---
title: Is PresbyMAX surgery suitable if you have large pupils?
description: "PresbyMAX can be performed in people with large pupils, but the risk of night‑time halos and glare must be carefully weighed. ## Potential issues with large pupils More light passes through peripheral optics. - Increased likelihood of halos, starbursts, or…"
url: "https://bluefinvision.com/knowledge-base/topics/suitability/is-presbymax-surgery-suitable-if-you-have-large-pupils/"
updated: "2025-12-24"
category: Suitability
---

# Is PresbyMAX surgery suitable if you have large pupils?

PresbyMAX can be performed in people with large pupils, but the risk of night‑time halos and glare must be carefully weighed.

## Potential issues with large pupils

More light passes through peripheral optics.

- Increased likelihood of halos, starbursts, or glare around lights at night
- Greater sensitivity to slight imperfections in the multifocal ablation
- Possible impact on night driving or low‑contrast tasks
- Subjective tolerance to these phenomena varies widely
- Large pupils may influence candidacy or laser profile choice

## Assessment and counselling

Decisions are highly individual.

- Measurement of scotopic pupil size during assessment
- Discussion of current night‑vision symptoms and expectations
- Consideration of alternative strategies (for example monovision) if risk seems high
- Advice that occasional spectacles may still be helpful in challenging night conditions
- Shared decision‑making after fully understanding trade‑offs