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Monovision surgery is used to help people with presbyopia. It corrects your dominant eye for close vision, and your other eye is corrected for distance vision.
While monovision can be achieved with corrective lenses, some people choose to get surgery so they can achieve it without glasses. This can be convenient and freeing, but it carries risks and downsides, which is true of any surgery.
The most common way this is achieved surgically is through monovision LASIK. As the name implies, this is a LASIK procedure which, through the use of a special laser, reshapes the inner cornea to achieve monovision in the patient.
This procedure is generally only done for people near the age of 40 or older. A milder procedure called mini-monovision LASIK is often used on those closer to age 40 to delay the need for more serious measures.
Intraocular implants are an alternative to LASIK. By inserting an artificial lens into the eye, replacing a person’s other lens (generally because it is clouded by cataracts), vision can be improved. The costs and risks are similar to LASIK.
Always talk to your doctor about the nature of any procedure you are considering to make sure you properly assess the risks and benefits. Also, note these procedures are generally not covered by insurance unless there is not a cheaper solution that can achieve a similar result. If monovision LASIK could work for you, it also usually means corrective eyewear could do the same.
Many people with presbyopia opt to instead simply wear glasses or contacts to achieve monovision. Some people may just wear one contact lens, correcting distance vision with one eye while still allowing them to see clearly up close. This is a much cheaper solution than monovision surgery, and it carries fewer risks.
Some people struggle with monovision, as it is a different and sometimes disorienting way to see. Talk to your doctor about all your options to determine what is best for you.
By age 40, the majority of people will experience the onset of presbyopia. This condition is characterized by it becoming gradually more difficult to focus on near objects. This gets progressively worse until a person is around 65 years old. It can make reading and focusing on other objects, such as phones, very difficult and frustrating.
It is generally this condition that causes some to consider monovision, also called blended vision. To understand what monovision is, one must first understand that the majority of people have a dominant eye. Your dominant eye is basically the eye you (usually subconsciously) prefer to use if you have to close one. It relays information to your brain a bit more accurately than your other eye.
Monovision is when this dominant eye is corrected for distance vision, while your other is left intentionally nearsighted. While this type of sight can take adjusting to, it can allow a person to see at any distance. This can be achieved in a number of ways (discussed later), but the most serious option is to have your eyes surgically altered through a surgery called monovision LASIK.
Assuming your doctor decides you are a good candidate, monovision LASIK carries a number of advantages.
- It gives you a greater ability to read and perform other tasks that require focusing on nearby objects.
- You will generally no longer require glasses.
While seeing in monovision can be strange and requires some adaptation, many people report not being able to tell which eye is set for farsighted vision and which is set for nearsighted vision.
At the same time, it is still a surgical procedure that must be considered carefully.
- Some people cannot adapt to the change. They find it annoying, frustrating, or otherwise distracting.
- There can be some loss of depth perception.
- In some cases, you may still need reading glasses for especially fine details.
- Any eye surgery carries risk. In severe cases, a problem with the procedure can lead to blindness in the affected eye.
Is Monovision LASIK for You?
When considering monovision surgery, talk to your doctor about all your options.
Generally, monovision LASIK is best suited for those who have already worn monovision contact lenses for several years. Using contact lenses achieves a similar effect, but without the risks of surgery. This ensures you’ll adapt to the results of monovision surgery well since you’re already familiar with them from wearing the contact lens for monovision.
Because near vision problems are not generally severe in younger people, most candidates for monovision will be 40 or older. While monovision surgery has its benefits, it has enough drawbacks that it should only be performed when a person is dealing with relatively serious nearsightedness.
There is also a very similar procedure known as mini-monovision LASIK. This procedure is largely the same as monovision LASIK but milder. It does not improve vision as much, but it may help you better perform daily tasks and avoid glasses in some situations where you previously needed them. This is often the procedure chosen for people near the age of 40 rather than older candidates.
Intraocular implants are another option for those seeking monovision through surgery. These artificial lenses are meant to replace the real lens in your eye. This is usually done when the lens in your eye is too cloudy due to cataracts.
This procedure is similar in costs and risks to LASIK, and it is worth bringing up with your doctor.
Preparation & Costs of Surgery
Any consideration of surgery should begin with a discussion with your doctor. Once you’re both sure monovision LASIK is a good fit for you, check to see if your insurance will cover the procedure.
Insurance plans generally cover procedures that are medically necessary when no cheaper alternative procedure can produce a similar result.
Unfortunately, insurance does not often cover LASIK. While LASIK can improve a patient’s quality of life, most insurance companies argue that corrective lenses can give the same benefit. This means you likely will have to pay out of pocket for your surgery.
Monovision LASIK is similar in cost to other LASIK procedures. While cost varies depending on the patient and the facility, you can expect to pay somewhere between $1,500 and $3,000 per eye.
Facilities touting extremely low costs (less than $1,000 per eye) are generally providing unrealistic estimates. You should be wary of such claims.
The average cost of LASIK is also slightly increasing each year.
Again, monovision LASIK is not the only option to help with presbyopia, nor will it be the solution your doctor immediately jumps to. Corrective lenses can produce largely the same visual effect.
If you are relatively happy with the vision provided to you by corrective eyewear and do not find it bothersome, you likely do not need monovision LASIK. Many people opt for this form of LASIK to escape the nuisances associated with eyeglasses and contacts.
While it is not a dangerous procedure, monovision LASIK is expensive, and like all surgeries, it carries some risks. You and your eye doctor will weigh the benefits and risks of the surgery before deciding to move forward with it.
What Is Monovision (or Blended Vision)? American Academy of Ophthalmology.
What You Should Know About Monovision LASIK. (October 5, 2017). Verywell Health.
Presbyopia. (December 6, 2017). Mayo Foundation for Medical Education and Research (MFMER).
Dominant Eye: Here’s Looking at You. (April 30, 2019). Healthline.
Intraocular Implants (IOLs). (March 1, 2016). American Academy of Ophthalmology.