Understanding LASIK and Monovision

One question that we are frequently asked is “Does LASIK correct for a person’s need for reading glasses?”  This blog post will cover the need for reading glasses, the options for vision correction, and one of the most popular ways to address distance and near vision for individuals over 40 called monovision.

Have you ever heard of having one eye set to see distance and the other set to see near?  That’s called monovision or blended vision.  You may be thinking that it sounds like a very unusual thing to do. You certainly wouldn’t be the first person to think it so!

What Does Monovision Do?

The goal of monovision is to reduce a person’s dependency on reading glasses for near-vision tasks such as reading a book or working on a computer.  It works very well for many patients with LASIK and with contact lenses. It’s quite popular with individuals older than 40 who would like to be less dependent on drugstore cheaters.

Whether we grow up wearing glasses or contacts or not, we all start to notice changes in our near-range vision as we get older.  It happens sooner for some than others, but it happens to everyone.  Maybe you have seen a person at the restaurant who is holding the menu at a distance from them so they can try to read it – or maybe that’s something that you are currently doing!  Maybe you know someone who has to put on the over the counter “cheaters” for their vision or maybe you are doing your best to keep track of yours!

This change with our near vision is the effect of the birthday-related eye condition called presbyopia.

Understanding Presbyopia

Inside the eye and directly behind the iris (the colored part of the eye) is the natural lens. The natural lens controls what our eyes are able to focus on.  The lens has muscles that are attached in a circle around it. When these muscles flex, the lens changes shape to focus.  Presbyopia is the change that happens to the lens as it loses its flexibility over time.

When a person looks at something up close, the eye’s focusing system flexes the lens to see clearly, and it relaxes when the eyes look on something at a distance.  The focusing power needed to see anything clearly within arms gets higher and higher as the object gets closer and closer to the body.

Presbyopia’s Effects on Your Vision

Throughout life, the lens inside the eye undergoes natural changes. As a result of these changes, the natural lens loses its flexibility over time.  The eyes need the greatest amount of focusing power on small, detailed objects very close to the body (especially with less than ideal lighting). This is when people typically notice the effects of presbyopia.

Presbyopia is progressive as the lens continues to lose flexibility.  So the effects start out with small, fine print being a bit blurry and continue to get worse until the mid-60s, where the effects basically “plateau” the with complete dependence on glasses for clear vision.

How presbyopia affects a person depends a few factors including their age and whether they wear glasses or contacts to see clearly at a distance.  For example, people who don’t need glasses or contacts start to notice changes in their near vision somewhere in the 40s. By age 65, people are essentially dependent on over-the-counter reading glasses to see anything within arm’s reach.

Those individuals who are nearsighted (can’t see far away) and use glasses to see at a distance have a slightly different experience as they go thru the 40s.  If a person is nearsighted, their eyes see clearly at near without glasses, but without glasses on, distance vision is blurry.  When these individuals notice that the menu at the restaurant isn’t very clear, they will do what most people do and hold the menu away from them a bit to see it clearly.

This works for a while. But the “magic distance” continues to be further and further away until that stops working because they can’t hold it far enough away.  When that stops working, these individuals will find that if they take their glasses off, they can see the menu (or other near-range object) clearly.

Of course, there are people who are more nearsighted than others. Those who are moderate to extremely nearsighted have to hold something very close to their eyes to see it clearly.  This isn’t always practical.  Patients who can take their glasses off to see clearly at a normal “reading distance” typically have an eyeglass prescription somewhere between -1.00D and -3.00D.

Presbyopia and Contact Lens Users

Individuals who are nearsighted and correct their vision with contact lenses have a very similar experience with their near vision changes thru the 40s as do individuals who haven’t worn correction for distance vision thru ought life.  These individuals, when they have their contacts in, essentially see the same as a person who naturally sees well at a distance.

Therefore, they notice the same changes up close as the naturally well-sighted individual:  somewhere in the mid 40’s the menu isn’t as clear as it was and ideal lighting is required, then the arms aren’t long enough to make the menu clear so they have to put on reading glasses to see it clearly, and then further down the road by 65 are dependent on reading glasses to see clearly anything within arm’s reach.

When a person wears contacts and starts to experience the effects of presbyopia, their regular eye doctor may recommend changing the power of one of their contact lenses.  If your eye doctor recommends this option, they are basically talking about monovision with contact lenses.

Is Monovision For You?

While talking about monovision is helpful in order to decide if it is a good option, experiencing  monovision is much more benneficial.  Your eye doctor can demonstrate it with a trial pair of contact lenses, and your eye doctor can show it to you in the office as well.  Patients who are over 40 and considering LASIK will hear about this option when they visit 20/20 Institute and the 20/20 Institute doctor will take the time to show them their options.

If you are considering monovision, a trial will be extremely helpful. You will get a good idea of what it looks like to see the world with one eye set for distance and the other set for near.  The vast majority of the time, the individual will quickly know if monovision is a good option for them.

Patients who like their vision with monovision contact lenses, but do not like having to wear the contact lenses can have LASIK performed purposed to replicate that visual setup with the biggest benefit of LASIK – not having to put the contact lenses in every day.

What To Expect From Monovision

There is always an adjustment period with monovision. That period differs from person to person, but usually is within a month or two to get fully adjusted.  As well, monovision is absolutely not “perfect” vision.  Unfortunately, there really is no “perfect” solution for distance and near vision for any person who is experiencing the effects of presbyopia.

The options are essentially limited to three options: 1) progressive lenses, 2) LASIK or contact lenses with reading glasses, or 3) LASIK or contact lenses with monovision.  Every one of these options has its own set of plusses and minuses.  While the ideal scenario of ‘perfect vision’ is not realistic, what most people find is that one of these three options is the best for them and that helps them be happier with their vision.

Contact 20/20 For A Free Consultation

Your 20/20 Institute LASIK doctor is happy to help you along the way with this decision. Our doctors have cared for literally tens of thousands of patients considering LASIK instead of glasses or contact lenses.  Sometimes, after that discussion, the patient decides that LASIK isn’t their best option, and sometimes patient decides that LASIK is their best option.

Your 20/20 Institute LASIK Specialist is primarily interested in one thing: helping you become happier with your vision.  We are happy to do the same for you.  To set up your complimentary consultation and evaluation with our experienced and genuinely service-oriented staff members, call 303.202.0669 or contact us here.