Monovision: LASIK after 40

People over 40 years old gradually lose the ability to change focus on near objects. This condition is called presbyopia and results from a loss of flexibility of the lens inside the eye, as well as other age-related changes. This is a gradual change throughout life but is not usually noticeable until the mid-forties. Although we may call this “reading vision,” it is also the vision we use for eating, putting on makeup or reading a watch or computer.

Nearsighted people who are also presbyopic (over 40) may use their nearsightedness to their advantage by removing their glasses or contact lenses to see up close. After laser vision correction, if the natural focus of the eye has been adjusted for clear distance vision it is as if you are always wearing your distance glasses or contact lenses and can't take them off to read. Therefore, if both eyes are corrected for distance, reading glasses will be necessary in people with presbyopia (those over 40).

To decrease the need for reading glasses, the technique of creating monovision may be helpful. With monovision the doctor fully treats one eye (usually the dominant eye) for distance, and the other eye for near vision. This leaves one slightly nearsighted (myopic) eye for good near vision without glasses. Monovision can help you maintain reading vision in one eye to avoid total dependence on reading glasses. With monovision you must often give up some distance sharpness to avoid the reading glasses. A weak pair of glasses may be helpful at times for driving. Near glasses may be needed at times for extended or difficult reading. Many people already experience monovision in their contact lenses and, occasionally, in their glasses, and are aware of its benefits and limitations. A trial period with contact lenses or glasses may help determine if monovision would be a good option for you.

Monovision is a slight compromise of both distance and near vision. Depth perception is also affected. For people with high visual demands like sports or constant near work, we recommend full distance correction with glasses for near vision. Monovision is reversible, and additional laser treatment can usually bring that eye to distance correction, if desired, generally at no charge.

Consult Washington Eye to get information about any/all refractive surgical procedures offered at our state-of-the-art Chevy Chase, Maryland facility. The Washington Eye Physicians and Surgeons are Washington DC LASIK specialists who routinely cater to patients over 40.

During your consultation you can discuss this option with your eye doctor, and together decide upon the best choice for you.

Options to preserve reading vision after age 45 to 50 are the crystalens® and ReSTOR® lens.