Post-Cataract Surgery Presbyopia: What to Expect - Ophthalmology

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Understanding post-cataract surgery, especially when it involves the implantation of monofocal intraocular lenses (IOLs), is crucial for patients to set realistic expectations regarding their vision. After cataract surgery, many patients experience significant improvements in their vision, particularly for distance. However, the choice of a monofocal lens means that the lens is designed to provide clear vision at one specific distance, typically far away. This is where the issue of presbyopia comes into play.

Presbyopia is a condition that typically begins to affect individuals in their 40s and 50s, characterized by a gradual loss of the eye's ability to focus on nearby objects. This condition is a natural part of aging and is not directly caused by cataract surgery. When a patient undergoes cataract surgery and receives a monofocal lens, they will likely find that they need reading glasses for close-up tasks, such as reading or sewing, especially if they had previously relied on bifocals or progressive lenses.

Regarding your specific question about the degree of presbyopia after surgery: the exact amount of near vision correction needed can vary widely among individuals. Typically, patients who have undergone cataract surgery with a monofocal lens may find that they need reading glasses for tasks that are within 12 to 18 inches from their eyes. The strength of the reading glasses required can range from +1.00 to +3.00 diopters, depending on the individual's age and the natural progression of presbyopia.
As for whether presbyopia will continue to increase with age, the answer is yes. Presbyopia is progressive, meaning that as you age, the lens of your eye becomes less flexible, making it increasingly difficult to focus on close objects. This means that even after cataract surgery, you may find that your need for reading glasses increases over time.
It's also worth noting that some patients opt for multifocal or accommodating IOLs, which can provide a broader range of vision, including near, intermediate, and distance vision. However, these lenses may come with trade-offs, such as reduced contrast sensitivity or halos around lights at night.

In summary, after cataract surgery with a monofocal lens, you can expect to need reading glasses for near tasks, and the degree of correction required will likely increase as you age due to the natural progression of presbyopia. Regular follow-up appointments with your eye care professional will help monitor your vision and adjust your prescription as needed. If you have further concerns or specific questions about your vision post-surgery, it would be beneficial to discuss them with your ophthalmologist, who can provide personalized advice based on your individual circumstances.