It happens to all of us: At some point in life, usually after 40, we don’t seem to see up close like we used to. For many people, monovision can help. Monovision is a popular method for treating presbyopia, a natural age-related condition that makes it difficult to focus clearly on nearby objects.1 Because presbyopia is a natural, age-related condition, many of us try to resolve it with over-the-counter readers. But nonprescription reading glasses may only work for those who have good, uncorrected distance vision. For the rest of us, monovision is a more convenient way to treat the condition, and it can be performed through LASIK surgery.

Tell me more about presbyopia

If your smartphone is suddenly harder to read, or the entrées on a menu look fuzzy, you’re likely experiencing presbyopia. Common symptoms include:
  • Having trouble seeing objects nearby
  • Difficulty seeing in low light
  • Finding it hard to read small print
Here’s what’s happening: As your eyes get older, their lenses become less flexible and as a result aren’t able to bend light and focus it on the retina (the light-sensitive cells at the back of the eyeball). At the same time, the muscles around the lenses grow weaker, making it harder to zero in on nearby objects.2 People who have never needed eyeglasses experience presbyopia, but it also occurs among those who are nearsighted or have astigmatism, a curvature of the cornea that causes distorted vision.3

How does monovision work?

Monovision, what some surgeons call blended vision, treats presbyopia by correcting the distance vision in the patient’s stronger (dominant) eye, while leaving the other eye somewhat nearsighted. The eyes will then work together so the patient can clearly see objects both near and far. 4 This change has been done for decades using contact lenses, wherein the patient wears one contact lens to correct distance vision (usually on the dominant eye) and another to correct near vision. If the concept works with contacts, LASIK monovision may be considered — it’s among one of the most popular ways to correct presbyopia.5 If you have common symptoms of presbyopia you should talk to your eye doctor to find out if LASIK treatment is right for you. Here are some important considerations.

3 factors that affect LASIK monovision

  1. Age. Because the brain needs to adjust to the new way of seeing through monovision, this treatment is better suited to those in their early 40s, when the brain is more flexible.
  2. How much you read matters. Monovision can lead to eye strain for those who spend a lot of time reading or looking at items within close range, such as accountants or woodworkers.6
  3. It could affect your game. Monovision can adversely alter depth perception and night vision. For some activities, such as golf or tennis, patients may benefit from using a contact lens in the eye that was uncorrected.7
Lastly, because our reading vision continues to degrade with time, even those of us who see well through monovision will likely eventually need reading glasses. The good news is we would depend on them less. If you notice any changes in your vision, you should schedule an appointment for a comprehensive exam. 

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1. "What is Monovision (or Blended Vision)?," by Kiersten Boyd, American Academy of Ophthalmology, May 7, 2018; https://www.aao.org/eye-health/treatments/what-is-monovision-blended-vision; accessed July 23, 2019.

2. "Information for Healthy Vision: Presbyopia," National Eye Institute, https://nei.nih.gov/healthyeyes/presbyopia; accessed July 29, 2019.

3. "Ibid

4. "What is Monovision (or Blended Vision)?," by Kiersten Boyd, American Academy of Ophthalmology, May 7, 2018; https://www.aao.org/eye-health/treatments/what-is-monovision-blended-vision; accessed July 23, 2019.

5. "Monovision LASIK a good option for emmetropic presbyopes," Ocular Surgery News, April 25, 2019, https://www.healio.com/ophthalmology/refractive-surgery/news/print/ocular-surgery-news/%7B9919afe0-909d-4b79-a735-2d239ac9e8b8%7D/monovision-lasik-a-good-option-for-emmetropic-presbyopes; accessed July 26, 2019.

6. Ibid.

7.  Ibid.