Farsightedness impacts about 5 to 10 percent of the American population, the National Eye Institute explains, and it can impact both children and adults. There are two main types of farsightedness, hyperopia and presbyopia, and treatment options can vary depending on the type and severity of the condition.
There are three main forms of refractive laser surgery for farsightedness, including LASIK (laser-assisted in-situ-keratomileusis), PRK (photorefractive keratectomy), and RLE (refractive lens exchange). Laser surgery involves permanently reshaping the cornea. While it is considered a minimally invasive procedure, there are some potential risks involved; however, the benefits often outweigh the possible cons.
There are some things you should know before getting laser surgery, and you will need to take certain measures before undergoing the procedure. Your eye prescription will need to have been stable for at least a year, and since the cornea is being reshaped, the measurements must fit into a certain range to be eligible for laser surgery. Recovery time is relatively quick, and it is important to take care of your eyes and follow your doctor's instructions after surgery to ensure a healthy recovery.
Laser surgery can eliminate the need for glasses or contacts, and be an effective means to correct blurry vision. Laser surgery has a high success rate, and most people are happy with the results.
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Hyperopia and Presbyopia
Farsightedness is the ability to see things well at a distance, but not up close. There are two main forms of farsightedness: hyperopia and presbyopia.
Hyperopia is the most common form of farsightedness, affecting 5-10% of Americans. It affects people of all ages, and those with hyperopic parents are more likely to be hyperopic themselves.
The condition is caused by misshapen corneas or eyeballs that are too short from front to back. Because their eyeballs are still growing, some children with hyperopia will grow out of the condition over time.
Hyperopia can be difficult to spot during a basic eye exam. This is because people with hyperopia can see things that are a few feet away from them (such as eye charts) just fine. However, if the condition exists, an eye doctor will spot it following a comprehensive exam.
Many people with hyperopia use prescription eyeglasses to see better. Others choose to have their hyperopia corrected with surgery.
Some symptoms of hyperopia include:
- Eye strain
- Difficulty focusing on things that are up close
- Blurred vision when looking at things that are close to you
- Difficulty reading, especially when the print is small
If you think you may have hyperopia, talk to your eye doctor. Only a qualified professional can diagnose and treat this condition.
Presbyopia is a form of farsightedness that typically develops in older people. According to the Mayo Clinic, presbyopia usually appears around age 40. From there, it often gets worse until a person reaches age 65.
Over time, eye muscles grow weaker and the eye’s lens loses much of its flexibility. A harder lens causes light to focus behind the retina, making it hard to see things that are close to you.
Presbyopia has the same symptoms as hyperopia, including:
- Eye strain
- Blurry vision close-up
- Difficulty reading
The difference is that for a person with presbyopia, these symptoms are new. For example, you may suddenly find yourself holding books and newspapers at arm’s length to try to see them better, even though you never used to do that.
Presbyopia can also only be diagnosed after a comprehensive professional eye exam. If you are worried you might have it, make an appointment with your eye doctor.
Farsightedness Laser Surgery Treatment Options
Mayo Clinic publishes that refractive surgery is most commonly used to treat nearsighted eye conditions (myopia); however, laser surgery can be a viable option for farsightedness as well. Laser eye surgery uses a specialized laser to ablate the cornea, reshaping it to correct refractive errors.
In the case of hyperopia, the laser shapes the cornea to make it steeper, lengthening it so the focusing power is directed onto the retina instead of behind it. Both LASIK and PRK are forms of laser refractive eye surgery that can be used to correct hyperopia.
Presbyopia can be treated with a specialized procedure called monovision that corrects one eye for distance vision and the other eye for close-up sight. This procedure may not be for everyone, as it can take some getting used to as the eyes will no longer focus together, and there is an adjustment period. Hyperopia and presbyopia can also be treated with intraocular lens (IOL) implantation or RLE, which involves replacing the natural lens with an artificial clear lens.
The three main types of laser surgery options for farsightedness are:
- Laser-assisted in-situ keratomileusis (LASIK). LASIK is one of the most common forms of laser eye surgery with a high success and satisfaction rate. The Food and Drug Association (FDA) publishes studies indicating that about 95 percent of patients are happy with their vision following a LASIK procedure. With LASIK, a specialized laser is used to create a small flap in the epithelial (outer part) of the cornea, which is hinged back, while a secondary laser is used to ablate the stroma (inner part), reshaping the curvature to the premeasured point. The flap is then replaced and allowed to heal on its own without the need for stitches or further medical intervention. The procedure is typically performed in under an hour, noninvasive, and considered safe.
- Photorefractive keratectomy (PRK). PRK is actually a type of LASEK (laser-assisted subepithelial keratectomy) surgery that involves cutting a thin flap into the cornea's epithelial layer and removing it entirely before reshaping the cornea underneath. The epithelial will grow back on its own and fit to the new corneal shape naturally. PRK is an option for people who have thin corneas and may not be eligible for LASIK.
- Refractive lens exchange (RLE). Lens replacement eye surgery, or RLE, actually replaces your natural lens with a completely new clear lens. This procedure is generally intended for people who may not be candidates for PRK or LASIK procedures and suffer from a high degree of hyperopia or presbyopia without cataracts. The journal Touch Ophthalmology publishes that RLE is generally more suited for correcting hyperopia than myopia, and the procedure can be helpful in correcting farsightedness when other options are not as viable.
Bladed vs. Bladeless LASIK
Your ophthalmologist has a choice between use bladed LASIK and Bladeless LASIK to cut a corneal flap during surgery. The main difference between the two techniques is:
- Bladeless LASIK: Also known as all-laser LASIK, it involves cutting the corneal flap using a surgical tool called laser keratome.
- Bladed LASIK: With this traditional method, the surgeon uses a mechanical instrument (microkeratome) with a blade to manually create the corneal flap.
According to the U.S. Food and Drug Administration (FDA), there’s no consensus among eye surgeons on which of the two methods is more effective or safer. Some ophthalmologists believe the all-laser option is better for flap creation.
Risks and Rewards of Laser Surgery for Farsightedness
LASIK and laser surgery procedures were initially intended to treat nearsightedness, or myopia. The Peer-Reviewed, Open Access Journal (PLOS One) publishes that it presents a different potential risk than myopic corrections, as it has been common for hyperopic eyes to lose their refractive power and regress post LASIK. Advances to technology over the years has lowered this potential risk, and laser surgery is more effective in treating hyperopia today.
Presbyopia has traditionally been treated with monovision LASIK, which means that the eyes are corrected differently. Since it can take a lot of adjustment, the eye being corrected for hyperopia often cannot be corrected as much as it may need to be for crystal-clear, close-up vision. Monovision can also cause some blurring with distance vision for some people. Newer technologies, such as IOLs and clear lens exchange procedures, are often preferable, the journal Review of Cornea and Contact Lenses reports.
Advances in IOL implants continue to be made, reducing the risks and improving the rewards for eligible patients. According to Optometry Times, RLE is a viable option for people who are not eligible for LASIK or PRK, even if their lenses are clear to begin with. There is a small risk for loss of vision due to infection or lens detachment, but it is considered minimal. In general, an RLE procedure is considered to be as safe and effective as other laser surgery procedures.
Laser surgery is a same-day procedure that is classified as minimally invasive, but it is still a surgical procedure with potential risk factors. Dry eyes, glares, halos around lights, decreased night vision, vision changes, and infection are all possible complications resulting from a laser eye surgery. The journal Review of Ophthalmology publishes that negative nighttime visual symptoms and prohibitive costs can be potential barriers for people seeking out IOLs for presbyopia.
Laser surgery for farsightedness is considered an elective procedure, and as such, it is rarely covered by insurance. Costs can range between $1,500 and $3,000 for each eye and can vary depending on the exact treatment needed and the severity of the condition being corrected.
In the long run, however, laser surgery may actually save you money on eye exams and prescription eyewear, as it can decrease the need to wear contacts or eyeglasses. There are payment and financing options to help people budget for laser eye surgery. The benefit of improved sight is often worth the cost.
How Effective is LASIK for Farsightedness?
LASIK surgery grows increasingly effective at treating farsightedness as more accurate and efficient tools become available. It’s already highly effective, and surgeons enjoy a high satisfaction rate among patients who chose this corrective elective procedure.
In a recent study, 69 percent of people who opted for LASIK for farsightedness achieved vision of 20/20 or better. About 97 percent gained 20/40 or better vision after the procedure.
Outcomes, however, can vary among patients, with vision stability being the main concern after treatment. Some people may experience dry eye. Others must wear prescription glasses to treat nearsightedness following LASIK surgery.
Preparing for Laser Surgery and Eligibility
In order to be eligible for laser eye surgery to treat hyperopia or presbyopia, you will need to be in good health, and this includes good optical health. Your eyes will need to have been stable with their prescription for at least a year. For the treatment of presbyopia, you will need to not have cataracts forming. Mayo Clinic warns that LASIK procedures may not be ideal for severe hyperopia.
Your doctor can determine if you are a candidate for a laser eye surgical procedure and which one might be best. The ophthalmologist will perform precise measurements of the eyes prior to this determination to ensure that you have enough thickness on your cornea for LASIK. If you don’t, PRK may be a better option.
Consider your expectations for the procedure and talk with your doctor in order to ensure that you are both on the same page. In preparation for a laser eye surgery, you will usually need to stop wearing your contacts (if you wear them) for a few weeks.
What to Expect
Laser eye surgery can help to improve your farsighted vision and decrease your need for reading or prescription glasses. Your eyes may still change with age. Just because you've had LASIK or another procedure, you may still need reading glasses later in life. In addition, cataracts can still form, and laser surgery does not affect the risk for these either.
Recovery from a laser eye procedure is relatively quick, with LASIK being the least invasive and having the fastest recovery time. Generally, you will need to take a day or so off work and refrain from eye strain. You may need to avoid watching TV, reading, or spending time on the computer for a few days.
Strenuous exercise and contact sports, as well as swimming or hot tubs, should be avoided for a few weeks after a laser eye procedure. You will also need to keep lotions, creams, and makeup off your face and away from your eyes for a week or two. Avoid rubbing your eyes.
The FDA publishes that your vision can take a few months to stabilize completely, but you should be seeing better within a few days after a laser surgery procedure. You will need to attend a follow-up appointment with your surgeon a day or two after the procedure, and follow the instructions given by the surgical team to enhance healing.
Costs of LASIK Surgery
A recent market report shows that the price for LASIK surgery per eye is about $2,246. This cost can vary based on various factors, including the surgical method your surgeon uses and how much your vision needs to be corrected.
Some ophthalmologists charge more for all-laser (bladeless) LASIK. Also, it may cost you more to customize your treatment. Others have a single price regardless of the LASIK procedure used to treat farsightedness.
The amount of vision correction needed usually impacts the complexity of surgery. A few LASIK surgeons consider this factor in their cost formulations.
Financing Your LASIK Procedure
Unfortunately, most health plans don’t cover LASIK surgery. They consider the treatment optional, meaning that it’s not medically required.
If you’re considering having LASIK, you may need to explore alternative financing methods. Your options may include Flexible Spending Accounts, Health Savings Accounts or private financing.
Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs)
If your employer offers an FSA or an HSA program, you can use it to cover your out-of-pocket eyecare costs. You’ll be putting a portion of your monthly pay into your account. (You can only have one of these accounts at a time, under IRS rules. Contributions to both accounts are pre-tax.)
Some finance companies lend money to patients to cover their medical costs, including eyecare. You may approach such a firm for a LASIK loan provided that they’re affiliated with your preferred ophthalmologist.
Most of these lenders offer flexible loan terms, including interest.
Is LASIK Really Worth the Cost?
The answer to this isn’t straightforward since treatment outcomes and expectations can vary widely.
Assume that you’re charged about $2,000 for LASIK per eye. If you get proper vision and don’t need to wear glasses ever, you may consider the one-time eyecare cost worthwhile and convenient.
That said, having LASIK surgery doesn’t rule out the need to wear prescription glasses. Some patients need eyewear therapy to read after LASIK surgery overcorrects their vision problem.
According to Statista, the average cost of prescription single-vision lenses is $112 and that of frames is $231. Insurance can cover these treatments, making eyewear a cheaper option for most farsighted patients.
Keep in mind that the overall cost builds up with time because you may need to replace or upgrade your eyewear after every few years. Also, most high-end prescription glasses and contacts are expensive.
Alternatives to Laser Eye Surgery for Farsightedness
There are other, non-LASIK ways to tackle farsightedness. Other potential treatment options include:
- Photorefractive keratectomy (PRK): Your surgeon scrapes away the top surface of your cornea instead of creating a flap.
- Intraocular lenses: These can be surgically implanted in your eye to correct farsightedness.
- Small-incision lenticule extraction (SMILE): Your surgeon uses laser to reshape your cornea.
- Eyewear: Prescription glasses and contact lenses can correct farsightedness.
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