PresbyMAX can increase halos and glare for some people, so marked glare sensitivity makes candidacy more cautious.
Potential pros and cons
Optical changes must be weighed carefully.
- Sharper focus can help some forms of blur‑related glare
- However, multifocal corneal profiles inherently increase light scatter
- Large pupils and high contrast conditions (night driving) may accentuate halos
- Those already highly bothered by glare may be less satisfied
- Pre‑operative demonstration with multifocal or monovision contacts can provide a preview
Assessment and counselling
Decisions hinge on tolerance and priorities.
- Detailed discussion of possible night‑time phenomena
- Consideration of alternative strategies with fewer optical side‑effects
- Importance of managing dry eye or surface issues that also cause glare
- Shared decision, accepting some level of glare as a trade‑off for spectacle reduction
- In very glare‑sensitive individuals, surgery may be deferred or avoided
