Presbyopia Treatment Options: How to Get Rid of Reading Glasses

Short answer: There are lots of ways to treat presbyopia, the need for reading glasses that nearly everyone develops from around 40 (AAO). At Focus Vision the options include monovision or blended vision LASIK, READ treatment on the Alcon WaveLight EX500, the Allotex corneal inlay, refractive lens exchange with an extended depth of focus or multifocal lens, and, if you’ve already had cataract surgery, a multifocal upgrade lens. No single treatment is best for everyone. We assess your eyes and how you use them, and recommend the option that suits you.

What is presbyopia?

Inside your eye, the natural lens changes shape to focus up close. When you’re young it is “soft and flexible”; with age it “grows stiffer”, so it can no longer focus on near objects (AAO). “Nearly all adults experience presbyopia starting around age 40”, and there is no way to stop the ageing process behind it (AAO). It affects an estimated 1.8 billion people worldwide (Fricke et al., 2018).

The signs are familiar: holding your phone or a menu at arm’s length, needing brighter light to read, and eye strain after close work. Presbyopia keeps progressing into your 60s.

Your options at a glance

Treatment	How it works	Often suits
Monovision / blended vision LASIK	One eye set for distance, the other slightly for near	40s and 50s, clear natural lens, with or without a distance prescription
READ on the Alcon EX500	Laser shapes the cornea to extend its range of focus, usually with a small difference between the eyes	People who want to reduce reading glasses with laser, with a smaller difference between the eyes
Allotex corneal inlay	A thin donor-tissue disc in one eye adds near focus	Good distance vision, only reading glasses needed
Refractive lens exchange	Natural lens replaced with an EDOF or multifocal lens	From the 50s, or with early lens changes
Multifocal upgrade lens	A second lens added in front of an existing lens implant	People who’ve already had cataract surgery with a standard lens
Glasses, contacts, drops	No surgery	Anyone, especially early presbyopia

Non-surgical options

Reading glasses and multifocal glasses are simple and reliable. Contact lenses, either multifocal or monovision (one eye for distance, one for near), work for many people; monovision contact lenses succeed in roughly 59% to 67% of wearers who try them (EyeWiki). A monovision contact lens trial is also the best way to find out whether you’d be comfortable with monovision LASIK, and we can arrange one.

Eye drops. Pilocarpine 1.25% (Vuity) was approved in the United States in 2021. It narrows the pupil to improve near focus for up to about six hours, and must be used every day (AAO; EyeWiki). The most common side effects are headache and red eyes, and rare retinal tears and detachments have been reported (FDA label). As far as we are aware, presbyopia drops are not approved for this use in Australia.

Monovision and blended vision LASIK

With monovision LASIK, your dominant eye is set for distance and your other eye slightly short-sighted for near. Your brain learns to use each eye for what it does best. Monovision is set at different strengths: a smaller difference for early presbyopia, and a larger one for older patients who need more reading power (EyeWiki). Blended vision uses a smaller difference between the eyes, so the two ranges of focus overlap and feel more natural. At Focus Vision, LASIK is performed on the Alcon WaveLight EX500. See Laser Blended Vision. For a fuller comparison, read monovision vs blended vision.

What the evidence shows:

• In 294 people with good distance vision who had monovision LASIK, the proportion who could read at 20/40 or better without glasses rose from 4.7% to 88.9%, and 85% were satisfied or very satisfied (Peng et al., 2018).
• In another study of people over 45 who had monovision after refractive surgery, 88% were satisfied (Jain et al., 2001).
• A related approach on another laser platform, which combines a small difference between the eyes with an extended depth of focus, largely preserved depth perception in most patients (Russo et al., 2022).

The trade-offs. The larger the difference between the eyes, the more depth perception and contrast can be reduced (EyeWiki). Some people find they simply cannot adapt to monovision, which is why a contact lens trial before surgery is usually recommended (AAO). Some people like distance glasses for night driving.

READ treatment on the Alcon EX500

READ is an Alcon treatment for presbyopia performed on the WaveLight EX500, the laser we use for LASIK. Rather than relying only on a difference in focus between the two eyes, it shapes the cornea to extend each eye’s range of focus, and is usually combined with a smaller difference between the eyes than standard monovision.

Laser treatments that change the shape (asphericity) of the cornea to extend its range of focus have been studied on the same laser platform. In a study of long-sighted patients treated with this approach, the authors reported better depth of focus than monovision contact lenses (Rahmania et al., 2021), and an earlier study found the planned change in corneal shape was achieved accurately and reproducibly (Courtin et al., 2016). As with any laser treatment for presbyopia, the natural lens keeps ageing, and your surgeon will discuss whether READ suits your eyes and prescription.

The Allotex corneal inlay

For people who see well in the distance and only need reading glasses, the Allotex corneal inlay adds near focus to the non-dominant eye without changing the distance prescription. It is a wafer-thin disc of sterilised donor corneal tissue, about 2.6 mm across, placed in the cornea over the pupil. Earlier synthetic inlays were withdrawn because of corneal haze and night-vision problems (AAO); the Allotex inlay is human tissue.

In a four-year European trial of 101 patients, 98.6% could read at 20/40 or better (newsprint) with both eyes at four years, distance vision was maintained, and three inlays were removed without lasting harm (European multicentre trial, J Refract Surg). In a three-year study, near vision improved significantly in the treated eye, with a one-line loss of best-corrected vision in that eye in 24% of patients (Keskin Perk et al., 2023). Because it can be removed, it is the most reversible surgical option.

Lens replacement (refractive lens exchange)

From your 50s, or once your natural lens shows early changes, refractive lens exchange is often the best long-term choice. Your natural lens is replaced with an artificial lens that gives a wider range of focus: an extended depth of focus (EDOF) lens, a multifocal (trifocal) lens, or the Rayner Galaxy spiral lens, which in early results gave a range of vision comparable to a trifocal with fewer halos than diffractive trifocal lenses (J Refract Surg, 2025). Because the natural lens is removed, the result doesn’t drift with age, and a cataract can never develop. See our RLE guide for how the lenses compare.

Two options designed to be reversible:

• If you want multifocal vision with a way back, Liberty2 places a monofocal lens and a removable multifocal AddOn lens at the same operation.
• If you’ve already had cataract surgery with a standard lens, a multifocal upgrade lens can often be added in front of it.

See multifocal upgrade lens after cataract surgery for both.

Which treatment is right for you?

There are lots of treatments for presbyopia, and the best one depends on you. At your assessment we look at:

• your age and your natural lens. Laser and inlays work with your natural lens, which keeps ageing; lens replacement removes it.
• whether you also need distance correction. Monovision LASIK and READ can treat both; the inlay suits people with good distance vision.
• the shape, thickness and health of your cornea, and your tear film.
• how you use your eyes: reading, screens, night driving, sport.
• how you feel about compromises such as halos at night or a small loss of depth perception, often tested with a contact lens trial first.

As a general guide: in your 40s with a clear lens, laser (monovision, blended vision or READ) or the inlay often suits; from the mid-50s, or with any lens change, lens replacement usually gives the more lasting result; and with a cataract, cataract surgery with a premium lens. We will determine which is best for your eyes, and explain why.

What it costs

LASIK, including monovision and blended vision, is from $4,250 per eye, all-inclusive; refractive lens exchange is from $6,000 per eye, including the anaesthetist. Prescribed medications and eye drops are extra (costs page). Interest-free plans over 24 months are available. Medicare doesn’t cover surgery done to reduce your need for reading glasses; cataract surgery, when a cataract is present, is Medicare-eligible. If a small prescription remains once your eyes are stable, enhancements are free for two years under our enhancement policy.

Outcomes we measure

Freedom from reading glasses depends on hitting the planned prescription, so our surgeons audit their results with the free Refractive Outcomes Analyzer they built and shared with eye surgeons worldwide, benchmarking against published international standards.

Get in touch

To find out which presbyopia treatment suits your eyes, book a free optometrist assessment, call (07) 3239 5005 or email hello@focusvision.com.au.

References

1. American Academy of Ophthalmology. What is presbyopia? EyeSmart. aao.org/eye-health/diseases/what-is-presbyopia
2. Fricke TR, Tahhan N, Resnikoff S, et al. Global prevalence of presbyopia and vision impairment from uncorrected presbyopia: systematic review, meta-analysis, and modelling. Ophthalmology. 2018;125(10):1492-1499. aaojournal.org
3. American Academy of Ophthalmology. Presbyopia treatment. EyeWiki. eyewiki.aao.org/Presbyopia_treatment
4. American Academy of Ophthalmology. Vuity. EyeWiki. eyewiki.aao.org/Vuity
5. U.S. Food and Drug Administration. Vuity (pilocarpine hydrochloride ophthalmic solution) 1.25%: prescribing information. NDA 214028. accessdata.fda.gov
6. American Academy of Ophthalmology. Monovision LASIK. EyeWiki. eyewiki.org/Monovision_LASIK
7. Peng MY, Hannan S, Teenan D, et al. Monovision LASIK in emmetropic presbyopic patients. Clin Ophthalmol. 2018;12:1665-1671. pubmed.ncbi.nlm.nih.gov/30233129
8. Jain S, Ou R, Azar DT. Monovision outcomes in presbyopic individuals after refractive surgery. Ophthalmology. 2001;108(8):1430-1433. pubmed.ncbi.nlm.nih.gov/11470695
9. Russo A, Reinstein DZ, Filini O, et al. Visual and refractive outcomes following laser blended vision with non-linear aspheric micro-anisometropia (PRESBYOND) in myopic and hyperopic patients. J Refract Surg. 2022;38(5):288-297. pubmed.ncbi.nlm.nih.gov/35536710
10. American Academy of Ophthalmology. What is monovision or blended vision? EyeSmart. aao.org/eye-health/treatments/what-is-monovision-blended-vision
11. Rahmania N, Salah M, Rampat R, Gatinel D. Clinical effectiveness of laser-induced increased depth of field for the simultaneous correction of hyperopia and presbyopia. J Refract Surg. 2021;37(1):16-24. pubmed.ncbi.nlm.nih.gov/33432991
12. Courtin R, Saad A, Grise-Dulac A, et al. Changes to corneal aberrations and vision after monovision in patients with hyperopia after using a customized aspheric ablation profile to increase corneal asphericity (Q-factor). J Refract Surg. 2016;32(11):734-741. pubmed.ncbi.nlm.nih.gov/27824376
13. American Academy of Ophthalmology. KAMRA and Raindrop corneal inlays: what patients need to know. EyeSmart. aao.org
14. Corneal allograft for near vision improvement in emmetropic presbyopia: 4-year safety and efficacy results from a prospective European multicenter clinical trial. J Refract Surg. doi:10.3928/1081597X-20251202-02. pubmed.ncbi.nlm.nih.gov/41665327
15. Keskin Perk FFN, Taneri S, Tanriverdi C, et al. Increasing depth of focus with allogeneic presbyopic inlays: 3-year results. J Cataract Refract Surg. 2023;49(10):1005-1010. pubmed.ncbi.nlm.nih.gov/37487178
16. Performance of the first spiral refractive intraocular lens for continuous full range of vision. J Refract Surg. 2025. doi:10.3928/1081597X-20250829-01. journals.healio.com