Lasik (Laser Assisted In-Situ Keratomileusis)

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Monovision Lasik

Monovision is one clinical technique used to deal with the correction of presbyopia, the gradual loss of the ability of the eye to change focus for close-up tasks that progresses with age. The intent of monovision is for the presbyopic patient to use one eye for distance viewing and one eye for near viewing. This practice was first applied to fit contact lens wearers and more recently to LASIK and other refractive surgeries. With contact lenses, a presbyopic patient has one eye fit with a contact lens to correct distance vision, and the other eye fit with a contact lens to correct near vision. In the same way, with LASIK, a presbyopic patient has one eye operated on to correct the distance vision, and the other operated on to correct the near vision. In other words, the goal of the surgery is for one eye to have vision worse than 20/20, the commonly referred to goal for LASIK surgical correction of distance vision. Since one eye is corrected for distance viewing and the other eye is corrected for near viewing, the two eyes no longer work together. This results in poorer quality vision and a decrease in depth perception. These effects of monovision are most noticeable in low lighting conditions and when performing tasks requiring very sharp vision. Therefore, you may need to wear glasses or contact lenses to fully correct both eyes for distance or near when performing visually demanding tasks, such as driving at night, operating dangerous equipment, or performing occupational tasks requiring very sharp close vision (e.g., reading small print for long periods of time).

Many patients cannot get used to having one eye blurred at time. The difference between monovision with contact lenses and monovision with LASIK is that you can always take contact lenses out or have them changed (the treatment is reversible and adjustable) as opposed to LASIK, where the result of the surgery is not reversible or adjustable. Therefore, if you are considering monovision with LASIK, make sure you go through a trial period with contact lenses to see if you can tolerate monovision, before having the irreversible surgery performed on your eyes. Just before this trial period starts, find out if you pass your stateŐs driverŐs license requirements with monovision, or if you need supplemental glasses to drive.

In addition you should consider how much your presbyopia is expected to increase in the future. Ask us when you should expect the results of your monovision surgery to no longer be enough for you to see clearly at near without the aid of glasses or contacts, or when a second surgery might be required to further contact your near vision.

(Taken in part from FDA website "Lasik Eye Surgery")