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Q: What is presbyopia?

A: Presbyopia is a normal aging process that results from the gradual thickening and stiffening of the crystalline lens of the eye and loss of muscle control of lens shape. As we age, usually sometime in our forties, it becomes hard to focus on near objects when fully corrected for distance vision (wearing spectacles, contact lenses or after refractive surgery.) Ordinary close-up tasks like reading the newspaper, a menu, or your cell phone becomes difficult. The traditional approach to dealing with presbyopia is to use reading glasses or bifocal spectacles. A few people manage well with bifocal contact lenses. After refractive surgery, if both eyes are corrected for distance vision, reading glasses are the only practical solution once you are presbyopic.


Q: What is monovision?

A: Monovision is an alternative approach to managing presbyopia. This technique has been used successfully for many years by presbyopic contact lens wearers. It has also been successfully applied in laser vision correction. In monovision, one eye is corrected for distance vision and the other eye is slightly nearsighted so it corrects for near vision. When you focus at a particular distance, your vision is clearer in one eye than the other. Since your brain interprets what your eyes see, it learns to select the images that are in focus and ignore those that are not, without you being consciously aware of it.


Q: Does monovision totally eliminate the need for reading glasses?

A: In many cases it may; however, monovision is generally better tolerated if the difference between the two eyes is not too great. Therefore, the reading eye is left with minimal nearsightedness so you can tolerate the difference between the eyes. This means that as you become fully presbyopic, typically in the middle to late fifties, you may need reading glasses for particularly demanding tasks such as reading the newspaper, a menu or routine paperwork. Ask Dr. Pokeza about your chances of totally eliminating the need for reading glasses.


Q: Is monovision any use to me if I do not yet need reading glasses?

A: Many patients who are approaching presbyopia choose monovision. The value of this choice is that monovision delays the need for reading glasses by many years. Monovision is generally not appreciated or tolerated well in patients who generally are not yet presbyopic. The only way to know if you can tolerate monovision is to try a monovision simulation with contact lenses. Some patients feel comfortable with the vision immediately, while some may take a few days to feel comfortable.