LASIK for presbyopia using monovision can provide clear vision without glasses or contact lenses, offering a significant improvement for adaptable individuals, despite potential drawbacks.
Have you ever found yourself needing to squint while reading the morning paper or struggling to read texts on your phone? If you're over 40, this change in vision, known as age-related farsightedness, may occur frequently and require you using of glasses or contact lenses for clear vision.
A common question that arises is if LASIK can correct hyperopia (farsightedness), can it also address presbyopia – age-related farsightedness?
LASIK may appear not suitable for presbyopia initially
Initially, it may seem unclear how LASIK can treat presbyopia. Presbyopia is caused by age-related changes in the lens, which affect its flexibility and ability to adapt its shape for clear near vision.
On the other hand, LASIK surgery involves reshaping the cornea helping light to focus on the retina and correct refractive errors. Because of this fundamental difference, LASIK may not appear to be a suitable treatment option for presbyopia.
LASIK for presbyopia
LASIK can correct presbyopia via a technique called monovision. It involves correcting one eye for distance vision while leaving the other eye slightly nearsighted, enabling clear vision of nearby objects. With time and training, the brain learns to combine the separate visual inputs from each eye, resulting in clear vision at all distances. Though this may initially sound complex, many individuals adapt well to monovision, often unaware of which eye is optimized for distance and which for near vision.1
Pros and cons of LASIK for Presbyopia
Let's explore the pros and cons of correcting presbyopia with LASIK, specifically from the perspective of monovision:
Pros of LASIK for presbyopia
- Clear vision for both near and far: Monovision lenses generally give wearers very clear vision for up-close tasks and faraway distances.
- Quick and safe procedure: LASIK is an outpatient procedure that typically takes around 20 minutes to complete. The laser used during the surgery is designed to automatically shut off if your eye makes sudden movements – a common worry among people before the LASIK procedure, minimizing the risk from the surgery.
- Reduced reliance on glasses or contacts: Many individuals who undergo LASIK for presbyopia find that they no longer need to rely on glasses or contact lenses. This newfound freedom allows them to fully engage in activities requiring hand-eye coordination.
Cons of LASIK for presbyopia
- Not suitable for everyone: Monovision, which is typically tried with contact lenses before undergoing LASIK, may not be successful for everyone. Around three in four (3/4) individuals find success with monovision using contact lenses.1 Secondly, even though near and distance vision may be clearer after LASIK, the clarity of objects in the midrange — such as text on a computer screen or speedometer — may worsen slightly.2
- Potential risks and side effects: As with any surgical procedure, LASIK carries certain risks, including dry eyes, nighttime glare, halos around lights, and potential injuries to the cornea flap.2
- Possibility of requiring LASIK again: Our vision prescriptions can change as we age, and individuals with higher prescriptions prior to surgery may experience a slight regression in vision quality over time. These factors may necessitate the need for another LASIK procedure to maintain optimal vision correction. 2
Questions to ask before having LASIK for presbyopia
Before undergoing LASIK surgery, it is essential to have a thorough conversation with your eye doctor to determine if LASIK is the right option for you. Below are some questions to help you assess your chances of success and satisfaction with LASIK, as well as address any concerns or potential limitations.
1. Is my refractive error within the treatment range?
LASIK is FDA-approved to correct specific degrees of nearsightedness, farsightedness, and astigmatism. It's crucial to determine if your refractive error falls within the range that LASIK can effectively address. Severe refractive errors may lower the chances of achieving optimal results and increase the likelihood of requiring retreatment. It's important to note that some people will still need glasses or contact lenses after LASIK.
2. What is the optimal time for me to have LASIK?
Vision can fluctuate at different stages of life and under certain circumstances, such as during early adulthood, pregnancy, or if you have certain conditions like cataracts or diabetes. It's important to discuss the timing of your LASIK surgery with your eye doctor to determine the most suitable timing.
3. Are my eyes stable enough for LASIK?
LASIK is generally recommended when your vision prescription has remained relatively stable. As mentioned above, certain factors can cause fluctuations even in adults.
4. Would any of the medications I'm taking rule out LASIK or affect the results?
Provide your eye doctor with a comprehensive list of all the prescription and over-the-counter medications you currently take. Some medications may affect your eligibility for LASIK or influence the results of the procedure.
5. Do I have other health or eye conditions that might rule out LASIK?
Certain health or eye conditions may prevent you from undergoing LASIK surgery or require treatment before considering LASIK. You should discuss with your eye doctor if you have conditions such as diabetes, autoimmune diseases, dry eye, uveitis, eye injuries or surgeries, keratoconus, corneal scarring, cataracts, glaucoma, retinal disease, and ocular herpes.
6. What results can I expect? What might be the best- and worst-case scenarios?
Even though many people may experience amazing results. Not everyone will be successful – more than one in four people, 1 some may even require retreatment. Further, as with any treatment or surgery, potential side effects and complications should be a part of the discussion with your eye doctor.
7. Can I try monovision with contact lenses first? Do you have any tips or exercises to help adapt to monovision?
Before opting for monovision through LASIK, most eye doctors would recommend trying monovision with contact lenses first. 1 This allows you to experience and adapt to the concept of monovision before making a permanent decision. Discuss with your eye doctor for tips or exercises to adapt to monovision and facilitate a smoother transition, which may sometimes take up to several weeks. 2
8. Should I have LASIK one eye at a time or both eyes simultaneously?
Performing LASIK on both eyes simultaneously allows for a faster overall healing process, typically taking just a few days before you can resume your daily activities. This approach is advantageous for those seeking a quicker recovery.
Alternatively, achieving monovision for presbyopia can be accomplished by correcting one eye at a time. Your eye doctor will also work with you to determine the appropriate wait time.
9. What is the typical duration of the recovery period, and what important considerations should I keep in mind?
Inquire about the estimated duration of the recovery process following LASIK surgery. Additionally, seek information regarding important precautions and potential adjustments for optimal healing.
10. What are the costs of LASIK?
Inquire about the costs of the LASIK procedure itself, as well as any potential additional treatments or procedures that may be required. Understand the financial implications and ensure that you have a clear understanding of the overall expenses involved.
Key takeaways
LASIK for presbyopia can be accomplished through the monovision technique. Although it may have some potential drawbacks, the opportunity to attain clear vision without relying on glasses or contact lenses can be a profoundly transformative experience for individuals capable of adapting to monovision. To ensure a well-informed decision, it is crucial to adequately prepare in advance and engage in thorough discussions with your eye doctor by addressing any queries or concerns you may have prior to proceeding. After all, you don't want to find yourself saying, "I didn't see that coming!"
Related article:
1. Can you have both farsightedness and nearsightedness at the same time?
2. Presbyopia and myopia, explained
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1. Jain, S et al. “Success of monovision in presbyopes: review of the literature and potential applications to refractive surgery.” Survey of ophthalmology vol. 40,6 (1996): 491-9.
2. Hom, M M. “Monovision and LASIK.” Journal of the American Optometric Association vol. 70,2 (1999): 117-22.
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