Monovision with contact lenses for presbyopia: Pros include clear vision for all ranges & cost-effectiveness. Cons involve ghost images, glare, and depth perception issues.
Continuing from the previous article about LASIK for presbyopia: tapping into monovision treatment strategy, this article explores monovision using contact lenses, which is typically tried before undergoing LASIK monovision surgery.
A quick reminder on what is monovision. Monovision is a treatment strategy for presbyopia, involving the full correction of one eye for distant vision and leaving the other eye slightly nearsighted. After some training, the brain adapts to combine the distinct visual inputs from each eye, resulting in a clear vision of both close-up and faraway views.1
Since last time, I have arranged a fitting appointment with my optometrist and acquired some supply of daily disposable contact lenses to appropriate to try it out. Now, after several weeks, I'd like to share my experience.
Monovision with contact lenses
Getting fitted for monovision contact lenses was a process similar to other contact lens fittings. However, unlike obtaining full correction for both eyes, as described above my dominant right eye was corrected for distance viewing, while the other eye was adjusted for near vision. Given my mild presbyopia, my dominant eye was fully corrected at -9.50 D, and the other eye was at -8.75 D.
After trying for two weeks, I made a few observations. The most noticeable aspect was the presence of a ghost imageāa slightly blurred shadow that overlapped on a clear image.
When out and about, the ghost image was less obvious and bothersome, which I could manage relatively well. However, upon returning home, the ghost image became more pronounced, leading to sensations of dizziness and nausea. At this point, I found myself wanting to switch back to my glasses.
While distance objects, especially under daylight, were fine, reading required some getting used to. Reading texts under monovision is best described as seeing overlying words that are both blurred and sharp simultaneously. It is a fascinating experience. By concentrating on my near vision eye, I could sometimes manage the focus so that I see clear text with a slightly fuzzy edge. Further, I often found myself tilting my head to the right or left, attempting to find the angle where the image was clearest.
However, throughout the time, I encountered difficulties with my mid to short-distance depth perception. Gauging distances became problematic, particularly affecting driving. As a matter of fact, I didnāt feel comfortable driving initially until I was more used to it.
The two-week trial period did show some improvement in the ghost imaging. While I could consciously manage and achieve clearer vision using the appropriate eye, the ghost images remained apparent. On the other hand, after two weeks I was still experiencing dizziness if I read or worked extensively on a computer or smartphone. So, at the end of the two weeks, I decided to revert to using multifocal contact lenses and glasses, particularly at home.
Pros and Cons of monovision with contact lenses
Monovision contact lenses work well for individuals with presbyopia who seek clear vision across all ranges and peripheral areas. This approach is particularly appealing to those in the early stages of presbyopia, as they tend to benefit more from monovision lenses.
Pros of monovision using contact lenses:
- Can be accomplished using most contact lenses available on the market.
- Provide s a high level of clarity for both up-close and faraway objects, and better peripheral vision than glasses.
- Successful adoption may prompt consideration of monovision LASIK.
- Single-vision contact lenses are less expensive than multifocal contacts.2
Cons of monovision using contact lenses:
- Ā The presence of ghost images might impact the overall quality of vision, especially in the midrangeāsuch as computer screens or speedometers. Some individuals may also experience glare at night, particularly around headlights and streetlights.2
- Ā Depth perception may be affected. 2
- The fitting process for monovision contact lenses is more complex and may incur higher charges.
- A notable percentage, ranging from 33% to 41% of individuals, may find it difficult to adapt to monovision.1
Key takeaways
My exploration of monovision contact lenses for my high myopia with presbyopia has provided valuable insights. This unique strategy works and can enable clear vision for different distances and better peripheral vision than glasses.
During my two-week trial, I experienced ghost images indoors, leading to discomfort and a desire to revert back to glasses. While distance vision improved, reading required adaptation, and depth perception was challenging.
Ultimately, due to dizziness during near-vision work and insecurity from my depth perception being affected when driving, multifocal contacts and glasses are still my preferred means. However, my trial was relatively short. If I were to consider monovision more seriously, I would try it for several more weeks. Until then, I'm content to see the world as it is ā sometimes may be a bit blurry from afar, instead of a new world of fuzzy clarity.
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Related articles:
1. Presbyopia and myopia, explained
2. Navigating presbyopia treatment options in people with retinal conditions
3. BRIMOCHOL PF eye drop: a new treatment in development for presbyopia
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