Presbyopia Treatment – Raleigh / Durham – Monovision
Monovision Treatment in North Carolina
The use of one eye for distance and one eye for near vision is referred to as monovision and is one of the options to consider as part of your refractive surgery decision. Monovision has been used successfully for over 20 years with contact lens correction and with various types of refractive surgery. By correcting one eye to focus in the distance and one eye to focus for near, the vision part of our brain tends to suppress or filter out the image from the eye that is not in clear focus. The patient is not bothered by the eye that is not in focus. We create monovision using the laser such that the dominant eye focuses at distance and the non-dominant eye at near.
One of the best ways to define monovision in the context of refractive surgery is that you can aim to have each eye corrected to a natural focus at any distance you choose. How well it will see at other distances depends upon how old you are. For example, if you are 30 and we correct each eye to excellent distance vision, then you will have good vision at almost any distance because, due to your young age, the eye will be able to accommodate (adjust focus) from far to near. If, on the other hand, you are over 40 and we correct each eye to excellent distance vision, you will not see well at a typical reading distance and will need reading or near vision glasses. This change in accommodation (focusing ability) will generally begin to be noticed about age 40 and will usually get worse quite rapidly over the next few years (presbyopia). This loss of ability to change your focusing distance from far to near will occur whether or not you have refractive surgery.
At any age, if you have the vision in one eye corrected to a natural focus for near tasks such as reading, you will not see clearly with it farther away as the ability to change focus only goes from far to near. The brain adjusts to each eye being focused at a different distance within 6-8 weeks. You do not need to consciously make any adjustments.
There is no right or wrong answer to the question of whether to have monovision treatment at the Laser Eye Center of Carolina. This information is to help you make this decision.
As a rule, we suggest against monovision if you are under the age of 35 for two reasons: 1) It will be a number of years before you will notice any benefit from it; and 2) It is very possible that there will be a better (or at least as good) surgical way to help presbyopia by the time it is a problem for you. We also generally recommend against monovision at any age for people who may need to see better than average for certain tasks. Some examples might be pilots, race car drivers, someone who drives for a living (especially at night), and avid tennis players (especially for playing at night).
In our experience, most people over the age of 40 to 45 who try monovision and take a few months to become accustomed to it, like it and find it very useful. Those who have monovision will be able to generally see well enough both at distance and near to do most things at any age without corrective lenses. Depending on the exact result obtained (as is true for everyone having refractive surgery) there might still be some situations when the very best vision or the maximum visual comfort might require wearing glasses (or possibly contacts). Night driving and prolonged reading are two examples that are mentioned frequently, but it could be anything for which you feel the need or desire to see the very best possible.
It is probably helpful to realize that without a specific cure for presbyopia, once you are past the 40 year age range, all refractive corrections involve compromise. If you have both eyes corrected for good distance vision, you will need glasses for close vision. If you have both eyes corrected for close vision (not a common choice) you will need glasses to clearly see everything far away. If you choose monovision, although your vision may work well for almost all purposes, you might feel it is less than perfect.
We know of no perfect way to help you make this choice. We would suggest that if significant doubt remains in your mind, that you aim to have your vision corrected for good general distance vision and plan to use reading glasses when necessary.
It is important to note that if you choose monovision and are unable to get used to it, it can be reversed by performing an “enhancement” procedure on the eye left for near. Once the enhancement is performed the near eye then sees more clearly in the distance and reading glasses are then required for all near tasks.
If you are over 40 and tired of wearing reading glasses, Monovision LASIK may also be an option to consider as part of your refractive surgery decision. Similar to the goal of CK, Monovision LASIK might be recommended for those with stronger up close vision needs.
Dr. Dornic’s outstanding reputation attracts numerous Raleigh LASIK eye surgery patients every year. At his elegantly appointed facilities, patients can also undergo advanced cataracts treatments, such as premium IOLs cataract surgery in Durham. Please visit the respective pages to learn more about these procedures.