quality contributes to greater comfort and satisfaction with the lens.
  • Balanced Binocular Vision: The Apthera IC-8 lens is designed to maintain balanced binocular vision, meaning both eyes work together seamlessly to provide clear and coordinated vision at various distances. This reduces the likelihood of visual discomfort or challenges associated with other types of multifocal IOLs.
  • Customized Implantation: The Apthera IC-8 lens is precisely customized to your individual eye measurements and visual needs. This personalized approach ensures that the lens provides optimal vision correction tailored to your unique requirements.
  • Simplified Adaptation: Patients typically experience a smoother and more rapid adaptation to the Apthera IC-8 lens compared to some other multifocal IOLs. The brain quickly adjusts to the extended range of vision, leading to a more natural and comfortable visual experience.

The Apthera IC-8 lens represents a remarkable advancement in the field of intraocular lenses, offering a comprehensive solution for enhanced vision across a wide range of distances. Its ability to provide clear vision, reduce the need for glasses, and maintain excellent visual quality makes it an appealing choice for individuals seeking optimal visual outcomes and an improved quality of life after cataract surgery or refractive lens exchange.

Apthera IC-8 Lens Diagram | IOLs available at LA Sight
Apthera IC-8 Lens Diagram
Apthera IC-8 Lens Implant Available at LA Sight

Clear Lens Exchange (Refractive Lens Exchange)

Clear Lens Exchange (CLE), also known as Refractive Lens Exchange (RLE), is a surgical procedure that involves replacing the eye’s natural lens with an artificial intraocular lens (IOL) to correct refractive errors, such as nearsightedness, farsightedness, and presbyopia. CLE is a versatile option that offers several benefits and various lens choices tailored to individual needs. Benefits include:

  • Visual Freedom: One of the primary benefits of CLE is the liberation from glasses or contact lenses. By customizing the IOL, CLE can provide excellent visual acuity at various distances, reducing or eliminating the need for corrective eyewear.
  • Correcting Presbyopia: CLE is an effective solution for individuals struggling with presbyopia (age-related loss of near vision). Multifocal or EDOF IOLs used in CLE can help restore clear vision for reading and other up-close tasks.
  • Permanent Vision Correction: Unlike other vision correction procedures, such as LASIK, SMILE, or PRK, CLE offers a long-term solution. Once the natural lens is replaced with an IOL, it generally does not change over time, providing stable vision correction.
  • Treatment for Cataracts: CLE can be performed as an early intervention for cataracts, improving vision before the cataracts become significantly impairing. Cataract development is a common age-related condition, and CLE can address both the cataract and refractive errors simultaneously.

Options in Clear Lens Exchange:

  • Monofocal IOLs: These lenses provide clear vision at one specific distance, typically chosen to be either for distance or near vision. Many individuals opt for monofocal IOLs for a single-focus correction, often choosing distance vision, and then using glasses for tasks that require up-close vision.
  • Multifocal IOLs: Multifocal IOLs, as the name suggests, offer multiple focal points, allowing for good vision at various distances, including near, intermediate, and far. These IOLs reduce or eliminate the need for glasses in most situations.
  • Toric IOLs: Toric IOLs are designed to correct astigmatism, a condition where the cornea or lens is irregularly shaped, leading to blurred or distorted vision. These specialized lenses can address both astigmatism and other refractive errors.
  • Extended Depth of Focus (EDOF) IOLs: EDOF IOLs provide a continuous range of clear vision, from near to intermediate to distance. They are designed to minimize visual disturbances like halos and glare, offering high-quality vision.

The choice of CLE procedure and IOL depends on individual factors such as eye health, lifestyle, and personal preferences. Consulting with Dr. Amir Moarefi is crucial to determine the most suitable option for achieving optimal visual outcomes and enhancing the quality of life through Clear Lens Exchange.


Reading Vision Consultation

Our goal at LA Sight is to provide patients with the most accurate and unbiased information possible, so that you may make the best decision for your vision. We understand that to choose to undergo any surgical procedure requires careful consideration and planning. That’s why we offer patients a comprehensive reading vision consultation and screening so that you can feel comfortable and educated about your options.

We’ve helped thousands of patients reduce their dependence on reading glasses. if you’re interested in learning more about your options available to ditch the readers for good, then schedule your free consultation with LA Sight today. We’ll be happy to evaluate your vision, and help determine the best course of action for your needs.