Blended Vision / Monovision

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After the age of forty, we all will begin to lose the ability to accommodate or focus the lens of our eye. This is a universal phenomenon and not caused by any disease or illness.

When the ability to accommodate is lost, it means that the eyes cannot adjust or focus images at different distances. Therefore, different glasses, at different focal lengths, are required for distance and near vision. People may find that if they can see well at distance, they now require glasses to read at near and vice versa.

This problem is called Presbyopia and is usually corrected with bifocals or glasses with two focal lengths, one for near and one for distance. Presbyopia may also be corrected with Blended Vision / Monovision. Blended Vision / Monovision corrects one eye for distance and one eye for near. Blended Vision / Monovision can only be used in patients who wear contacts or who have refractive surgery. Thus, the need for glasses with two different focal lengths is resolved by focusing each eye at a different focal length.

People over 40, who require glasses for distance vision – nearsighted or myopic individuals – frequently find that they can read up close quite well without their glasses. Correcting their distance vision to 20/20 almost always means that they will need glasses to be able to read up close. This is because they can no longer focus or adjust their focal length.
Typically in Blended Vision / Monovision, the eye that is correct for distance is the dominant eye. One can usually determine which eye is dominant by raising a thumb, holding it out in front of both eyes, and blocking an object with the thumb while both eyes remain open. Once the object is blocked, close one eye or the other, and the eye that cannot see the object is the dominant eye.

Patients over forty must make a choice. Either both eyes are corrected for distance or one eye is corrected for distance and the other for near. If the patient is unsure of what they would like, contacts can sometimes be used to simulate post-operative results.

If you are over 40, or wear bifocals or reading glasses, your surgeon will want to discuss Blended Vision / Monovision as part of your Consultation in order to make sure you get the best possible results.

If you are over 50 and do not wish to have Blended Vision / Monovision LASIK, you will most likely require reading glasses after your LASIK surgery. For patients over 50 who wish to have both their far and distance vision corrected without Blended Vision / Monovision or using reading glasses, a possible option to explore in order to effectively manage their presbyopia is Lens Replacement Surgery.

Is Blended Vision / Monovision right for me?
Blended Vision / Monovision addresses the problem of presbyopia that most people start to encounter at the age of 40-45 when they begin to need reading glasses or bifocals for close vision. With Blended Vision / Monovision, the dominant eye (the eye you would use to focus a camera) is focused for distance vision, and the non-dominant eye is focused for near to intermediate vision. This can be done with contact lenses, refractive surgery or intraocular lenses.

Blended Vision / Monovision certainly isn’t appropriate for everyone. However, when paired with the right person, it can be a great fit. Blended Vision / Monovision is a blend of near and distance vision, and is ideal for people with an active lifestyle. However, there is a caveat to consider: since it is a compromise, most people’s vision isn’t perfectly crisp up close or far away. Instead, it offers the best of both worlds.

Most people who opt for Blended Vision / Monovision go through a brief period of adaptation as the brain “learns” to see with the eye best suited for the task. If you’re considering refractive surgery as a permanent form of Blended Vision / Monovision, it might be best to consider a “test drive” with contact lenses before making a decision.
When helping you to decide whether Blended Vision / Monovision is right for you, your doctor or eyecare professional may ask these questions:

Do you enjoy golf or activities that require sharp distance vision?
Do you read for long stretches or have a hobby that requires precise near vision?
Do you drive extensively at night?
Are you very discriminating about the quality of your vision?

If you answered yes to any of these questions, Blended Vision / Monovision may not be best suited to you. It’s ideal for those who are willing to accept a compromise so they can be as independent from glasses as possible.