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If you are near or over age 40 and considering LASIK, consult your eye doctor to determine if monovision LASIK is right for you.

In my 15-year career as a LASIK doctor, I have corrected over 50,000 eyes. The most common question I get from my patients over age 40 is about how to correct for both distance and reading vision. This can be a source of confusion for some individuals and requires careful consideration prior to having the procedure.

Age-Related Vision Changes

As we mature into our 40s and beyond, the lens in the eye begins to change. It loses its elasticity and hardens into more of a plate shape. This process is called presbyopia. When patients with this condition have their vision corrected for distance, nearby objects become fuzzy. For this reason, many individuals wind up wearing reading glasses or bifocals. Presbyopia affects nearly all of us as we enter middle age, and by the time most of us reach age 45, it has progressed to the degree that it is visually noticeable and requires some form of correction.

Monovision Laser Vision Correction

One potential treatment for patients with presbyopia is a laser vision correction procedure called monovision or blended vision. We all have a dominant eye just like we have a dominant hand (although ocular dominance and hand dominance don’t correspond). With monovision, the dominant eye is usually corrected for full-distance, and the non-dominant eye is left nearsighted to enable it to see up close. The brain then has to adjust to this new way of seeing, which can take a few weeks. Over time, most patients become comfortable with monovision and don’t even realize the difference. Monovision correction works well for those who want complete freedom from glasses or contacts, but it does have some limitations. For someone who spends most of his time reading or looking up close, such as a tax attorney, monovision can lead to eye strain. Monovision can also adversely affect depth perception and night vision. Because the need for reading correction increases over time, someone who can initially see well up close with monovision will probably need reading glasses eventually, but she will be less dependent on them.

Personal Experience

I am very happy with the results of my monovision procedure, but I realize that it is a compromise. Although my distance vision is good, it’s not quite as sharp as it was when I used both eyes together — plus glasses or contacts — for distance. For certain activities, such as tennis, I may use a contact lens to correct the eye that was uncorrected for distance, so that I can use both eyes together.

If you are near or over age 40 and considering LASIK, consult your eye doctor to determine if monovision is right for you. It is usually best suited to someone in his early 40s, because at that age the brain is more flexible. It works especially well in patients who have been doing monovision with their contact lenses, because they have already adjusted to that way of seeing. It can also work well for those who have never needed glasses for distance vision but have noticed a loss of reading vision. Individuals over 50 who have never tried monovision may not be able to adapt to it as easily. Also, there are some types of correction that do not work well with monovision. Your doctor will go over all the options with you, so you can choose what works best.

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