Monovision: An Alternative to Bifocals
After age 40, our ability to focus on close objects usually lessens as our eyes’ lenses loses its flexibility to change distances. Bifocal glasses or bifocal contacts are often prescribed, but it’s also possible to correct the problem with monovision techniques using contact lenses, laser surgery or lens replacement surgery. These treatments let you use one eye for distance and the other for near vision. The following information is meant to help you make a choice that is right and comfortable for you.
With refractive surgery, each eye is corrected to a natural focus at the distance of your choice to compensate for the weaker eye. For people in their 30′s and younger, you should have good vision at any distance with this treatment because the lenses of your eyes should still be flexible. People in their 40′s and older, however, often develop presbyopia (loss of near-vision due to the lens becoming inflexible as part of the natural aging process) and may not see well at a reading distance even after surgery. They will still need reading glasses. Monovision may be a good option for older patients.
Monovision with contacts simply means wearing one contact lens for near vision, and one in the dominant eye for far. Both eyes still work together to see clearly at all distances, but you will not see close objects clearly through the lens that is corrected to see far, and visa versa. With a little time, most patients are able to easily adapt to monovision, as the brain learns to ignore the objects that are out of focus when using the eye that is in focus. It should take 6 or 8 weeks for your brain to adjust to monovision. Monovision with contact lenses is a recommended “test-drive” before considering any surgical method.
Monovision surgery works the same as monovision with contacts, in that the non-dominant eye is left slightly near-sighted so that patients can still see up close without the need of glasses.
In general, we do not recommend surgical monovision for people under 40 because it will be several years before you notice any benefit from it, and in that time, it’s very likely that a better surgical solution will become available by the time presbyopia affects you. We also do not recommend it for people who need superior vision for certain tasks, such as pilots, race car or truck drivers (especially for night driving), engineers and people who play fast-moving sports, such as tennis, because depth-perception could be reduced. Those who spend a lot of time on the computer should also think carefully about proceeding with monovision.
What sort of success can you expect from monovision? It’s important to remember that your vision will be less than 20/20, but with both eyes open, you should be able to see comfortably both near and far. People between the ages of 40 and 45 find monovision very useful after a few months’ adjustment period. They usually do not need glasses, except for certain, occasional situations. However, presbyopia tends to worsen with age, so reading glasses may be inevitable. Even so, older patients with monovision find they can still read large print, computers and dashboards without glasses.
Keep in mind that monovision can be reversed with an “enhancement” procedure designated for near vision so that the near eye may see distances more clearly. Reading glasses will then be necessary for near tasks.
Monovision is a very personal decision. Dr. Jenkins and her team of experts will be glad to answer any questions you may have and discuss monovision in detail with you during your exam. Please call us at (855) 522-2020 to schedule your appointment.
