Monovision
An Answer to Presbyopia
Colorado Custom LASIK Vision
Correction
Laser Eye Surgery with CustomVue Wavefront LASIK in the Denver & Boulder Metro Area
If
you are over thirty-five years old, please read this section very
carefully. It may seem confusing, and you probably think that this
will never happen to you, but it is very important that you understand
this information. If you are over forty-five, you'll understand.
HERE COMES PRESBYOPIA...
Around age forty to forty-five, you will begin to lose the ability
to focus your eyes for seeing at near. The medical term for this
aging change is "Presbyopia" which comes from the Greek words meaning
"old" and "vision." EVERYBODY develops Presbyopia because with aging,
the natural lens in our eye becomes rigid, losing its elasticity.
Although the focusing muscles in the eye still work well, the lens
no longer will focus images at near. You will have difficulty focusing
your eyes to read! If you are going to have Laser Vision Correction,
you must decide how you will compensate for your inevitable loss
of near vision. Laser Vision Correction does not cause Presbyopia.
It is due to aging and everybody gets it.
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WHAT OPTIONS DO I HAVE?
If you have Laser Vision Correction and are over the age of 45 and
want to read, you have two choices. You can either wear reading
glasses or you can have Monovision. I am a very strong proponent
of Monovision. If you are Presbyopic and decide to have Laser Vision
Correction and do not have Monovision, you will have to wear reading
glasses 100% of the time - to see your watch, to read a menu, to
dial a phone, to read the newspaper. I feel that the goal of Laser
Vision Correction is to decrease the patient's dependence on corrective
lenses. If we do not Monofit and you are 45 or older, you will have
excellent distance vision, but will have to wear glasses 100% of
the time to see near. This dependence on glasses for reading somewhat
diminishes the benefit of Laser Vision Correction. However, with
Monovision, patients are much less, if at all, dependent on correction.
WHAT IS MONOVISION?
Monovision is an updated version of the monocle. In the "old days",
people wore a monocle in one eye for reading and used the other
eye for distance vision. With Laser Vision Correction we can, once
again, use this "monocle" concept, now called "Monovision" or "Monofit",
to address the problem of Presbyopia. With Monovision, one eye is
set with the Laser to focus at distance and the other eye is set
to focus at near. When a patient is Monofit, the patient can see
both at near and at distance without the need for glasses. There
is no need to close one eye to see near or far; the brain makes
the adaptation without the patient even being aware of which eye
is being used for near or far. Monovision may sound archaic and
difficult to tolerate, but in fact, it has worked very well for
most patients. Peripheral vision and depth perception are minimally,
if at all, affected by Monovision.
HOW DIFFICULT IS IT TO ADAPT
TO MONOVISION?
Getting used to Monovision generally takes several weeks. Most Monovision
patients will almost never use glasses and are able to see well
for both distance and near without correction. Patients with Monovision
can legally, and safely, drive a car without correction. Occasionally,
patients with Monovision will want to wear glasses to "fine tune"
their vision. This may be only for night driving or for prolonged
reading or computer use.
I WENT TO OTHER LASER CENTERS
THAT SAID MONOVISION DOESN'T WORK AND DON'T EVEN CONSIDER IT!
I hear this quite often and I vehemently disagree! Those centers
are simply denying their patients access to a very powerful option;
that of not needing reading glasses! I am monofitting myself and
I promise you it works extremely well for me. I have a visually
demanding job as an Eye Surgeon and can see extremely well to perform
my job, without reading or distance glasses. I do agree that most
Laser Centers don't encourage monovision. Either they experienced
enough with monovision to understand how well monovision works for
the vast majority of men and women over the age of 45, or they are
in too big of a rush and don't want to spend the time necessary
to fully explain monovision to prospective candidates. I do agree
that monovision may initially sound crazy and it takes time to explain
to patients the advantages of monovision. Many Laser Centers simply
do not want to spend the necessary time with you to explain monovision.
Monovision works in over 95% of my patients! I remind you that I
do not charge extra for monovision and if you do not like monvision,
I will retreat you at no charge and undo the monovision for you.
If a Laser Center discourages you from considering monovision (rarely,
people may have specific work or recreational situations not suitable
for monovision, but this is rare!), I would invite you to have a
free consultation with me and my staff regarding Laser Vision Correction
and monovision.
WHAT IF I AM MONOFITTED WITH
THE LASER AND HATE IT?
If you choose Monovision, with one eye being Lasered as a distance
eye and the other eye being Lasered as a reading eye, and can not
adapt to it, the "near" eye can be corrected for distance with a
second Laser procedure. This second Laser procedure on the eye that
we initially Lasered to make a reading eye is done at no charge,
is painless and very safe. If you only have one eye Lasered for
distance, leaving the unlasered eye as a reading eye and don't like
this monofit situation, we can then Laser your previously unlasered
reading eye, making it a distance eye. (Obviously, in this situation,
you would have to pay the Laser fee to have the second eye lasered.)
I've done Monovision on 60% of my Laser Vision Correction patients
and I have had to undo less than 1% of the Monofit patients! Undoing
the Monovison will eliminate the remaining nearsightedness. However,
you will then need to wear reading glasses to see up close.
AT WHAT AGE DO YOU RECOMMEND
MONOVISION?
I strongly encourage any patient who is presently having trouble
reading or who presently wears bifocals or reading glasses to have
the Monofit. For patients between 35 and 45 who are not yet having
trouble reading, I strongly encourage them to at least consider
Monovision. For younger patients, I briefly mention Monovision as
an option but realize that they would not benefit from the Monovision
until they reach their mid-40's.
I'M OVER 45, NEARSIGHTED,
AND JUST TAKE MY GLASSES OFF TO READ.
Some nearsighted patients over forty-five do not wear bifocals,
but merely take off their distance glasses when they want to read.
If you must take off your distance glasses to read or see up close,
then you have Presbyopia. After Laser Vision Correction you will
no longer be able to take your glasses off to read because you will
no longer be wearing glasses! If you are nearsighted and take your
glasses off to read and are not interested in Monovision, you must
consider if you really want to have Laser Surgery for your nearsightedness.
If you have Laser Vision Correction for nearsightedness and you
do not have Monovision, you will just be exchanging distance glasses
for reading glasses.
WHAT HAPPENS IF I JUST IGNORE
ALL OF THIS?
If you have Laser Vision Correction and don't do the Monovision,
you will have to wear reading glasses to see at near after age 45.
I STILL DON'T GET IT...
This issue of Presbyopia is confusing and if this information
just confused you more, please feel free to call our office at 303-393-0347
for clarification. We offer free, complimentary consultations for
anyone considering Laser Vision Correction. We can actually show
you in our office what Monovision would look like. And if you are
presently wearing soft contact lenses, we can give you a temporary
soft contact lens so that you can actually see what it is like to
experience Monovision.
Phone
(303)393-0347 Fax (303)393-1026 
Rose Medical Plaza,
4545 East Ninth Avenue, #270, Denver, CO 80220
Free Consultation
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