What Options Do I Have If I am above the age of 40?

If you are over 40 years of age and have laser vision correction to correct both eyes for distance vision, you will need reading glasses in order to see things within 36 inches and closer.  This occurs sometime between the age of 38 and 46.  This process is called presbyopia and it affects 100% of people.  There is no current, accepted way to correct presbyopia- except for reading glasses.

One alternative to reading glasses, however, is called mno-vision:  one eye is corrected for distance vision and one eye is corrected for close-up vision.  Mono-vision is an alternative laser vision procedure best suited for patients who have presbyopia. With Mono-vision, the dominant eye is usually corrected for distance vision and the other eye is corrected for near vision.

There are advantages and drawbacks with Mono-vision.  The single, obvious advantage is that Mono-vision allows glasses free vision at near and far for most tasks.

There are drawbacks.  These may include the occasional need for glasses to see very small print, threading needles, prolonged reading or reading in dim light.  Night driving, especially in unfamiliar surroundings or in the rain, as well as intensive distance activities such as tennis or golf may require distance correction in the near vision eye , to enhance depth perception.  Our current glasses can be modified to meet this need if necessary.

Mono-vision is not perfect.  Mono-vision is a compromise that will enable you to have distance near vision without correction, but the quality of the vision will likely not be as sharp as with your glasses or contact lenses.    It requires adaptation, which may require several weeks, up to several months to fully adjust.  During this adjustment period, each eye may sometimes interfere with the other, and depth perception may sometimes seem off, but these problems gradually resolve.  If after three months you feel mono-vision is not working for you, the nearsighted eye may be enhanced for distance correction.  You will then need reading glasses for all near tasks.

In order to gauge your tolerance, a mono-vision trial was performed during your preoperative consultation.  Although this is usually a good predictor of mono-vision tolerance, it is possible that you might not tolerate or adapt to the mono-vision once you have it 24/7.  You may find that the quality of the vision is significantly reduced.   In some cases, this will improve over time (several weeks to months).  In other cases, these symptoms persist and the only recourse will be to enhance the "near" eye to enable good distance vision both eyes;  in these cases, patients will then need to wear reading glasses.

Mono-vision patients will frequently notice imperfections in their distance vision while they enjoy excellent reading vision.

The distance effects of mono-vision are accentuated in dim or dark-light settings, such as driving at night.  Mono-vision can adversely affect depth perception.  Mono-vision, therefore, may not be as advisable for patients who need excellent distance vision at night (such as truck drivers, law enforcement personnel, pilots, etc.).  Mono-vision may also affect ability to quality for certain professional licensures. 

Mono-vision will not guarantee that you will be completely free of glasses or contact lenses.  Because of the distance vision effects of mono-vision, some patients who are otherwise very happy with their mono-vision will use glasses (that will improve distance vision in the" near" eye for certain distance activities (such as driving at night).  Less commonly, some patients may need extremely precise near vision and will use glasses to improve the near vision in the "distance" eye).

You will have to weigh whether the benefits of mono-vision (not needing glasses for the majority of your activities) are worth its imperfections.

Graf Optical doctors have had extensive experience with Mono-Vision and offer it to our presbyopic patients.  Ninety five percent of our patients are happy with mono-vision.  Please do not hesitate to ask your Graf Optical eye doctor should you have any questions.  Graf Optical eye doctors can fit you in a mock contact lens set up to simulate the mono-vision set up found in lasik eye surgery.  If you are unsure about your ability to tolerate mono-vision in laser eye surgery ask a Graf Optical eye doctor to fit you for mono-vision in contacts to prepare you for laser eye surgery.