I'm over 50, should I get laser eye surgery??

Presbyopia—the gradual loss of near-focus ability—is a normal part of aging. By the time most people reach their mid-40s or 50s, reading menus, phone screens, or fine print becomes noticeably harder. It’s natural to look for treatments that offer freedom from reading glasses, including laser eye surgeries such as LASIK, PRK, and newer “presbyLASIK” approaches.

But while laser vision correction is effective for many refractive errors, patients over 50 often aren’t the best candidates for presbyopia-focused laser procedures. Here’s why.

1. The Root Problem Isn’t the Cornea—It’s the Lens

LASIK and PRK reshape the cornea to change how light enters the eye.

Presbyopia, however, is caused by age-related stiffening of the eye’s internal lens, not the cornea.

Laser procedures can simulate near-vision correction (often through monovision or multifocal ablation), but they don’t reverse the underlying aging of the lens. As the lens continues to change, results may diminish.

2. Higher Risk of Cataracts Makes Long-Term Results Less Reliable

By age 50–60, many people are in the early stages of cataract development—even if they don’t notice symptoms yet.

If a laser presbyopia correction is performed and cataracts progress later:

• Cataract surgery may overwrite the previous laser correction

• Additional procedures may be needed to fine-tune the prescription

• The original laser treatment may have only a short window of benefit

Because cataract surgery replaces the aging lens with an artificial, clear one, it often becomes the more durable solution for people in this age group.

3. Dry Eye Is More Common After 50—and Laser Surgery Can Worsen It

Age-related tear film changes make dryness more common.

Laser procedures—especially LASIK—can temporarily disrupt corneal nerves that regulate tear production.

This can result in:

• Worsening dry eye symptoms

• Visual fluctuations

• Longer healing times

For patients who already struggle with dryness, the risk may outweigh the benefits.

4. Monovision Isn’t Comfortable for Everyone

A common approach for presbyopia correction is monovision, where one eye is corrected for distance and the other for near.

While it works well for some, people over 50 may have:

• More difficulty adapting to the imbalance

• Reduced depth perception

• Challenges with night driving

Even a successful monovision laser surgery can feel uncomfortable if the brain can’t fully adapt.

5. The Prescription May Continue to Change

As the lens ages, focusing ability and refractive errors tend to shift.

This means:

• The “perfect” correction may not stay stable

• Enhancements may be needed

• Some may return to using glasses within a few years

Laser surgery is generally most effective when prescriptions are stable—something that becomes less predictable after 50.

6. Safer, More Predictable Alternatives Exist for This Age Group

Modern lens-based procedures often offer more durable and comprehensive solutions for presbyopia in older adults, including:

• Refractive lens exchange (RLE)

• Multifocal or extended-depth-of-focus (EDOF) intraocular lenses

• Early cataract surgery with advanced lens implants

These approaches directly address the aging lens—the root cause of presbyopia—and avoid complications related to corneal reshaping.

The Bottom Line

Laser eye surgery has transformed vision correction for millions, but age matters.

For many people over 50, the combination of lens aging, cataract development, dry eye risk, and diminishing long-term stability makes laser presbyopia treatments less ideal.

That doesn’t mean clear vision is out of reach—far from it. It simply means that lens-based procedures often provide better, longer-lasting results for this age group.

As always, decisions about eye surgery should be made with a qualified eye care professional who can evaluate individual eye health, lifestyle needs, and long-term goals. Book with Mr Benson to discuss your options.