Why Is the Pre-LASIK Eye Examination Important, and Why Does It Take Up to 3 Hours?

Having both myopia and farsightedness together refers to a condition where both near and distant vision are unclear, commonly occurring in people with myopia who begin to develop age-related presbyopia. Both myopia and farsightedness can be treated simultaneously with glasses, contact lenses, LASIK surgery, or intraocular lens implantation, depending on an ophthalmologist’s recommendation. The choice of treatment depends on vision prescription, age, corneal thickness, and professional advice from an ophthalmologist. Having both myopia and farsightedness simultaneously is a condition found in some adults, particularly when individuals with myopia begin to develop presbyopia. This causes abnormalities in both near and distance vision, affecting daily activities such as reading, working on screens, or driving. Understanding the causes and treatment options helps patients choose appropriate, safe, and effective eye care solutions.     What Does Having Both Myopia and Farsightedness Mean? Having both myopia and farsightedness means both near and distant vision become unclear. People who already have myopia may use glasses to improve distance vision, but when presbyopia develops with age, those same glasses may no longer provide clear near vision, requiring adjustments or new lenses.   In people with myopia, the issue is mainly due to the eye’s physical structure — either an elongated eyeball or an overly curved cornea — causing incoming light to focus in front of the retina. This results in blurred distance vision and often develops during childhood or adolescence.   Presbyopia, on the other hand, is unrelated to eyeball length. It is a natural age-related condition typically beginning after age 40. The crystalline lens inside the eye gradually loses elasticity and the focusing muscles weaken, reducing the eye’s ability to focus on near objects.   When both conditions occur together, the structural myopia remains unchanged while age-related lens stiffness develops concurrently.   This situation can be challenging: distance vision remains blurry due to existing myopia, while wearing myopic glasses may worsen near vision because the aging lens can no longer adjust focus effectively.   However, individuals with mild myopia (around -1.00 to -2.00 diopters) may sometimes read comfortably without glasses because their natural focal point aligns with reading distance. Once they wear myopic glasses again, near vision blur often returns.     Correction and Treatment Options Treatment focuses on ensuring incoming light accurately focuses on the retina. Options generally fall into three main categories:   1. External Vision Correction Devices Using external devices is a safe and easily adaptable option for those with both myopia and farsightedness.   Progressive Eyeglasses Progressive lenses are currently the most popular option and represent a modern standard for working adults. These seamless lenses gradually change prescription from top to bottom — distance correction at the top, intermediate vision in the middle (e.g., computer use), and near vision at the bottom.   The main advantage is clear vision at all distances without switching glasses. They also lack visible dividing lines, maintaining a youthful appearance. However, some users may need a short adaptation period.   Contact Lenses Multifocal contact lenses function similarly to progressive glasses, incorporating multiple prescriptions in a single lens. They often use concentric ring designs to support both near and distance vision.   The brain adapts by selecting the clearest image automatically. While convenient and glasses-free, sharpness may be slightly reduced compared with eyeglasses, particularly in low light, and adaptation may take time.   Another option is monovision, where one eye is corrected for distance (dominant eye) and the other for near vision. The brain combines both images for functional daily vision.   This approach is often more affordable than multifocal lenses but may slightly reduce depth perception, affecting night driving or 3D perception in some individuals.   A combined approach involves wearing myopia-correcting contact lenses for clear distance vision and using reading glasses only when needed. This provides excellent clarity at lower cost but does not eliminate glasses entirely.   Because fitting contact lenses for this condition is complex, professional evaluation by an ophthalmologist or optometrist is essential.   One drawback may be higher long-term costs and the need for careful lens hygiene.   2. Laser Vision Correction LASIK (Laser-Assisted in Situ Keratomileusis) permanently corrects refractive errors including vision prescriptions such as myopia, hyperopia, and astigmatism. The procedure involves creating a corneal flap, reshaping the cornea with laser energy, and repositioning the flap. Recovery is typically quick, with clearer vision often within 24–48 hours. Temporary dry eyes, glare, or halos at night may occur during adjustment.   It is suitable for individuals wanting to reduce reliance on glasses or contact lenses with adequate corneal thickness. Those with severe dry eyes, chronic eye disease, or unsuitable prescriptions may consider PRK or refractive lens exchange (RLE).   3. Intraocular Lens Implant Surgery RLE (Refractive Lens Exchange) involves replacing the natural lens with an artificial intraocular lens (IOL). It is suitable for individuals with significant combined myopia and farsightedness or presbyopia. Modern IOLs can correct multiple refractive errors simultaneously.     How to Choose the Right Treatment Selecting the best treatment depends not only on visual clarity needs but also on several factors:   Lifestyle and preferences: Glasses or contact lenses suit those avoiding surgery, while LASIK or RLE offer longer-term solutions. Overall eye health: Detailed eye examinations assess corneal thickness, retinal health, and other conditions to determine safe treatment. Cost considerations: Surgical treatments typically cost more upfront than glasses or contact lenses. Expected outcomes: Laser surgery may reduce but not always eliminate the need for reading glasses.     Why Choose LASER VISION Center at Bangkok Eye Hospital? Bangkok Eye Hospital provides comprehensive eye care with advanced technology at the LASER VISION Center and experienced ophthalmologists. Services include accurate diagnosis, treatment for myopia, hyperopia, and other vision problems, along with continuous follow-up care. The hospital emphasizes personalized consultation, appropriate treatment recommendations, and a supportive environment for safe, comprehensive eye care.   Summary Combined myopia and farsightedness occur when individuals with myopia develop age-related presbyopia, causing both near and distance vision difficulties. Existing myopic glasses may improve distance vision but not near vision. Correction options include glasses, contact lenses, LASIK, or intraocular lens surgery. The best choice depends on prescription, age, eye health, and lifestyle. For comprehensive diagnosis and treatment, visit Bangkok Eye Hospital, equipped with advanced technology, specialists, and dedicated eye care centers.   Related Articles Understanding Vision Prescriptions and Their Impact on Daily Life PRK vs LASIK: Eye Surgery Techniques You Should Know Before Deciding FemtoLASIK: Advanced, Safe, and Precise Vision Correction Technology Frequently Asked Questions (FAQ) People with both myopia and farsightedness often have questions about symptoms and treatment options. Here are common FAQs:   Can LASIK treat both myopia and farsightedness? Yes, LASIK can treat both conditions, but suitability depends on corneal thickness and eye health. Some patients may require alternative options such as intraocular lenses for optimal safety and results.   How should contact lenses be chosen? People with combined refractive errors may use multifocal or progressive contact lenses designed for multiple focusing distances. Consultation with an ophthalmologist or contact lens specialist is recommended for proper selection.   What are the symptoms? Symptoms include blurred near and distance vision. Individuals who previously used myopic glasses may find distance vision clear but struggle with reading or phone use due to presbyopia, requiring adjustments in eyewear.

Age-related presbyopia is a condition caused by the gradual hardening of the eye’s natural lens, leading to difficulty seeing objects up close. It commonly occurs in people aged 40 and above. Treatment options for presbyopia include reading glasses, progressive lenses, multifocal contact lenses, LASIK for presbyopia, and intraocular lens replacement. At Bangkok Eye Hospital, presbyopia can be treated with Presby-LASIK at the LASER VISION Center, supported by experienced ophthalmologists and state-of-the-art technology. As we age, developing farsightedness is a natural process, especially after the age of 40. This condition is known as age-related presbyopia. It occurs when the crystalline lens of the eye, which was once flexible, gradually becomes rigid. As a result, focusing on close objects—such as reading books or viewing a smartphone—becomes more difficult and causes blurred vision.     What Is Age-Related Presbyopia? As we grow older, the crystalline lens loses its flexibility, and the eye muscles responsible for focusing also weaken. This makes it difficult for the eyes to adjust focus for near objects. This condition is different from congenital hyperopia, which is a refractive error present from birth.     Treatment Options for Presbyopia Understanding the available options for correcting age-related presbyopia helps patients choose solutions that best suit their lifestyle and visual needs.   Reading Glasses Reading glasses are the simplest method for correcting presbyopia. They can be purchased as ready-made glasses or customized through a comprehensive eye examination for greater accuracy. The lens power can be adjusted to match individual reading distances, helping to reduce eye strain.   Progressive Lenses Progressive lenses are ideal for individuals who want a single pair of glasses that provides clear vision at all distances—near, intermediate, and far. These lenses feature a smooth transition of lens power, allowing natural focus adjustment and reducing neck strain from frequent visual shifts.   Multifocal Contact Lenses Multifocal contact lenses are an excellent option for those who prefer not to rely on glasses. These lenses contain multiple focusing zones designed for near, intermediate, and distance vision simultaneously. Lens parameters can be tailored to specific activities such as computer use or driving.   LASIK/PRK (Monovision) In this technique, laser correction is applied differently to each eye—one eye is optimized for distance vision, while the other is corrected for near vision. The brain learns to combine images from both eyes, enabling clear vision at both ranges.   Presby-LASIK Presby-LASIK is a laser-based surgical technique designed to reshape the cornea to create multiple focal zones within the same eye. This allows patients to see clearly without relying on glasses or contact lenses. It is ideal for individuals aged 40+ who wish to reduce dependence on reading glasses.   Presbyopia Treatment with Intraocular Lens (IOL) Implantation Lens replacement surgery involves removing the eye’s natural lens and replacing it with an artificial Multifocal IOL. These lenses correct multiple vision problems simultaneously, including farsightedness, nearsightedness, astigmatism, and presbyopia.     How to Choose the Right Presbyopia Treatment Selecting the most appropriate treatment depends on several factors, including lifestyle, personal preferences, and overall eye health. Consultation with an ophthalmologist is recommended to determine suitability, expected outcomes, and budget considerations.   Why Choose LASER VISION Center at Bangkok Eye Hospital? Bangkok Eye Hospital provides comprehensive eye care services supported by advanced technology at the LASER VISION Center. Emphasis is placed on personalized consultation and a friendly environment to ensure patients feel confident throughout their treatment journey.   Summary Presbyopia can be treated through various methods ranging from reading glasses to advanced surgical solutions such as Presby-LASIK and refractive lens exchange (RLE). Choosing the right treatment should consider eye health, lifestyle needs, and desired outcomes to achieve the most comfortable vision possible.   Frequently Asked Questions (FAQ) How long does LASIK for presbyopia last? The corneal changes from LASIK are permanent. However, age-related changes in the natural lens may continue. Some patients may still require reading glasses in the future as the lens continues to age.   Can presbyopia be treated naturally? Natural methods cannot permanently correct presbyopia but may relieve symptoms. These include eye exercises, visual breaks, proper lighting, and consuming eye-nourishing foods like leafy greens and carrots.   Can presbyopia resolve on its own? No, age-related presbyopia does not resolve naturally. It is caused by the physiological hardening of the lens and requires correction through optical or surgical means.