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Specialized LASIK Eye Surgery with Monovision

Reviewed by JoAnn Chang, M.D.

LASIK monovision may be a good option for people over 40 considering Laser Vision Correction. After the age of forty, we all will begin to lose the ability to accommodate or focus the lens of our eye. This is a universal phenomenon and not caused by any disease or illness.

When the ability to accommodate is lost, it means that the eyes cannot adjust or focus images at different distances. Therefore, different glasses, at different focal lengths, are required for distance and near vision. People may find that if they can see well at distance, they now require glasses to read at near and vice versa.

This problem is called Presbyopia and is usually corrected with bifocals or glasses with two focal lengths, one for near and one for distance. Presbyopia may also be corrected with Monovision. Monovision corrects one eye for distance and one eye for near. Monovision can only be used in patients who wear contacts or who have refractive surgery. Thus, the need for glasses with two different focal lengths is resolved by focusing each eye at a different focal length.

People over 40, who require glasses for distance vision – nearsighted or myopic individuals – frequently find that they can read up close quite well without their glasses. Correcting their distance vision to 20/20 almost always means that they will need glasses to be able to read up close. This is because they can no longer focus or adjust their focal length.

Typically in Monovision, the eye that is correct for distance is the dominant eye. One can usually determine which eye is dominant by raising a thumb, holding it out in front of both eyes, and blocking an object with the thumb while both eyes remain open. Once the object is blocked, close one eye or the other, and the eye that cannot see the object is the dominant eye.

Patients over forty must make a choice. Either both eyes are corrected for distance or one eye is corrected for distance and the other for near. If the patient is unsure of what they would like, contacts can sometimes be used to simulate post-operative results.

If you are over 40, or wear bifocals or reading glasses, your LASIK surgeon will want to discuss Monovision as part of your Consultation in order to make sure you get the best possible results.

If you are over 50 and do not wish to have monovision LASIK, you will most likely require reading glasses after your LASIK surgery. For patients over 50 who wish to have both their far and distance vision corrected without monovision or using reading glasses, a possible option to explore in order to effectively manage their presbyopia is Lens Replacement Surgery.

©2011 The Medical Management Services Group

updated 5/3/11