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Monovision LASIK

If you are researching laser eye surgery in Greater Cleveland, you will likely come across this term: Monovision LASIK. Monovision might sound like the name of a superhero power, but it refers to the technique of correcting one eye for distance viewing and the other eye for near viewing. Within the first few weeks, the brain adjusts and “blends” your vision, allowing you to see both far and near. This can be done through contact lenses, and increasingly, it can be done as a variation of traditional LASIK surgery.

As you will learn, there are pros and cons to Monovision LASIK, but it can be ideal for patients in their 40s who are looking to reduce their use and reliance on reading glasses. If you have questions or want to explore your candidacy for the procedure, reach out to the team at LVC.

What Happens During a Monovision LASIK Procedure?

The same LASIK technology used in traditional LASIK is used during a Monovision LASIK procedure. The eye surgeon will use a laser to reshape the cornea of one eye for far vision, while reshaping the other eye for near vision. The procedure generally is very quick and painless.

The biggest difference between LASIK and Monovision LASIK comes in the pre-operative and post-operative care for patients. Much of the pre-operative process will be similar to patients undergoing traditional LASIK. However, before any Monovision LASIK procedure is performed, there will likely be a contact lens trial. Your eye surgeon will determine your dominant eye through a procedure referred to as “ocular dominance testing.” 

The dominant eye will be set for distance vision, and the nondominant eye will be set for myopia. While wearing your monovision contact lenses, you will be asked to go about a typical day—and incorporate the types of activities that you normally do, whether that’s going for a walk or playing a round of golf. This trial gives the patient a sense of what it feels like to have both eyes set to different vision prescriptions and having to use both eyes together to see clearly.

What Is the Recovery From Monovision LASIK?

You may be wondering, Are there any side effects from monovision? Will I like the results of monovision or will I regret it?

The most concerning part of Monovision LASIK for patients is the recovery. It can be difficult to adjust to the anisometropia—an imbalance between the eyes—that is caused by the procedure. Patients may experience the following:

• Glare and halos

• Reduced vision at night, especially while driving

• Reduced depth perception

• Blurry or flogging distance or reading vision

Typically, once your eye surgeon and care team has addressed any typical post-operative concerns, such as dry eyes, they will shift their focus to helping you alleviate any symptoms of anisometropia. For example, you may need to wear glasses during certain activities as you adjust. 

What Are the Experts Saying About Monovision?

Dr. J. Bradley Randleman, a professor of ophthalmology at the Cole Eye Institute of the Cleveland Clinic Foundation, described the adjustment to Monovision LASIK in the Review of Ophthalmology.

“It’s not uncommon for people to be aware of the fact that they’re seeing distance with one eye and near with the other, but the ultimate goal is for that to become integrated to the point where they’re just seeing,” says Dr. Randleman. “We don’t want patients to be particularly mindful of which eye is functioning at which distance in the long term. It’s an unconscious process that just has to happen.”

Who Is a Candidate for Monovision LASIK?

The primary candidates for Monovision LASIK are patients with presbyopia. Presbyopia is the name for the gradual loss of flexibility in the eye’s lens. Many adults in their 40s begin to experience presbyopia, which occurs over time. It is why you may find yourself picking up a pair of reading glasses in order to read tiny print. While traditional LASIK does not treat presbyopia—and cannot prevent it—Monovision LASIK can benefit patients with presbyopia. 

Dr. Kathyrn M. Hatch, the director of refractive surgery at Mass Eye & Ear and an assistant professor of ophthalmology at Harvard Medical School, described how she discusses this type of treatment in the Review of Ophthalmology.

“I start talking about presbyopia with patients who may be approaching it in the coming decade. It’s good for all patients to know what it is because in general, presbyopia is a different issue from other refractive errors like myopia, astigmatism, and hyperopia,” Dr. Hatch says. “Certainly, patients in their 40s and older who already need some sort of reading correction are finding out their options.”

How Your Career Impacts Your Eligibility for Monovision LASIK

Keep in mind: Your occupation plays a role in whether Monovision LASIK will be a good fit. For example, if you are a pilot, a commercial truck driver, or a professional athlete, you need to have clear vision without much variation. You may not be able to tolerate any level of undercorrection. This would be something to discuss with your LASIK surgeon. Your doctor will also consider the following factors:

Screening for any refractive errors

• Occupation or daily activities

• Age (typically over the age of 45)

• Any level of monovision in your current contact lens prescription

Monovision LASIK Pros and Cons

Monovision LASIK is safe, effective, and—for many patients—can be an easy adjustment. However, if it does not work for you or you simply cannot adjust, you can return to your eye surgeon to have the monovision removed. Again, it is best practice to undergo a contact lens trial so that you have an understanding and an opportunity to experience the effects of Monovision well before you undergo laser eye surgery. We would be happy to talk to you about Monovision LASIK and whether this procedure might be right for you. Reach out to our team at any time. 

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