Understanding LASIK and Monovision

LASIK can accomplish some amazing things for your vision—for example, it can eliminate or drastically reduce nearsightedness, farsightedness, and astigmatism.

These three conditions are what cause someone to have blurry vision, and they’re caused by the shape of the cornea or the clear part on the front of the eye where a contact lens sits. 

If the cornea is too steep or too flat (or a combination of both), it won’t focus light properly to the back of the eye where vision is processed. If the cornea doesn’t match the shape or size of the eye, blurry distance vision is likely—it’s like having a camera that’s out of focus…the picture will turn out blurry if the light isn’t properly focused.

What happens to our up-close vision as time goes by? Why do you and/or others wear “readers” or “bifocal glasses” to see a phone screen, computer monitor, or other things we like to enjoy up close? 

A phenomenon called Presbyopia occurs in everyone, and it starts to occur in the early to mid-40s. There’s a tiny lens inside of our eye, right behind the iris (i.e., the colored part you can see in the mirror). 

When we’re young, it’s flexible…think of it like a dodgeball. When a dodgeball is in your hand, it’s almost perfectly spherical, but if you throw it against a brick wall, the moment it hits the wall it contorts to a flatter shape for a moment. Those are the shapes of the lens inside your eye.

When you look at something up close, the lens is round and spherical. When you look at something far away, it flattens out. This isn’t something we consciously control. When you pick up your phone to check a message, your brain tells your eye to make the lens more rounded, and when you look across the room at the clock on the wall, the lens flattens out. 

Just like we lose the elasticity in our skin, the lens loses its ability to change its shape over time…it gets stiffer and tends to get stuck in the flatter shape. So, when we’re in our early to mid-40s, and when we look at something up close, the lens isn’t able to change to the rounder shape and magnify what we are trying to look at. This is how putting on “readers” helps with this issue: it magnifies images up close because the lens inside of the eye can no longer do so as it once did. 

Presbyopia isn’t something that just happens overnight…it’s a slow gradual change that can take several decades to fully occur.

Because LASIK is performed on the cornea, it doesn’t fix presbyopia (as mentioned before, presbyopia occurs on the lens inside of the eye). This leaves us with a couple of different options:

  1. Have excellent distance vision and wear readers for any up-close tasks; or
  2. Have monovision LASIK  and achieve “blended vision”

What exactly is monovision? Monovision or “blended vision” is a technique in which LASIK is used to set one eye for far distance vision and one eye for near. 

With both eyes open, your brain blends the distances together so that you can see both far and near. It may sound strange, but it works really well for a majority of patients over the age of 40.

The brain is incredibly adaptable, and over the first few weeks of having the procedure, patients become accustomed to monovision, life goes on as usual, and it will lessen or eliminate the need to wear reading glasses for up-close tasks. 

If you’ve worn monovision contacts and enjoyed the experience, you will enjoy monovision LASIK without the hassle of wearing contact lenses.

When you come in for a FREE consultation at the 20/20 Institute, you’ll discuss all of these options and more. Your Doctor will even show you what monovision will feel like! 

Plus, if you have monovision LASIK and you feel like it is not for you, most can return and have the monovision corrected so that both eyes are clear for distance. Although, this will require most patients age 45 and older to rely on reading glasses for most up-close tasks.