When it comes to vision problems, most people know something is off but aren’t sure exactly what it is. Whether you’re squinting at distant road signs or struggling with up-close reading, understanding the difference between short-sightedness (myopia), long-sightedness (hyperopia), astigmatism and presbyopia is the first step to finding the right solution.
At Harley Vision, we specialise in diagnosing and treating all major refractive errors with world-class vision correction surgery. This guide breaks down the differences between these conditions and explores the range of modern treatment options,from laser eye surgery to implantable lenses and advanced lens exchange procedures.
What Is Short-Sightedness (Myopia)?
Short-sightedness, or myopia, means you can see clearly up close but distant objects appear blurred. It happens when the eyeball is too long or the cornea is too steep, so light focuses in front of the retina.
Symptoms of Myopia:
- Difficulty seeing signs while driving
- Blurred distance vision
- Eye strain from squinting
What Is Long-Sightedness (Hyperopia)?
Long-sightedness, or hyperopia, is the opposite: distant objects are clear, but close-up vision is blurred. This occurs when the eyeball is too short or the cornea too flat, causing light to focus behind the retina. As you approach your 50s, even the distance vision can start to become blurred.
Symptoms of Hyperopia:
- Blurred vision when reading or using a screen
- Eye fatigue or strain
- Headaches after close work
What Is Astigmatism?
Astigmatism results predominantly from a non-round shaped cornea or lens, more like a rugby ball than a football. This uneven curve causes light to scatter in multiple directions, leading to blurred or distorted vision at all distances.
Symptoms of Astigmatism:
- General visual blur, ghosting
- Double image when looking through each eye
- Trouble with night driving
- Frequent squinting or headaches
What Is Presbyopia?
Presbyopia is an age-related condition that affects the eye’s ability to focus on nearby objects. Unlike other refractive errors, it’s caused by the natural hardening of the eye’s lens, reducing its flexibility and making close-up tasks like reading more difficult.
It usually becomes noticeable after the age of 40 — even in people who have never had vision problems before. It worsens with age, meaning you need stronger reading glasses as you get older.
Symptoms of Presbyopia:
- Difficulty reading small print
- Needing to hold reading materials further away from you (e.g. at arm’s length)
- Eye strain or fatigue during close work
- Switching between multiple pairs of glasses
Am I Too Old for Vision Correction Surgery?
It’s a common question: “Have I missed my chance for vision correction surgery?” The truth is, you’re almost never too old — just a candidate for a different kind of solution.
Vision correction surgery has evolved drastically over the last 10 years, and we have the technology to keep you spectacles independent for the rest of your life.
While laser eye surgery such as LASIK and SMILE is typically most suitable for younger adults (usually ages 18–60), those over 45 or 50 often benefit more from lens-based procedures like Refractive Lens Exchange (RLE) or cataract surgery with premium intraocular lenses (IOLs).
Why Age Matters
As we age, the natural lens inside our eye becomes stiffer (leading to presbyopia) and eventually cloudy (cataracts). This makes lens exchange procedures far more effective than cornea-based laser treatments for patients over 45.
You’re Not Too Old, You Just Need the Right Procedure:
- In your 40s–50s: RLE can correct both distance, intermediate and near vision, and prevent future cataracts.
- In your 60s and beyond: Cataract surgery with premium IOLs not only restores clarity but can also free you from glasses.
Complete Range of Surgical Vision Correction Options at Harley Vision

Thanks to modern vision correction surgical techniques, prescription errors can be corrected safely and effectively. At Harley Vision, we offer a wide range of cutting-edge laser and lens-based correction vision surgery to treat myopia, hyperopia, astigmatism, and presbyopia — tailored to your specific eye health, age, and lifestyle needs.
At Harley Vision, we assess your age, eye health, and visual goals to recommend the most appropriate treatment. Many of our patients in their 60s, 70s, and even 80s achieve spectacular results, often better than they thought possible.
Below we summarise correction vision surgery techniques and indications.
1. LASIK (Laser-Assisted In Situ Keratomileusis)
Best for: Myopia, hyperopia, astigmatism, presbyopia
LASIK reshapes the cornea using a laser under a protective flap. It’s fast, precise, and highly effective for eligible candidates.
2. LASEK / PRK (Surface Laser Treatments)
Best for: Myopia, hyperopia, astigmatism.
These surface treatments reshape the cornea without a flap, making them ideal for certain corneal profiles (e.g. thin cornea) and active lifestyles (e.g. contact sports).
3. SMILE (Small Incision Lenticule Extraction)
Best for: Myopia and astigmatism
SMILE uses a small incision to remove tissue from the cornea, correcting vision with minimal disruption to the eye surface.
4. ICL Surgery (Implantable Collamer Lens)
Best for: High myopia, astigmatism, thin corneas, or dry eyes
A permanent biocompatible artificial lens is implanted in front of the natural lens of the eye. ICL surgery is ideal for patients aged 21–50 years who would like to achieve crisp vision, and results in visual outcomes as good if not sometimes slightly better than laser vision correction in certain eyes.
5. Refractive Lens Exchange (RLE)
Best for: Long-sightedness, presbyopia, short-sighted, patients over 45 years
RLE replaces the eye’s natural lens with a custom intraocular lens (IOL). It’s one of the most effective treatments for age-related near vision loss (presbyopia) and can also correct other refractive errors.
For patients above the age of 45–50 years, it is an ideal long term solution, as it means you can achieve spectacle independence for distance, intermediate and near vision.
🔹 Premium lens (e.g. multifocal, trifocal, galaxy IOL) offers clear vision at near, intermediate, and far distances
🔹 Eliminates the future need for cataract surgery
🔹 Long-term solution for both reading and distance vision
6. Cataract Surgery (With Advanced Lens Implants)
Best for: Age-related cataracts and combined refractive correction
Cataract surgery replaces the clouded lens with a clear IOL. At Harley Vision, we offer premium lenses that can correct short-sightedness, long-sightedness, astigmatism, and presbyopia in one procedure.
Why Choose Harley Vision?
Harley Vision is a London-based centre of excellence for vision correction surgery, delivering personalised vision correction plans with outstanding clinical outcomes:
- Expert Clinical Director: Mr. Mukhtar Bizrah is a UK and Canada trained refractive, cataract and corneal surgeon, known for delivering outstanding outcomes with premium lenses. He is one of the few ophthalmic surgeons in the world certified in the UK, USA, Canada, Europe.
- Advanced Diagnostics: We use state-of-the-art diagnostics, AI-assisted algorithms and cutting-edge surgical technology to deliver the best possible desired visual outcomes.
- Consultant-led, patient-focused care: You will be assessed comprehensively by a specialist eye surgeon, and a vision correction plan will be tailored to your lifestyle needs.
- Hospital-Based Surgery: Procedures are performed at top-rated CQC-registered London hospitals and clinics (including the Hospital of St John and St Elizabeth, and King Edward VII’s Hospital).
- 0% finance: Harley vision offers flexible 0% finance payment plans and transparent pricing
- Excellent patient feedback: We achieve consistently excellent patient feedback for delivering patient centred and ethical care at Harley Vision.

Hear from Our Patients: Real Harley Vision Reviews
Our patients consistently share their positive experiences at Harley Vision. Here are a few examples from Trustpilot:
- “Found all of staff to be very friendly and accommodating like the fact that they knew who I was, called me by my Name when I arrived. As for the treatment got exactly what was said on the tin. Every thing I was told about the treatment and what would happen would unfold as describe , so no surprises. Day of the operation staff where very good, professional and friendly made me feel very relaxed. Already recommending them to others.” Gary, UK
- “It’s like magic! I can see… no more glasses! The journey was seamless.
Dr Bizrah not in anyway pushy & explained everything I needed to know. The surgery itself was no problem & not once was I uncomfortable or scared or in any discomfort. Can’t express how happy I am to have unaided sight again!!” — Sarah, UK - “This is the ultimate experience in ocular precision. Wonderful treatment. Wonderful result. How technology has progressed. Dr Bizrah deserves to receive all the credit he gets..” — Raymond, UK
- “I am a consultant surgeon and I needed an important eye operation (cataract). The team at harley vision are exceptional in terms of organisation, communication, efficiency professionalism and overall care. Dr Bizrah is a fantastic doctor and world class ophthalmologist. Outstanding care and result!” — Dr Alex, UK
- “From the initial consultation to the aftercare, the service at Harley Vision was outstanding. Mr. Bizrah is a highly skilled surgeon, and I felt completely at ease throughout the process. My ICL surgery has been life-changing.” — Aisha, UK
At Harley Vision, we are dedicated to providing exceptional care and achieving outstanding results for everyone who chooses us for their vision correction surgery in London.

Book Your Free Consultation Today
If you’re struggling with reading small print, seeing in the distance, or dealing with glasses for multiple prescriptions, Harley Vision can help.
Whether it’s laser eye surgery, ICL surgery, or lens replacement surgery, we will find the best solution for your unique eyes and lifestyle needs.
📞 Call us or book online to schedule your free consultation with a specialist at our Harley Street clinic.
📍 Location: Multiple Central London locations including Harley Street
📞 UK: 0207 030 3181
🌍 International: +44 207 030 3181
📧 Email: [email protected]