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If you are near or over age 40 and considering LASIK, it’s important to consult with your eye doctor to see if monovision LASIK is the right option for you.
In my 25-year career as a LASIK surgeon, having corrected over 105,000 eyes, one of the most common questions I receive from patients over 40 is how to address both distance and reading vision. This can be a point of confusion and requires careful consideration before proceeding with the procedure.
As we enter our 40s and beyond, the lens in the eye naturally changes, losing elasticity and hardening into more of a plate shape—a process called presbyopia. This condition makes it difficult to focus on nearby objects, even if your distance vision is corrected. As a result, many people end up relying on reading glasses or bifocals. By age 45, most individuals notice these changes and require some form of correction.
One potential solution for presbyopia is monovision laser correction. Much like having a dominant hand, everyone has a dominant eye. In monovision, the dominant eye is corrected for distance vision, while the non-dominant eye remains slightly nearsighted to improve close-up vision. The brain adjusts to this setup, typically over a few weeks, allowing for more freedom from glasses or contacts.
However, monovision has its limitations. For individuals who spend a lot of time reading or doing close-up work, it may cause eye strain. It can also affect depth perception and night vision. Additionally, as presbyopia progresses, even those with monovision may need reading glasses, but they will be less dependent on them.
As someone who underwent monovision LASIK myself, I’m very pleased with the results. That said, I recognize it’s a compromise. While my distance vision is clear, it’s not quite as sharp as it was when I relied on both eyes, plus glasses or contacts. For activities like tennis, I sometimes wear a contact lens to enhance distance vision, bringing both eyes into full focus.
If you’re over 40 and thinking about LASIK, talk to your eye doctor to determine if monovision might be a suitable option. It’s typically ideal for those in their early 40s, as the brain is more adaptable at this age. It’s especially effective for individuals who have already adjusted to monovision through contact lenses or those who never needed glasses for distance but have noticed a decline in reading vision. For those over 50 who have never tried monovision, adapting may be more challenging. Additionally, not all types of vision correction are compatible with monovision. A thorough consultation with your doctor will help you understand the options and make the best choice for your vision needs.
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