Short answer
The lens inside the eye stiffens over the years and can no longer focus up close. That is where the need for reading glasses comes from. It can be corrected with glasses, contact lenses, a lens exchange or laser — and from 25 October 2026 KSA has the SCHWIND Signature Line laser for exactly this.
Have you noticed that reading messages on your smartphone, studying book text, or examining product labels requires holding the screen or paper further away, almost at arm's length? Or have you found that reading in dim evening light causes blurry letters, eye fatigue and mild forehead tension headaches?
If these symptoms sound familiar, you are not experiencing an eye disease or sudden vision damage. Instead, you are noticing a completely natural physiological milestone called presbyopia. Presbyopia affects 100% of the population after age 40 to 45, regardless of whether you previously had perfect vision, nearsightedness or farsightedness.
The optics and the lens anatomy
To understand presbyopia, we look inside the eye. Behind the pupil sits a clear natural crystalline lens, surrounded by the ciliary muscle. In youth this lens is highly flexible, like a soft gel pad. When looking into the distance, the ciliary muscle relaxes. When focusing up close, such as reading a book, the muscle contracts, causing the flexible lens to curve and increase its focusing power. This rapid focus-switching ability is called accommodation.
As we age, starting around 40 to 45, natural changes occur within the crystalline lens:
- Loss of lens flexibilityLens proteins gradually harden and lose elasticity.
- Ciliary muscle fatigueThe muscle works harder to flex the lens, but the rigid lens can no longer change shape easily.
Consequently, incoming light rays from close objects focus behind the retina, making near text appear blurry without optical assistance.
Clinical symptoms
Presbyopia develops gradually over several years. Common warning signs include:
- Arm's length syndromeNeeding to hold phones, books or menus further away to see clearly.
- Need for brighter lightingReading in low light becomes increasingly difficult. Bright light constricts the pupil, the pinhole effect, increasing depth of field.
- Eyestrain and asthenopiaBurning, dry or heavy sensations in the eyes after reading or computer work.
- Tension headachesPersistent muscle effort causes aching around the eyebrows and forehead.
- Delayed refocusingSwitching focus between near screens and distant objects takes several seconds.
The video also mentions dry eye, which often travels with presbyopia — a gritty sensation and constant watering are signs of dry eye rather than presbyopia. They are examined and treated separately: dry eye diagnosis and treatment.
Presbyopia, hyperopia and myopia are different things
- Hyperopia, farsightednessA structural eyeball issue, short axial length, present from birth or childhood.
- Myopia, nearsightednessAn elongated eyeball that allows clear near vision but blurs distant objects.
- PresbyopiaAge-related hardening of the eye's internal lens. It affects everyone — former non-glasses wearers, emmetropes, as well as nearsighted and farsighted people.
In more detail: hyperopia and myopia.
Reading your prescription: the ADD value
After the age of 40, your eye prescription will include a new metric called ADD, the reading addition.
- SPH — sphere
- Distance vision correction in dioptres.
- ADD — addition
- Additional plus power added to your distance prescription for close work.
- Ages 40 to 45ADD is typically +0.75 to +1.25 dioptres.
- Ages 50 to 55ADD is typically +1.50 to +2.00 dioptres.
- Ages 60 and aboveADD stabilises at +2.25 to +2.50 dioptres.
Diagnostic evaluation
Buying off-the-rack reading glasses does not provide an accurate solution. At KSA in Tallinn and Tartu, patients undergo the Vision Audit:
- Assessment of lens accommodation and the focusing power of the eye.
- 3D corneal topography and micron-accurate corneal thickness mapping.
- Intraocular pressure and retinal health checks.
The corrective options
Reading glasses · plus lenses for close work
Plus lenses used only for close-up tasks.
Advantage. Simple and accessible.
Limitation. Must be carried constantly, easily misplaced.
Progressive lenses · one pair for every distance
Multi-zone glasses for distance, intermediate and near.
Advantage. One pair for all distances.
Limitation. Peripheral distortion, an adaptation period, higher cost.
Multifocal contact lenses · concentric zones
Contacts with concentric zones for near and far.
Advantage. No spectacle frames required.
Limitation. May cause dry eyes or reduced contrast in low light.
Refractive lens exchange · RLE, trifocal IOL
Replaces the natural lens with a trifocal intraocular lens.
Advantage. Suitable for ages 55 to 60 and above; prevents future cataracts.
Limitation. Intraocular surgery with the associated risks.
Touchless laser surgery · Flow3, PresbyMAX profile
Reshapes the corneal surface to extend depth of focus.
Advantage. 100% touchless, blade-free, lasting freedom from glasses.
Limitation. Requires stable eye parameters and a thorough pre-examination.
New at KSA: the SCHWIND Signature Line and the Presbyopia Project
Starting 25 October, KSA's operating suite is equipped with the SCHWIND Signature Line laser system, made in Germany. In collaboration with the SCHWIND Application Manager Team, KSA is launching a dedicated presbyopia laser project.
Treatment for low hyperopes and emmetropes. Previously, individuals with low farsightedness, or those who never needed glasses in youth, had to rely on reading glasses as they aged. The new SCHWIND Signature system and its laser profiles allow KSA to treat presbyopia symptoms and solve reading vision complaints for these patients.
Extended depth of focus. The laser sculpts a precise multifocal surface profile on the cornea, increasing depth of focus. This provides sharp vision for smartphones, computer screens and distance without reading glasses.
Touchless and blade-free.It keeps KSA's no-cut, blade-free surface approach, ensuring rapid recovery and preserving corneal structural integrity.
The first step: a Vision Audit examination
Take the first step towards living without reading glasses. A Vision Audit examination in Tallinn or Tartu establishes the exact anatomy of your eyes and whether they are suited to the new generation of laser procedure.
We examine in Tallinn and in Tartu. The laser procedure itself is done in Tallinn.