It is possible to aim deliberately for distance vision in one eye and near vision in the other, to try and minimise the need for glasses. This is called monovision.
If you choose this option, you may find it difficult to adjust and may have some visual difficulties, as only one eye is used at a time, for either distance or near vision. You may still need glasses for some tasks such as computer work or night driving. This option is not always ideal and you should only choose this after very careful consideration.
Should I Do Monovision
The customary goal of laser vision correction is usually stated as, “to reduce or eliminate the need for glasses and contacts”. If you are over 40, you may wonder, “What about reading glasses and near vision problems that occur with age?” For patients over age 40, Monovision may be a great choice. Monovision can help the majority of patients achieve good distance and near vision without glasses.
First, a brief lesson may be helpful. Presbyopia is a normal age related eye condition in which the natural lens of the eye hardens and loses the ability to “autofocus” for near work. Sooner or later, presbyopia causes a gradual worsening of near vision during the forties. Though many patients are not opposed to using over-the-counter reading glasses for near work as they age, others truly want to be “glasses-free” for near work.
With Monovision, one eye is “set” for distance focus, and the other eye is set for better near focus. Having mild nearsightedness in one eye can help negate the effects of presbyopia and restore/preserve near vision. Monovision allows a patient to see both distance and near images without glasses by having blended visual focal points. The goal of Monovision is to be independent of glasses for most day-to-day activities. After Monovision it is realistic to be able to read a menu, do computer work, watch TV, and drive a car legally without glasses.
While Monovision is not a “perfect” solution to presbyopia, for carefully selected patients, it is well tolerated and very satisfactory over 85% of the time. Most patients who choose Monovision are satisfied with both near and far vision without glasses. Alternatively, about 15% of Monovision patients notice certain tradeoffs, including difficulty with high performance sports or night driving, or with intricate close work. Monovision may be appropriate for a 50 year-old accountant, but not appropriate for a 50 year-old motorcycle police officer. My goal is to help my patients be satisfied with their vision, for their specific lifestyle and activities, regardless of their age. Ultimately, deciding between a Full Distance correction and a Monovision correction is an individualized choice that is based on many factors. Accordingly, there is not one “right” answer. After getting to know your goals and lifestyle, I can help guide you to the most appropriate procedure for your specific needs.
Reasons for considering Monovision correction(“Blended Vision”) may include:
• Age 40 or older
• Seeking the convenience of “glasses-free” lifestyle
• Being opposed to needing reading glasses for near work
• Not active in high performance sports (i.e. tennis, motorcycle riding)
• Tried Monovision with contact lenses and liked it
• Being “okay” with about the possibility of using distance glasses to fine-tune distance vision for sports or night driving (so both eyes see 20/20). Or a LASIK re-treatment could “un-do” Monovision at a later date, if desired
Reasons for considering Full Distance (not Monovision)vision correction include:
• Age 40 or younger (eventually will use readers in mid-forties)
• Over age 40, but seeking the most “perfect” distance vision possible for sports or night driving
• Being “okay” with needing over-the-counter reading glasses for close work (usually after age 43)
• Tried Monovision with contact lens trial, but did not like it
• Difficulty adapting to changes to vision (new bifocals, new glasses prescription) or just “feeling” that
Monovision will not work for you
• Having a very large amount of Farsightedness
• Having a weak/lazy eye (amblyopia)