Monovision: An Interesting Solution for Better Vision in Old Age?

You are farsighted, always need reading glasses, and are wondering what other options there are to counteract this. One of these solutions could be "Monovision". In this blog post, we dive into the world of monovision, explaining what it is, how it works, and who it is suitable for.

What is Monovision?

Monovision is a method for treating presbyopia (farsightedness), often achieved through laser eye surgery. In this method, the dominant eye is corrected for distance vision, while the other eye is optimised for near vision—with the goal of eliminating the need for visual aids and allowing for clear vision at all distances.

The idea behind monovision is that the brain learns to "switch" between the two eyes, depending on whether you're looking at something far away or up close. Initially, this method can take some getting used to, as the brain has to adjust to the different focusing powers of the eyes. However, over time, most people adapt to this way of seeing and appreciate the flexibility it offers.

Monovision can be achieved not only through surgical procedures but also by using specially designed glasses or contact lenses. In this approach, one lens or eyeglass is adjusted to optimise distance vision, while the other is tailored for near vision. This allows wearers to see clearly at various distances without constantly having to switch between different visual aids.

Who is Monovision Suitable For?

Monovision is primarily intended for individuals who suffer from presbyopia (farsightedness). Since this method aims to optimise vision both for near and far distances, it can be an attractive option for anyone who doesn't want to constantly switch between different glasses.

In addition to patients with presbyopia, monovision could also be considered for other groups depending on individual vision needs and life circumstances. However, it is important to note that monovision is not suitable for everyone:

• During pregnancy and breastfeeding: Hormonal changes can affect vision.

• For rheumatic conditions: Rheumatic diseases can cause or worsen eye problems.

• People with certain eye conditions: Monovision may be contraindicated for specific eye problems or diseases, such as corneal disease or glaucoma.

• For extreme refractive errors: People with very high diopter values may have difficulty adapting to monovision. This also applies to poor vision performance: If vision in one eye is poor—or if a person is blind in one eye.

• For thin corneas: A thin cornea may limit the possibilities for refractive treatments that support monovision.

• In cases of inability to adapt: If the brain cannot adjust to monovision.

• For individuals with an unclear dominant eye.

• When laser treatment is not possible: Depending on the correction, laser treatment may not be feasible, such as in cases of insufficient correction.

• For professional drivers: This should be carefully reviewed and assessed beforehand.

What are the Benefits of Monovision?

Monovision offers a number of benefits that make it an attractive option for many people dealing with presbyopia.

Here are some of the main advantages:

Adequate Near Vision in Old Age

One of the main benefits of monovision is the ability to see well up close even in old age. While many people struggle to read small print or recognise details up close as they age, monovision enables balanced vision at various distances.

Easy Testing with Contact Lenses

Before committing to a permanent solution like laser eye surgery, monovision can be tested with contact lenses. This allows individuals to try out the method and see if it suits their lifestyle and vision needs.

Flexibility and Independence

Monovision can reduce the dependence on multiple glasses or the constant switching between them. This offers users more flexibility in their daily lives and can enhance the overall visual experience.

Cost-effectiveness

Compared to other corrective procedures or the constant purchase of new glasses, monovision can be cost-effective in the long run.

Adaptability

Many people report that after a period of adjustment, they can easily adapt to the new visual experience and come to appreciate the benefits of the method.

What are the Disadvantages of Monovision?

While monovision offers many benefits, there are also some disadvantages and potential challenges that should be considered:

Limitations of Depth Perception

Since monovision optimises one eye for distance vision and the other for near vision, it can lead to limitations or disturbances in depth perception. This can be especially problematic for activities such as driving or sports, where precise depth perception is required.

Blurry Vision

Some people report blurry vision, either when reading or looking at distant objects. This can occur especially during the adjustment phase to monovision and can be bothersome for some individuals.

Adjustment Period

Adapting to monovision can take time. While some people adjust quickly, others may require more time to get used to the new visual experience.

Not Suitable for Everyone

As mentioned earlier, monovision is not suitable for everyone. For individuals with extreme vision impairments, very thin corneas, or other specific eye problems, this method of vision correction is not recommended.

Possible Incompatibility with Monovision Contact Lenses

With monovision contacts (sometimes known as blended lenses), there is always the risk of incompatibility, infections, or dry eyes.

Compromise Between Near and Distance Vision

Monovision is a compromise between near and distance vision. This means that neither near nor distant vision can be perfect, which may not be ideal for some people.

How Does a Monovision Surgery Proceed?

Here is an overview of the typical process for a monovision surgery:

Pre-examination and Consultation

Before considering eye surgery, the ophthalmologist conducts a thorough examination to determine if you are suitable for monovision. This includes various vision tests, measurements, and a detailed explanation of expectations and potential outcomes.

Choice of Procedure

There are different surgical procedures to achieve monovision, including various laser eye surgeries such as Femto-LASIK or Trans-PRK. Additionally, there is the option of implanting intraocular lenses (IOL). The ophthalmologist will recommend the most suitable procedure based on your individual needs and eye health.

The Surgical Procedure

During the procedure, the dominant eye is typically corrected for distance vision, and the non-dominant eye is corrected for near vision. In Femto-LASIK, for example, a thin layer of the cornea (flap) is lifted, and the underlying area is reshaped using a laser. In lens implantation, an artificial lens is placed in front of the natural lens of the eye to correct the refractive error.

Aftercare

After the surgery, it is important to follow the doctor's instructions carefully to avoid complications and achieve the best results. This may include taking medications, attending regular follow-up appointments, and wearing protective glasses.

Adjustment Phase

After the treatment, it may take some time for your eyes to adjust to the new way of seeing. During this phase, temporary blurred vision, dryness, or light sensitivity may occur.

What Alternatives Are There to Monovision?

Monovision is just one of several options to improve vision in old age. If monovision is not the right choice for you or if you'd like to consider other possibilities, there are various alternatives:

Refractive Lens Exchange (RLE)

In refractive lens exchange, the eye's natural lens is replaced with an artificial lens. This procedure is primarily performed to correct severe refractive errors and also helps prevent cataracts.

Multifocal Contact Lenses

Multifocal contact lenses have multiple focal points to allow for clear vision both up close and at a distance. They are an alternative to monovision with contact lenses and can be particularly suitable for people who have difficulty adjusting to monovision.

Progressive Glasses

Progressive lenses have different corrective strengths in various parts of the lenses to correct both near and distance vision. They are a traditional solution for presbyopia and can be a good option for those who do not wish to undergo refractive treatment or use contact lenses.