Presbyopia & Monovision

Presbyopia

 All patients must understand that presbyopia is a natural aging change that

LASIK will not prevent.

 After LASIK, patient’s near vision is usually the same as it was pre-sx with

their glasses or contact lenses.

 Some patients will notice a change in their near vision if they are under or

overcorrected- this should be demonstrated to patients in their 30-40’s pre-sx.

 It is normal for all patients to experience more difficulty reading for the first

1-3 weeks after LASIK and this improves with time.

 Any myopic patient that removes their glasses to read should understand that

correction of myopia with LASIK will take away a patients near range of focus

and result in need for a near prescription.

 We recommend that a trial frame with glasses or CL be used with hyperopic

patients to show them that their near VA will be better, but reading glasses may

still be required in patients that are Presbyopic.

Monovision

 We do not recommend a monovision target more than -2.00D.

It is also not recommended to slightly undercorrect both eyes at distance.

We do not recommend monovision when a patient already has decreased best

corrected vision.

 The non-dominant eye is the usually the one that is targeted for near,

unless the patient is currently wearing monovision opposite and likes it.

 If patients are not currently using MV, then we require a trial in either glasses or

CL so patients can assess their ability to see dist/near in their daily activities.

 Vision quality at distance and near is not as sharp for most monovision

patients as it is when both eyes are corrected for distance.

 Monovision can take several months for the eyes to adapt.

 Patients need to understand that monovision is a way to make them less

dependant on reading glasses, but it will not prevent the need for them forever.

 Night vision can be more difficult and distance driving glasses may be required.

 Glasses or contact lenses can be worn in the near eye, but anisometropia can

cause headaches and difficulty focusing on fine details.

 Some patients will lose depth perception because both eyes are not working

together (golfers/hunters usually do not like monovision).

 It is not always possible to enhance patients who are having difficulty with MV.

Ex.) Patients with 20/25 VA in their dominant eye may complain of decreased

vision at distance, but vision at this level would not qualify for an enhancement.

 Please make sure all patients have read the “Consent for Monovision Refractive

Surgery” (included in the forms section).

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