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.