If you are 40 or older or have severe vision problems, you may want to discuss these options with your eye surgeon:

(Please read our previous article about LASIK vs PKR Surgery options)

Monovision. With this approach, LASIK may be used to correct one eye for distance vision and the other eye for near vision as a solution for presbyopia, a focusing problem that affects all people beginning at around age 40.

However, some people cannot adjust to monovision. You might first consider wearing contact lenses providing monovision or trying it with “trial lenses” in your doctor’s office, to make sure this approach works for you.

Multifocal or Accommodating IOLs. If you choose this type of lens for a refractive lens exchange or cataract surgery, your eye’s natural lens will be replaced permanently.

These artificial lenses potentially can restore a full range of vision, but can also produce side effects such as decreased depth perception or night vision problems in the form of halos or glare.

Also, you may still need to wear eyeglasses or contact lenses or have a “laser touch-up,” because it’s possible the lenses will fall short of restoring a full range of vision. Be sure and discuss the pros and cons of these new lenses with your eye surgeon.

Vision Correction for Severe Nearsightedness or Farsightedness. LASIK, PRK and other laser vision correction procedures do have their limitations and may not be the best option for you if you have severe nearsightedness or farsightedness. Some eye surgeons consider implantable lenses (Visian ICL and Verisyse) the best option for extreme nearsightedness.

Refractive lens exchange, in which the eye’s natural lens is replaced with an artificial one, is a possible option for extreme farsightedness. Particularly if you are older than 40, you also might need to consider multiple vision correction solutions to achieve the very best possible vision for your age and lifestyle.

For instance, you might choose LASIK or PRK in your 30s to correct distance vision. Then, when you reach your mid-40s and your near vision is affected by presbyopia, you might follow up with an “enhancement” using conductive keratoplasty.

With CK in one eye, you may be able to sharpen near vision blurriness caused by the age-related condition of presbyopia.

Most eye surgeons will tell you it’s unlikely that any vision correction procedure can give you permanent, optimal vision for a lifetime. Just as you probably needed to change out eyeglasses and contact lenses in the past, you very likely will need a LASIK enhancement or other surgical correction as you grow older, to maintain good vision.

Also, keep in mind that all vision correction procedures have the usually slight risk of side effects that can range from mild to severe. So be sure you discuss all options and potential risks in detail with your eye surgeon or eye care provider before making any final choices.

Very important: Always discuss and make these decisions based upon a formal appointment with your optician, health care professional and/or eye surgeon.

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