What is presbyopia?
As a natural part of aging, when a person reaches the approximate age of 40, the lens loses its elasticity. This results in a decreased ability to focus near even though distant objects may remain sharp. For clear vision, you will need different corrections for near, intermediate and far distances. This loss of focusing ability is called "presbyopia" and usually gets progressively worse with age and necessitates the use of reading glasses, bifocals, or even trifocals for correction.
How do you treat Presbyopia with contact lens?
For those who do not like bifocal glasses, bifocal contacts may help. Both soft bifocal and rigid bifocal contacts are available. The main advantage of bifocal contacts is that they adequately allow both distance and near vision at the same time. Many contact lens wearers, both old and new alike, find that the freedom to be rid of reading and bifocal glasses (for activities such as dining out, shopping, and computer work) is worth the minor inconvenience of bifocal contacts.
What is monovision?
For some people, who are not able to attain the best near vision with bifocal contacts, we have "monovision". This is when one eye has been corrected with a contact lens set for best distance vision and the other eye has a contact set only for near vision. The main disadvantage is that this does not allow for distance or near depth perception. Also, some patients are unable to tolerate this amount of discrepancy between the two eyes.
How does LASIK affect presbyopia?
Presbyopia is a change occurring at the level of the lens. Since LASIK treats the cornea, the clear outer membrane of the eye, LASIK does not directly treat presbyopia. After LASIK procedure, presbyopic patients, ie. those in their 40’s or older, can expect one of two results. If you are near-sighted (myopic) prior to treatment, depending on your level of myopia, after LASIK you may find that your distance vision has improved though your near vision may not be as good as it was prior to the procedure. This problem is easily corrected with reading glasses after LASIK. If you are far-sighted (or hyperopic) prior to treatment, after undergoing LASIK you may find that both your near and distance vision have improved, with most of the improvement occurring in the distance vision. In a far-sighted person, though your near vision may have improved you may still need to wear reading glasses for the best near vision possible.
How do you achieve monovision with LASIK?
If you do not like the idea of having to wear reading glasses after LASIK, you may want to consider a monovision correction. In monovision correction, one eye is treated with LASIK for distance and the other eye is treated with LASIK for better vision at near. As in contact lens fitting, some people may not be able to tolerate this type of discrepancy in their depth perception. As a rule we recommend a trial of monovision with contact lens to ascertain that the patient will enjoy this dual functionality before the patient is treated with LASIK.
To help you make an informed decision about LASIK, presbyopia and monovision, please contact our office by phone or email to discuss these and other options during your initial consultation.