Presbyopia, which literally means “old eyes,” is a normal and expected consequence of the aging process, which results in the inability of the eyes to focus at all distances, due to the slow degeneration of your eye muscles. Usually you will first notice the effects of presbyopia when fine print starts to blur and you find yourself hold reading material farther and farther from your face.
This usually begins having an effect when you’re between the ages of forty and fifty, and it continues to worsen until you reach about age sixty-five. An estimated 90 million baby boomers in America either have presbyopia or will develop the condition in the next 10 years, according to an April 2004 report by Refractec Inc.
Monovision LASIK surgery treats presbyopia by correcting one eye for long distance vision and the other eye for near vision. This procedure offers presbyopic and pre-presbyopic patients the ability to retain near and distance vision after surgery with little or no reliance on glasses or contact lenses. If you are over 50 and you choose to have traditional, rather than M-LASIK, you’ll probably still need reading glasses after surgery. The concept of using one eye for close vision and one for distance is not new. It dates back as far as 1720, when Baron Philip Von Stosch invented the monocle. In more modern times, using different eyes for different vision has been done successfully for several decades, using contact lenses. Monovision as a form of LASIK surgery is the most recent development in presbyopia treatment, taking advantage of the fact that each of us has a dominant eye, much as we have a dominant hand.
Having radically different vision in each eye can take some getting used to. We are used to using both our eyes to see any object from two slightly different angles, which provides us with our depth perception. When your eyes are corrected for different distances, you’ll be seeing almost all objects clearly through only one eye or the other. It is surprising how many people adapt readily and happily to this vision option, but it’s not for everybody. Some people dislike its effect, particularly those whose work requires extremely precise near or far vision, such as engineers or police officers. For most people, the brain eventually adjusts to the difference in perception between the two eyes, but the period of adjustment is harder on some than on others. Certain aspects of sight that particularly require both eyes to work well together, such as night vision and depth perception, will never be perfect. Therefore, after monovision LASIK, you may want to own a pair of glasses that provide full distance vision correction (in both eyes).
Because not everyone can adjust to this new way of seeing, many doctors recommend you wear special monovision contact lenses for at least a week before committing to surgery. Monovision LASIK is a permanent operation to the cornea, and you want to be sure it will work for you before you commit to it.
Monovision LASIK was performed off-label for many years, meaning that it had not received official FDA approval as an approach to correcting presbyopia. However, this changed on July 12, 2007, when the FDA officially approved the surgery as a treatment for presbyopia. While this is an ambitious type of laser eye surgery, requiring careful patient selection and counseling, Monovision LASIK can offer excellent visual outcomes for both distance and close vision, and may be especially attractive to those hoping to never have to wear granny glasses!