Monovision: an Additional Risk to Lasik?
Monovision is a fairly common medical technique ophthalmologists use to correct the effects of presbyopia. Presbyopia is a fairly naturally occurring phenomenon that comes with age, specifically the gradual loss of the eye’s ability to change focus for close-up tasks like reading. The most common accepted theory about presbyopia (and thus the possible need for monovision with Lasik or other means) is that the aging eye starts to lose elasticity in its crystalline lens, or possibly changes in the curvature of the lens.
Monovision and Lasik
What the eye professional will do is to correct the vision of the presbyopic patient by adjusting one eye for near viewing and one for distance viewing. This used to be done primarily with contact lenses; the doctor would fit one eye with a lens to correct the near vision, and the other eye with a different prescription to correct the far vision.
The idea is the same with Lasik – one eye is operated on to correct the farsightedness, and one the nearsightedness. In other words, the goal is to operate for vision worse than 20/20.
The problem with this is that because each eye is corrected for different distances, the two eyes cannot work in tandem anymore, resulting in poor quality of vision and a depth perception decrease. Brightness helps this resulting monovision by shrinking the iris. However, it’s worse and more noticeable in environments with low light and in instances when very sharp vision is required, such as reading small print for long periods of time or night driving.
Also, there is the possibility that – because it’s not always clear how slow or fast the muscles of each eye will grow or change with age – Lasik surgery for other eye symptoms could result in the inadvertent result of monovision.
Considerations for Those With Monovision
If you are considering monovision through Lasik surgery, it is really important to talk to two or three well-regarded ophthalmologists to have a thorough check up. One needs to know how much his or her presbyopia might or might not increase in the future, and whether his or her eye(s) can tolerate a second or third procedure to correct any problems later.
Often times patients are unsure whether they would prefer to have their eyes surgically corrected so they have to work in tandem (thus monovision) or just have both eyes corrected to see equally. There are costs and benefits with both; it really depends on your doctor’s assessment of your eyes and your personal habits.
Help answer the question about lasik monovision
why does lasik monovision take so long to work?
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Many patients have a hard time tolerating one eye blurred at all times, so a reputable eye doctor will likely make a potential lasik patient go through a trial period with contact lenses to make sure he or she can tolerate monovision before having the actual surgery. Also, it’s important for the candidate to check with his or her Department of Motor Vehicles to find out if state driver’s license requirements can be met with monovision.
Additionally, a good lasik surgeon should explain any and all possibilities of monovision as a possible result of laser eye surgery , whether intended or not, and how long the candidate should safely convalesce and use medicated drops.
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9 Responses to “Monovision: an Additional Risk to Lasik?”
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It can take up to six months for your vision to settle down; the cornea needs to heal. After six months, you may need another procedure; it happened to me. Give it some time and be sure to use lots of artificial tears; your eyes can dry up and this definitely affects your vision. Believe me, it is worth it in the end! Good luck!
Number one question…Did you try monovision in contact lenses prior to the procedure? If not, you may never get the quality vision that you desire. Monovision is not for everyone yet some cavalier surgeons do it on anyone over the age of 40. Regardless, give it about 1 month to gage your happiness. By then, your eye should have healed enough to judge the result.
I have done it 10 years ago and do not regret it for a second.
I do not have the perfect vision but I am happy.
Give it sometime longer it will all adjust just fine.
One of my eyes healed slightly faster then the other. I don't think there is a formula to it.
I got lasik a few years ago, and I also noticed some difficulty in focusing near. For me it was really only very near objects, so if I held the page out just a little farther I was fine.
Basically, the surgery has changed the way you focus, and your eyes/brain just needs time to adjust to this. You should be fine after a short while, but if you are really concerned (or the extent of your focusing problem is really major) then you should talk to your doctor.
For presbyopic individuals (those who need reading glasses for near work) monovision is a very effective strategy to achieve good (not perfect) vision at distance as well as near without the need for any glasses. In monovision, one eye is corrected for distance vision and the other eye for near vision. The procedure entails using PRK or LASIK to fully correct one eye for distance and undercorrect the other eye (by 1 to 2 D) for near vision. Not every patient is a good candidate for monovision. The monovision option may be associated with compromises of binocular visual function, and some people may not be able or willing to accept the vision compromises. (http://www.agingeye.net/lasik/lasik.php)
All patients who opt for monovision must understand that monovision has adverse effect on some aspects of visual function. Specifically, they need to understand the risks of reduced binocular visual acuity, stereoacuity, and contrast sensitivity. Monovision patients may require spectacle correction to obtain optimal visual functioning for certain tasks such as night driving or fine near-vision tasks. In addition, they need to be made aware of the risk of distance and near ghosting as a result of incomplete blur suppression. Blur suppression appears to be particularly problematic under night driving conditions because interocular blur suppression becomes less effective under dim illumination conditions. Therefore, patients must be advised of the need to wear distance glasses when driving.
That's what I had done. The important thing to know is that you should spend the extra money on the Lifetime Acuity Plan, because I had it done 2 years ago and had to have an enhancement on my left eye just this past Friday. The doctors were really nice when they found out I needed the enhancement and since I had the Acuity Plan, I didn't have to pay any extra to get everything corrected. They don't exactly know why my eyesight changed, but I'm SO glad I invested the extra cash just in case…..But, I now have 20/20 again. It's pretty amazing.
Make certain of it.
i knew someone who went it and it worsened their eye problems