February 26, 2022 | Lasik

The Things to Know For Lasik Over 55 Years of Age

By Barrett Eubanks, M.D.

The Things to Know For Lasik Over 55 Years of Age

Thinking of getting lasik? When you reach a certain age there are a few more things to think about. It can still work, but some things are just done differently. So what can you expect after the age of 55?

After the age of 55, lasik can still provide glasses independence through a technique called mini-monovision or monovision. It can work well for some individuals but is less effective for others. Also, lasik won't last forever - eventually cataracts will develop necessitating cataract surgery to fix.

Lasik still can be worth it for the right people despite the additional limitations that age causes. For others, however, there is an alternative procedure called lens replacement surgery which can be a better option to correct vision.

The Age of Presbyopia

The biggest difference for those getting lasik above the age of 55 is the presence of presbyopia.

Specifically, presbyopia occurs when the natural lens inside our eye loses the ability to focus up close. This starts to occur within the mid-40s and by the age of 55, this lens just doesn't do much anymore.

This causes difficulty reading up close! This lens becoming weaker is the reason you start to need reading glasses, bifocals or progressive glasses in order to see things up close (however for some - the nearsighted individuals, they find they see better up close without their glasses and end up taking off their glasses to read instead).

Distance Lasik Correction

Presbyopia presents challenges when doing a lasik correction.

When younger people get lasik, both eyes are corrected fully for the distance. This provides great clear distance vision. Because younger individuals have no issues with their natural lens being able to focus up close (they haven't reached the age of presbyopia), these lasik treated individuals can also see up close just fine as well.

But if we were to correct distance vision for someone with presbyopia, they would have great clear distance vision, but they would have trouble seeing up close. Same as with their contact lenses, their lens won't be able to focus up close and they would need reading glasses.

Correcting both eyes for distance can work well for certain individuals: those who have very active lifestyle outdoors and / or highly value distance vision (cycling, golf, hiking, professional drivers or pilots).

But correcting both eyes for distance can also be a bad solution for other individuals: those that are naturally nearsighted, who can see just fine up close without their glasses and spend much of their day on up close tasks (such as computer work, reading, etc.). By taking these individuals and correcting their vision for distance, you essentially just put them in reading glasses full time.

But there is another way to perform lasik.

Monovision or Mini-Monovision

Instead of correcting both eyes for distance, one can get out of glasses for both distance and reading vision through a technique called monovision.

With monovision, one eye is corrected for the distance, but the second eye is corrected for computer and reading vision. This covers the range of vision you need to function without glasses (mini-monovision is the same concept with just less difference between the two eyes).

As you can imagine, it does take some time to adjust to monovision. But over 90-95% are successful in adjusting to monovision after lasik.

When looking off in the distance, the up close eye will be blurry. This causes a sensation that the eyes are "fighting each other". This will also cause extra glare at night-time from the blurred up close eye.

But gradually over time, we adjust to this monovision set up and these symptoms continue to improve. Our brains are quite remarkable in what they can adjust to. If you've never worn a wrist watch before and then start wearing one, you will notice this watch all the time. But gradually over time, you start to forget that you are wearing a watch.

This is the same thing that happens with monovision; as the brain learns how to use your eyes, you start to forget that each eye does separate things.

In addition to the extra time necessary to adjust to monovision, there is a downside to having both eyes doing separate things. Both eyes working together for distance vision can actually improve your distance vision. Monovision does have that trade-off in order to provide that glasses independence. This trade-off can potentially be noticeable driving & especially at night. Some individuals with monovision actually prefer to use a pair of glasses to correct their up close eye to match the distance vision of their distance eye for the task of driving.

Also check out Everything To Know About Monovision Lasik to learn more.

Farsighted Prescriptions

Many people who seek out lasik after the age of 55 do so because they've had great vision for their whole life up until their 40s and 50s. Gradually during their 40s, they started to lose their up close vision and eventually their distance vision becomes blurry as well.

These individuals have farsighted prescriptions. Our natural lens is able to focus through farsighted prescriptions - that is, until our natural lens can't focus anymore. When we are younger, we don't notice that we have a farsighted prescription because our lens is doing all the work to correct this prescription for us. But when this lens stops working because of presbyopia, things start to become blurry.

But unfortunately, lasik doesn't work quite as well for farsighted prescriptions as it does for nearsighted prescriptions:

  • There is less prescription that lasik is capable of treating. For small farsighted prescriptions, lasik can still work and correct vision with monovision or mini-monovision. But for larger prescriptions, lasik may only be able to correct for distance vision. Not exactly ideal when the up close vision is typically the most bothersome for farsighted individuals.
  • Lasik for farsighted prescriptions can also have more regression than lasik for nearsighted prescriptions. With regression, farsighted individuals can find that they start to need reading glasses again. This limits the overall longevity of the lasik procedure

Learn more at How Successfully Can Lasik Fix Farsightedness?

Eventual Cataracts

But the farsighted individuals aren't the only ones with limited longevity to the lasik procedure. There is one thing changing in the eye that limits how long lasik will last for everyone over the age of 55: once again, it is the lens.

After the lens becomes weak due to presbyopia, the lens continues to change over time. It begins to become cloudy. In the beginning stages, you can still see through this cloudiness; it affects your vision in more subtle ways. But eventually, the cloudiness of this lens will cause you to lose vision. At this point, this lens is called a cataract.

When cataracts develop, your lasik procedure won't work as well to correct your vision. Your prescription may still be on target, but your vision will be blurry from the cataracts. Cataracts are something that happen to everyone, it is just a matter of when. For some people, they can notice cataracts in their 50s, for others, they may not develop any significant clouding until their late 70s. But eventually, cataracts will limit low long lasik will "last".

But even before the cataracts cause your vision to be blurry, the changing lens can actually change the prescription in your eye. As the prescription changes in your eye, the lasik doesn't work the same as what it once did. Some people experience a small degree of this while others can have very large changes in their prescription.

So between these lens and prescription changes and cataracts, the overall longevity of a lasik correction for anyone over the age of 55 will have some limits.

An Alternative: Lens Replacement Surgery

There is an option which improves on many of the downsides of lasik past the age of 55. This option is called lens replacement surgery.

Because eventually you will need cataract surgery and frequently people get their vision corrected at the time of cataract surgery, lens replacement surgery applies those same principals earlier to correct vision permanently before cataracts even develop.

During lens replacement surgery, the lens is removed and replaced with an artificial lens to correct vision (just like with cataract surgery).

Unlike lasik, lens replacement surgery:

  • Is permanent. There is no regression to deal with and no more lens changes or cataract development that can affect vision.
  • Can avoid the need for monovision for some people through the use of special artificial lenses called trifocal lenses.
  • Doesn't have any limitations on how much prescription it can treat. It can still work very well even for those individuals with a high amount of farsighted prescription.

But all these benefits do come at an increased cost to the procedure compared to lasik - frequently lens replacement surgery can be twice the cost or more compared to correcting vision with laser eye surgery.


Lasik can still work really well for certain individuals over the age of 55. Monovision is a great technique to provide independence from glasses. However, lasik will be more of a short-term solution and won't work well for certain individuals (especially those with farsighted prescriptions). Lens replacement surgery may be a better option than lasik for some people, especially those looking for a permanent way to correct their vision.

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