- Monovision Contact Lenses
A contact lens professional will work with "one-eye dominance" to produce monovision. This is typically where the dominant eye is prescribed a contact lens power for optimum distance vision (or not corrected at all in people who have good distance vision without glasses) and the other eye is fit with a contact lens that has a modified power to provide good near vision.
Patients who don't need glasses to see far would simply wear contact lens in their "near" eye. This option works for some people, but may not work well for others.
This system relies on the brain suppressing the blurry image in the reading eye when looking far, and suppressing the blurry image in the distance eye when looking up close - referred to as "binocular vision". Binocular vision is preserved in monovision to adjust depth perception for driving or sports. But one eye sees more clearly in the distance, and the other eye sees better up close.
- Multifocal Contact Lenses
A contact lens in each eye has both distance and near components, so that each eye can see distance and near. Some patients may get glare, haloes, or blurry vision, especially during dimly lit conditions and at night.
But this option may be worth trying, especially if monovision didn't work for you.
- Monovision Laser Vision Correction
This is the same idea as monovision contact lenses. Normally, both your eyes work together equally when you look at an object, to produce what's called binocular vision.
However, you probably have a dominant eye that your brain tends to favor for "sighting" (most right-handed people are right-eye dominant, for example).Most people try this option with contact lenses first, and if they like it, they will do well with monovision LASIK.
For patients who had LASIK in the past and are now of presbyopic age, may consider trying monovision contact lens in their non-dominant eye. If they like it, they can have laser vision correction enhancement to improve their reading vision. When undergoing laser vision correction, it's worth considering surgeons whose initial fee includes future enhancements, in case you want to have enhancement for near vision in the future.
- Conductive Keratoplasty (CK)
Radiofrequency energy is applied to the peripheral cornea to shrink collagen fibers so that the cornea becomes more curved, thereby improving near vision.
This is similar to monovision laser vision correction and is an option that may be considered in patients who are not candidates for laser vision correction. It works best in patients who don't have distance correction and are interested only in improving their near vision.
- Lens Replacement Surgery
As we age, the lens inside the eye becomes less flexible - this is the problem that causes presbyopia or difficulty seeing up close.
The aging lens can be removed and replaced with a new lens - a lens that can give the patient ability to see at all distances; far and near and at mid distances for computer use.
Some lenses can actually flex, like our lens, when we are young. Some act like multifocal contact lenses.
The choice of the lens design depends on a number of factors, some of which include each patient's unique anatomy, their activities, their vision preferences, etc.
Lens replacement surgery is best for patients who need to improve their vision both far and near - those in contact or multifocal glasses and for patients who developed opacities and other age related changes in their lenses called cataracts.
For information on Dr. Ella Faktorovich, visit www.pacificvision.org
