Monovision Lasik and Presbyopia
Even if you undergo LASIK (laser-assisted in sitiu keratomileusis) or PRK (photorefractive keraterctomy) when you’re young and achieve 20/20 vision, you will still develop a condition called presbyopia usually between the ages of 40 and 50. Presbyopia is the inability of the eye to focus at all distances and is usually noticed when fine prints begin blur.
Medical professionals disagree about what is the cause of presbyopia, but most believe that stiffening of the eye’s lens contributes to the condition. Others believe that presbyopia could also be associated with continued growth of the lens or atrophy of the muscles controlling the lens. In the past, the remedy for presbyopia was to wear bifocals or reading glasses. Nowadays, however, surgical remedies for this condition are available for patients who meet certain criteria.
Monovision to Treat Presbyopia
Monovision was once possible only through the use of contact lenses, but advances in LASIK have now made it possible to achieve permanent monovision. Through LASIK, a highly trained surgeon can use an excimer laser to reshape the cornea so it can properly focus images, and your surgeon can correct distance vision in one eye and up-close vision in the other eye.
Typically, both of our eyes work together when we look at an object to produce what is called “binocular vision.” However, most of us have a dominant eye that our brain tends to favor.
Sometimes, LASIK surgeons produce monovision in their presbyopic patients by purposely leaving the non-dominant eye slightly near-sighted so that they can see up close without glasses. Some are wary of this technique because not everyone can become used to the absence of binocular vision. It has been suggested by some LASIK surgeons to try monovision with contact lenses or trial lenses first to be sure you can adapt.
FDA Approval
Monovision LASIK initially was used off label, meaning that it had not yet received official Food and Drug Administration (FDA) approval as an approach to correcting presbyopia. In July 2007, the FDA announced approval of the Advanced Medical Optics (AMO) and Visx CustomVue excimer laser for performing the monovision procedure.
One drawback of permanent monovision is that our eyes will no longer work together, and some patients find it difficult to get used to one of their eyes being blurry all the time. If you are considering LASIK for treatment of presbyopia, you may want to try monovision with contact lenses first to see how you adjust.
Help answer the question about lasik monovision
Eye strain with LASIK monovision?
I had LASIK a couple of years ago and did the monovision option. I’m generally very happy with it, but I find my eyes get very strained and tired after a day of using my computer at work or doing detailed work. Would it help to use a pair of reading glasses? Or distance glasses like I use when I’m driving?
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If you live in the San Jose area of California and would like to learn more about monovision, presbyopia and LASIK, please visit the website of the Laser Eye Center of Silicon Valley today.
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9 Responses to “Monovision Lasik and Presbyopia”
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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.
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!
Make certain of it.
i knew someone who went it and it worsened their eye problems
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.
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.
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.
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.