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Monovision refers to the use of one eye for distance and the other for near vision and is one of the options to consider as part of your refractive surgery decision. By correcting the dominant eye to focus for distance and the non-dominant eye to focus for near vision, our brain tends to suppress or filter out the image from the eye that is not in clear focus. The patient is usually not bothered by the eye that is not in focus. We can create monovision with contact lenses or by using laser or lens replacement surgery.

One of the best ways to explain monovision in the context of refractive surgery is that you can aim to have each eye corrected to a natural focus at any distance you choose. How well the eye will see at other distances usually depends upon how old you are. For example, if you are 30 and we correct each eye to excellent distance vision, then you will have good vision at almost any distance because, due to your young age, the eye will be able to accommodate (adjust focus) from far to near. If, on the other hand, you are over 40 and we correct each eye to excellent distance vision, you will most likely not see well at a typical reading distance and will need reading or near vision glasses. This change in focusing ability usually begins at about age 40 and will worsen rapidly over the next few years. It is called presbyopia. The loss of ability to change your focusing distance from far to near will occur whether or not you have refractive surgery.

At any age, if you have the vision in one eye corrected to a natural focus for near tasks such as reading, you will not see clearly with it farther away as the ability to change focus only goes from far to near. The brain usually adjusts to each eye being focused at different distances within six to eight weeks. You do not need to consciously make any adjustments.
There is no right or wrong answer to the question of whether to have monovision. This information is to help you make this decision.
As a rule, we recommend against monovision if you are under the age of 40 for two reasons: 1) It will be a number of years before you will notice any benefit from it, and 2) It is very possible that there will be a better surgical solution for presbyopia by the time it affects you. We also generally recommend against monovision at any age for people who need to see better-than-average for certain tasks. Some examples are pilots, race car drivers, someone who drives for a living (especially at night), and avid tennis players (especially for playing at night). In general, engineers do not adapt well to monovision. People who do a great deal of computer work should proceed with monovision with caution.

In our experience, most people 40 to 45 years of age who try monovision and take a few months to become accustomed to it, like it and find it very useful. Those who have monovision will be able to see well enough both at distance and near to do most things without corrective lenses. Depending on the exact result obtained (as is true for everyone having refractive surgery), there may still be situations when the very best vision or the maximum visual comfort might require wearing glasses (or possibly contacts). Night driving and prolonged reading are two frequently mentioned examples, but it could be any situation in which you feel the need or desire to see as well as possible. Monovision may not completely eliminate the need for glasses but may be the best method to minimize the need for glasses.

It is helpful to realize that without a specific cure for presbyopia, once you are past the 40-year age range, all refractive corrections involve compromise. If you have both eyes corrected for good distance vision, you will need glasses for close vision. If you have both eyes corrected for close vision (not a common choice) you will need glasses to clearly see everything far away. If you choose monovision, though your vision may work well for almost all purposes, you might feel it is less than perfect.
We know of no perfect way to help you make this choice. If significant doubt remains in your mind, we suggest that you aim to have your vision corrected for good general distance vision and plan to use reading glasses when necessary.

It is important to note that if you choose monovision and are unable to get used to it, it can be reversed by performing an "enhancement" procedure on the eye designated for near vision. Once the enhancement is performed, the near eye sees much more clearly in the distance and reading glasses are then required for all near tasks.

Below are the answers to frequently asked questions related to monovision. If you have further questions regarding your care, please contact us.

Frequently Asked Questions

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