In these toggles we explain what you need to know about presbyopia

Presbyopia is a reduced ability of the eye’s natural lens to focus at near.

Presbyopia occurs naturally with increasing age and is typically noticed as we enter our mid-40s.

Near vision becomes more blurred, and we hold material further away to read it. Soon afterwards, we may need to start using reading glasses.

Watch this video on presbyopia:

The eye’s lens can change shape, allowing it to focus light on the retina. It adjusts depending on where the light is coming from. If the light is far away, the lens becomes thin. If the light is near, the lens becomes thick. This process is called accommodation and is strongest in early life.

However, the lens’ ability to change shape declines over time because of a natural loss of elasticity. Presbyopia is the result of these changes and is noticed when we reach our 40’s and 50’s. This is why reading glasses become necessary – they provide the extra focusing power required to see near objects.

Presbyopia also results from cataract surgery where a monofocal lens implant is used.

To diagnose presbyopia, we perform a clinical examination, reading vision assessment and refraction test (a measurement of the eye’s ability to focus).

This enables us to determine how advanced the presbyopia is and the strength of your prescription.

The most appropriate treatment option for you will depend on several factors. These include:

  • Your exact spectacle prescription
  • The precise clinical examination findings
  • Your age
  • Your job
  • Your hobbies
  • If you have any other eye conditions or issues

Glasses and contact lenses

Presbyopia is usually treated by opticians in the first instance by the use of prescription reading glasses.

Some patients decide to use multifocal contact lenses, or single vision contact lenses with one eye focused for distance and the other eye focused for near (also known as monovision).

Refractive lens exchange (RLE)

After a while, some patients grow weary of needing reading glasses or find them very inconvenient and seek a surgical option to provide good vision for distance and close-up without the need for glasses. This is where Prof Muhtaseb can help.

Treatment options will typically include refractive lens exchange (RLE) with a choice of lens implants.

By understanding your lifestyle requirements, Prof Muhtaseb is able to explain the various lens implant options and the benefits of each. By involving you fully in the decision-making process, he will recommend a personalised treatment plan.

What happens if I have developed a cataract?

Patients that undergo cataract surgery with a monofocal lens implant also need to use reading glasses to see clearly at near distances. We can reduce this dependence on reading glasses by opting for a multifocal lens implant at the time of initial surgery.

Watch this video on correcting presbyopia with Refractive Lens Exchange:

What Happens in Cataract Surgery / Lens Extraction?

When the natural lens becomes cloudy with time, this is called a cataract. During cataract surgery, the natural lens is removed and replaced with a clear plastic lens.

This new lens is monofocal and is best able to focus light on the retina from one distance. Spectacles are then required to see clearly at other distances.

Usually, patients like to see clearly in the distance and use spectacles for intermediate (computers, painting, sheet music) and near (reading) work. However, there are some exceptions.

Premium lenses

If you are considering cataract surgery or refractive lens exchange, but don’t want to rely on glasses to read afterwards, you should consider the choosing a ‘premium’ lens to reduce your reliance on glasses for reading and other ‘near vision’ activities. Such lens implants include multifocal and accommodating lenses.

What are multifocal intraocular lenses?

Multifocal Intraocular Lenses (mIOL’s) employ new technology that mimics the ability of the eye’s natural lens to adjust its shape and so focus light. They create focal points for light coming from far, intermediate and near objects.

It is not usual to implant a different type of IOL in each eye. The eyes most commonly receive the same kind of lens, although we treat each case individually, and we will advise you with your best interests in mind.

Depending on your unique requirements, the same mIOL may be used for both eyes, or we may suggest a “mix-and-match” approach to mIOL implantation.

Multifocal intraocular lenses for astigmatism

If you have astigmatism, we must correct this visual error before or after we implant the multifocal lenses. There are several ways of doing this.

With trifocal, toric form lenses, we can correct your astigmatism in addition to giving you good distance and reading vision. This is all done in one operation and avoids multiple surgeries with higher expenses.

The lens is adorned with lines that mark the axis of astigmatism correction. This allows us to place the lens in exactly the correct orientation in the eye that allows you to enjoy full visual potential at both far and near without glasses.

Is spectacle independence guaranteed if I receive a multifocal IOL?

Medical treatment does not generally carry a guarantee. However, the likelihood that you will need glasses for near work are greatly reduced with a multifocal IOL compared to a standard lens. The vast majority of patients can see well at all distances without using glasses. However, some people may need to wear spectacles for some tasks, such as using a computer, reading for prolonged periods or driving at night.

Is mIOL suitable for everyone?

No medical intervention is suitable for everyone. The overall health of your eyes, your visual requirements, expectations for postoperative vision, and other factors will inform the decision regarding suitability.

Astigmatism may need to be corrected before mIOL implantation, depending on the examination findings.


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Discover the number one mistake patients make when choosing cataract surgery

Unfortunately, most people only find this out after having cataract surgery. The information in this Wales Cataract Guide could save you frustration and worry. Simply click the button below to give us your email and we’ll send you this life changing guide.


If you can see yourself below, then we can help you

You’re over 45 and would love to read again without glasses

Unfortunately, reading glasses or varifocals get in the way of many of the things you most enjoy. Yes, spectacles help, but they are annoying little appendages that you lose or must clean to see clearly.

If you feel annoyed, anxious and limited by reading glasses or varifocal spectacles, we can help. Don’t let your favourite hobbies become tiring chores.

Be free from reading specs for good. Experience the liberation from squinting and headaches that you might have already begun to accept as part of life.

Instead, look forward to enjoying everything that your vision has to offer. Whether you enjoy reading, gardening, or the great outdoors, everything looks better when your eyes see as young as you feel.

Get a new lease on life. Contact us today and take the first step towards a better life.

Your vision is yellowing, duller, and cataracts are forming. You feel like your eyes are letting you down

The effect on your life can vary from being slightly frustrating, through to significantly affecting your ability to function independently, or even causing a devastating reduction in vision.

Before you developed cataracts, you were living a full life. You may enjoy the outdoors, have indoor hobbies or enjoy travelling. Or, perhaps you have finished working and are now taking the time to enjoy everything you may have missed when you were busy making a living.

Sadly, your eyes now dull the shine of life’s beautiful landscape. The trees, the flowers and even the sky don’t seem as bright as they used to look.

Get your life back without the compromise. Experience what life used to look like. Even better, if you’ve worn glasses or contact lenses, discover the incredible once-in-a-lifetime opportunity that modern cataract surgery affords.


We treat patients from all across Wales

“I would like to thank you most sincerely for the laser surgery you performed to improve my eyesight. It really has improved the quality of my life and I feel like a new person.”

R M, Refractive Surgery

“I was given a choice of lenses and detailed information before making my decision. I am now able to drive and read without glasses. It was entirely painless and the care I received before and after the procedures was excellent.”

Mrs. B R, Intraocular Lens

“I was very impressed with the preop eye assessment and the consultation by Mr Muhtaseb explaining the options properly, sensibly and in detail focusing on my individual situation. Surgery (PRK) went well, and the results are excellent.”

Dr. C E, Laser Refractive Surgery

“My vision is really clear. I easily read the Sunday paper without glasses the day after my surgery.”

M B, Lens Exchange

“A very grateful thank you to you and your team for the operations that have enhanced my sight so much. It is a wonderful feeling to have my confidence back both in walking and driving”

Mrs. F L, Cornea

“Many thanks to ‘The No. 1 Medic’.”

Dr. A E, Intraocular Lens

“Thank you so much, you’ve changed my life forever.”


“Mr Mutaseb and his team were very professional , friendly and reassuring and held a no hassle policy on having to follow through with any procedure for laser correction. The procedure could not have run smoother and the after care was excellent.”


“I am very happy with Mr Muhtaseb’s professional, detailed and careful approach to my surgery. I have had successful surgery and am very happy with the result. This has been a life changing surgery for me.”

Professor H J, Refractive Surgery

“Thank you for all that you have done. I would not have gone through it without the complete trust I have in you. Thanks again.”

Mrs. S G, Multifocal Intraocular Lens

“It’s fantastic. I feel like a new person.”

D R, Refractive Lens Exchange

“Thank you for taking such good care of me during my LASIK surgery – I was terrified! I am so pleased with the outcome, which was pretty much instant – it has made such a difference to my life not having to wear glasses all the time.”


“Many thanks to you and your team for all the kindness, care and expertise shown to me when having my cataracts removed. It is lovely to have a new lease of life.”

Mrs. R B, Cataracts

“I can’t thank you enough for the gift your ability as a surgeon has given me. I am like a child with a wonderful new toy. I can see the world anew.”

Mrs. A D, Refractive Lens Exchange

“I’m amazed at how much I can see.”

C H, Multifocal Lens

“I made my highest break in years last week. It was 137!”

Anonymous, Multifocal Piggyback Lens
More patient stories

Patients will form queues for post-COVID cataract surgery. You can make progress towards clear vision (and beat the queue for surgery) by having your first appointment from the safety of your home

Meet online with our surgeon, Prof Muhtaseb, and get a clear answer about all of your cataract surgery options (including the little known possibility of fixing your reading and/or distance vision at the same as you fix your cataracts). Critically, after your video appointment, you will have the opportunity to secure your spot in the waiting list once our clinic re-opens. Click the button below now to book your video consultation…


Enjoy a life free from cataracts, glasses and contact lenses in three easy steps

Talk to us

Give us a call on:

073 80 80 2000 and we’ll guide you towards an initial assessment.


Meet your consultant

I’ll see you before treatment to ensure you’re a good candidate and treat you at one of my facilities in South Wales.

Revitalise your eyes

I’ll supervise your aftercare as you begin to experience a life free of cataracts and glasses and contact lenses.


Learn more about eye conditions and eye treatments


Educate yourself further about lens replacement by reading the links below

The NHS has compared laser eye surgery and lens replacement, and is worth a look. Click here for more information.

This 12-page guide provides you with the benefits of refractive lens exchange, as well as the risks and alternatives. Click here for more information.

Presbyopia is a condition that can make patients undergo a lens replacement – but what exactly is it? Click here for more information.


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Prof Mohammed Muhtaseb, FRCOphth

Consultant Cornea, Cataract and Refractive Surgeon

iLase is the private practice of Consultant Ophthalmic Surgeon, Prof Mohammed Muhtaseb. Based in South Wales, he is one of the very few ophthalmologists working in the UK who is a fellowship-trained specialist in Cornea, Cataract and Refractive Surgery. He holds full specialist registration with the General Medical Council and was appointed as a Consultant in the NHS in 2006.

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