Monovision, which is sometimes referred to as “blended vision,” is a method used to correct problems that occur as the eye ages. The normal aging process creates the onset of presbyopia, which can make it challenging to focus on close objects. You might discover that reading your phone, ordering food from a menu, or even watching TV can become a challenging task.
Using readers, eyeglasses, and other vision assistance tools can be annoying if you become dependent on these resources. If you lose them somehow, then your ability to engage with the rest of the world can see dramatic reductions. How many times do they disappear on the counter directly in front of you, on your head, or in unusual places?
Monovision LASIK tends to work better for patients with presbyopia because having one eye see at distance is helpful when the other naturally reverts to be a little nearsighted. As with any medical procedure, there are some specific pros and cons that you’ll want to address with your doctor before deciding that this option is the one you wish to try.
List of the Pros of Monovision LASIK
1. It is a procedure that is fast and safe.
Monovision LASIK is an outpatient procedure that can take less than 30 minutes for some patients. Most of the time that you are dealing with the procedure involves getting set up for the surgery. You will remain awake through the entire process, although some patients can benefit from having a Valium to relax with a laser entering their eyeball. If the eye makes any sudden movements for any reason, then the laser shuts off to avoid an injury or an error in the corrective process.
The rate of complications with all LASIK procedures is at less that 1%. Over 96% of patients who choose this option for any reason are satisfied with the results. Monovision has a lower overall satisfaction rate because of the challenges there are in adapting to having one eye with vision and the other without. There are over 7,000 peer-reviewed published studies that confirm this advantage.
2. The results are very fast when choosing monovision LASIK.
It does not take a patient long to regain clear sight or achieve it for the first time. Most people will notice the difference within a few hours of the operation. By the next day, you are going to be seeing better than maybe ever before. It takes about 48 hours for the average person to resume their normal daily activities. Then you can enjoy the crispness of the colors and their vivid hues in ways that are as good as, if not better, than what you got to experience in the past.
In some specific situations where a LASIK-like surgery is used instead, then a longer recovery might be necessary if the surface of the cornea was removed. It may take up to 4 weeks for a full return, but it will also include an improvement to your vision.
3. You can put away your contacts or glasses.
When you and your doctor decide that monovision LASIK is the best way to treat your vision concerns, then you can have life-changing results in just minutes. Patients often get to enjoy basic activities that once hindered them because of their poor vision. There is usually a trigger that is the final straw, like constantly dealing with dry eyes or losing their glasses while driving or riding a bicycle and becoming stranded.
Although some patients may still need to use glasses or contacts for limited situations, most people can put them away for good. You have a 20-30% chance to achieve 20/20 vision after recovery, but it is an excellent chance that you can function without corrections.
4. Patients do not need to make conscious adjustments to their vision.
When monovision LASIK is successful, the dominant eye will see at distance, while the other takes care of the close-up tasks. Most people can adjust to this type of eyesight in about 6-8 weeks, although it can take up to 12 weeks for some patients. You don’t need to make conscious choices to create the better outcomes post-operatively with this procedure. Your brain will work to interpret the signals correctly so that you feel like you can see better even though your eyes are given unique jobs instead of working together.
5. The cost of the monovision LASIK procedure could be covered by Medicare.
If your doctor decides that your vision improvements are a necessity to maintain or improve your quality of life, then the recommendation for monovision LASIK could be covered by Medicare Advantage. Anyone with private health insurance would go through the regular procedures for handling copays, deductibles, and the percentages of coverage.
If you don’t medical coverage, then the cost of LASIK runs between $1,500 to $3,000 if only one eye is involved with the vision correction.
6. There can be improvements to your contrast vision.
If you decide that monovision LASIK is an option you want to use to correct your vision, then you will see an immediate improvement in your contrast vision. Some people can even start driving at night thanks to this unique advantage. Although you might not be able to make the eyeglasses disappear entirely, it can create dramatic results and allow some people to regain a measure of their independence.
List of the Cons of Monovision LASIK
1. Some people are not eligible for the LASIK procedure.
Most people who are above the age of 40 are not considered a suitable patient for a monovision LASIK procedure. This disadvantage occurs because of an issue called presbyopia. It causes the eye’s lens to become stiff, which is why close-up vision can be hindered. This procedure alters the cornea instead, so it wouldn’t be helpful to improve the patient’s eyesight anyway.
If you have a thin cornea or a significant prescription for your glasses, then a photorefractive keratectomy might be a better option than monovision LASIK. The process is similar, but it avoids the “flap-making” that the LASIK procedure involves.
2. There are some risks of which you need to be aware.
It is not unusual for someone who goes through the monovision LASIK procedure to have dry eyes for up to three months afterward. The odds of this issue becoming permanent are rare, but it can happen. Most people can manage the issue by using artificial tears to support their vision.
You might encounter problems with halos and nighttime glare after your surgery as well. The risks are much lower than they used to be, and the treatment zone now covers the entire cornea instead of a portion of it. About 0.6% of patients lose up to two lines of visual acuity on a standard eyechart test.
3. The flaps from monovision LASIK can be damaged years afterward.
The traditional monovision approach to LASIK creates a thin, hinged flap in the cornea. It is lifted for the application of laser energy that works to reshape the eye. An instrument called a microkeratome creates this outcome. If you choose a provider who takes this approach (or had surgery before 2007), then any injury to your eye can result in a reversal of the procedure. Something as simple as an eye poke or a scratch can do it.
The first FDA-approved bladeless procedures began appearing in 2007 and are marketed now as iLASIK. Visumax, zLASIK, and Femtec are also options to consider if you wish to avoid this potential disadvantage.
4. You might need to go through the procedure once again.
People with a higher prescription prior to their monovision LASIK surgery are at the highest risk of experiencing this disadvantage. A condition called myopic regression can cause minor decreases to vision quality over time even after the procedure. The tendency to drift back to the old prescription will not be to the same degree, but it can be enough to impact a person’s way of life over time.
If you and your doctor decide that a second surgery is an option, then there are an entirely different set of risks to consider. Most patients need to have 20/20 vision in one eye and J2 in their reading eye to be satisfied with the results of the procedure.
5. It will only correct one eye.
Because of the issue with presbyopia, patients who are eligible for monovision LASIK will only receive the correction in a single eye. It isn’t a perfect solution since there can be problems with intricate close work, depth perception, and night driving, but there can be an improvement for older patients who normally wouldn’t qualify for the operation. That’s why it is a satisfactory and well-tolerated outcome about 85% of the time.
You will want to speak with your doctor about trying monovision through corrective lenses first to see if you can manage this unique procedure. If you can tolerate it on a temporary basis, then it could be a full-time solution that improves your eyesight.
6. Some patients need brighter light levels for reading.
Because of the changes that occur after monovision LASIK, some individuals find that they need brighter light levels for their sessions of extended reading. It can be uncomfortable to try to read text in low light or warm tones like a computer can provide with this procedure. This disadvantage can cause enough discomfort that some people resort to using glasses to manage this situation.
Some doctors who provide monovision LASIK even recommend using glasses still for visually demanding events, such as a theatrical show or driving during the nighttime hours.
7. Patients do not always adapt well to monovision.
Even after going through a trial period with monovision while using corrective lenses, some patients find that having the real thing can be problematic for them in real life. Doctors are sometimes receiving requests to reverse or enhance the outcome because the adjustments are challenging for them. It takes up to three months for some individuals to get used to the change in visual feedback, so there can be a lot of unhappiness in the recovery if clarity is not immediately experienced.
8. Medicare does not cover the cost of LASIK.
If you have the original Medicare coverage, then any LASIK procedure is classified as an elective operation. Even if your doctor agrees that the surgery is necessary to improve your way of life, there are no benefits paid out to you. The only exception to this disadvantage may be if you have glaucoma or diabetes and the procedure is medically necessary as part of your treatment plan for those conditions.
That’s why you might want to consider a Medicare Advantage plan. This policy must provide your Part A and Part B benefits, but many offer additional coverage options that include routine vision care. You’ll want to ask specifically about LASIK coverage if you are concerned about the costs of this procedure.
9. Some patients experience haze in their vision.
You can start resuming normal activities about a day after receiving monovision LASIK, which is similar to other surgical interventions for this type of eyesight. Some people will have crisp, vivid vision during their recovery, but others can experience a “haze” that doesn’t go away entirely. Imagine the last foggy day that you can remember and what it was like to see something at distance. Remember what the lights looked like with the reduced vision? That description is a fair analogy of what some people encounter after going through with this surgical option.
Verdict of the Pros and Cons of Monovision LASIK
Monovision is a choice to consider when you want one eye for distance needs and the other for near vision. This option becomes part of your treatment plan if you are over the age of 40 and struggle with your eyesight in specific ways.
It is a procedure that has over 20 years of successful implementation with contact lens correction. LASIK makes it possible to create a permanent outcome in patients who are excellent candidates for this type of vision. This option allows the dominant eye to focus at distance to ensure the most comfortable results.