At Pure Sight Eye Surgeons, we diagnose and manage all types of refractive errors. For patients who want to reduce or eliminate their dependence on glasses or contact lenses, Dr Chiu offers a range of surgical options tailored to the type and degree of refractive error, your age, and your eye health.
Types of Refractive Errors
Myopia (short-sightedness)
In myopia, the eye is slightly longer than normal, or the cornea is too steeply curved. Light focuses in front of the retina rather than on it, making distant objects appear blurred while close objects remain clear. Myopia typically begins in childhood or adolescence and can continue to progress into early adulthood.
Hyperopia (long-sightedness)
In hyperopia, the eye is slightly shorter than normal, or the cornea is too flat. Light focuses behind the retina, which can make both near and distance vision blurred, particularly as you get older and the eye’s ability to compensate diminishes.
Astigmatism
Astigmatism occurs when the cornea or lens has an irregular shape, more like a rugby ball than a soccer ball. This causes light to focus at multiple points rather than a single point, resulting in blurred or distorted vision at all distances. Astigmatism commonly occurs alongside myopia or hyperopia.
Presbyopia
Presbyopia is the gradual loss of the eye’s ability to focus on close objects, caused by the natural hardening of the lens with age. It typically becomes noticeable from the mid-40s and affects everyone, regardless of whether they’ve had refractive errors before. The most common early sign is needing to hold reading material further away or needing brighter light for close-up tasks.
Correction Options
Glasses and contact lenses
Glasses and contact lenses remain the most common and straightforward way to correct refractive errors. They work by adjusting the way light enters the eye so it focuses correctly on the retina.
Surgical options
For patients who want to reduce their dependence on glasses or contact lenses, several surgical approaches are available. The right option depends on the type and degree of your refractive error, your age, and the health of your eyes:
- LASIK — reshapes the cornea using an excimer laser after creating a thin corneal flap. Suitable for myopia, hyperopia, and astigmatism in patients with adequate corneal thickness
- PRK (also known as LASEK, ASL, ASLA) — reshapes the corneal surface without creating a flap. Suitable for patients with thinner corneas or those where LASIK may not be appropriate
- SMILE Pro (lenticule extraction / LALEX) — a minimally invasive laser procedure that removes a small disc of corneal tissue (lenticule) through a tiny incision, without a flap. This is a distinct technique from surface ablation and is particularly well suited to myopia and astigmatism correction
- PRESBYOND — a laser blended vision technique that addresses presbyopia by creating a customised corneal profile in each eye, providing functional vision at distance, intermediate, and near
- ICL (Implantable Collamer Lens) — a lens implanted inside the eye, in front of the natural lens. Particularly suited for patients with higher prescriptions or those not suitable for laser correction
- ICL Viva — the newest generation ICL that also corrects presbyopia. Dr Chiu was the first surgeon in Australia and New Zealand to implant this lens
- Refractive lens exchange (RLE) — replacing the natural lens with an artificial intraocular lens. Most appropriate for patients over 45 with presbyopia or high refractive errors
In general, laser correction can treat higher myopic (short-sighted) prescriptions than hyperopic (long-sighted) prescriptions. Dr Chiu assesses each patient individually and will recommend the option most likely to give you the best long-term outcome.
Frequently Asked Questions
Can refractive errors get worse over time?
Myopia often progresses during childhood and teenage years before stabilising in early adulthood. Hyperopia can become more noticeable with age as the eye’s ability to compensate decreases. Presbyopia is progressive and affects everyone from the mid-40s onwards. Regular eye examinations allow changes to be monitored.
Can children have refractive errors?
Yes. Refractive errors are common in children and can affect their learning and development if not corrected. Children don’t always realise their vision is blurred, which is why regular eye checks are important. Myopia, in particular, is becoming more prevalent in children and can progress rapidly.
Can I have surgery to get rid of reading glasses?
Surgical options for the natural near vision decline called presbyopia is possible.
There are several techniques available, and your assessment with Dr Chiu and her team will advise on the best solution, if any, for you.
Am I too old for vision correction surgery?
Age isn’t a barrier in itself, but the right procedure changes with age. Laser correction and ICL are generally most appropriate for younger adults. For patients over 45 to 55, PRESBYOND, ICL Viva, or refractive lens exchange may be more suitable, depending on the prescription and lens health. After this age cataract becomes increasingly common so surgery to remove this becomes the procedure of choice. Dr Chiu will advise on the best option for your situation.
Is presbyopia the same as cataract?
Presbyopia is the natural age related change in the lens that leads to a loss of near vision. When younger, when the eye sees clearly for distance (with or without glasses depending on the person), the lens inside the eye is soft and flexible and adjusts it’s shape to change the focus to near, and back again, resulting in a clear and full range of vision. Over time, the lens loses its softness and flexibility and near vision becomes difficult. Usually in mid-40s, reading glasses are required. The progression of changes in the natural lens with further aging cause the lens to become cloudy – this is a cataract. Surgery can be performed to correct vision in both instances.