The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on scleral expansion surgery for presbyopia.


Presbyopia results from age-related deterioration of the lens in the eye.

This leads to difficulty with accommodation (focusing on close objects). Scleral expansion surgery involves making small incisions in the eye and inserting bands to stretch the part of the sclera (the tough fibrous layer of the eyeball) that lies beneath the muscles controlling accommodation (ciliary muscles). This is claimed to improve accommodation.

Coding recommendations

C55.4 Expansion of sclera

In addition the ICD-10 code H52.4 Presbyopia is assigned