Monovision - Laser Eye Surgery for
Presbyopia
Reading without Glasses for the
over 45’s
Reading Glasses (Presbyopia)
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When you reach your mid forties reading gets harder especially
in poor lighting. You have to hold things farther away to be able
to read them clearly. Soon your arms are too short and an expensive
trip to the opticians is needed. This is because the lens and
muscles inside the eye have become stiff with age. You can no
longer flex the lens to give it the extra power needed for reading.
The need for reading glasses is different to the need of glasses
for good distance vision. Reading glasses help distance vision for
people only with long sight.
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Life without Reading Glasses
Monovision Laser Eye Surgery can restore youthful vision and let
you once again enjoy life naturally without glasses. Monovision
could allow you to shed that old aged look of glasses perched on
the end of your nose. You can read the newspaper, see a menu
clearly, use a mobile phone, score your golf card in the rain, put
on make up and fiddle with all the other little things in life
which have become difficult to see. Unfortunately Monovision
is not for everybody, so please read on.
Monovision Laser Eye Surgery
During the consultation your weaker eye (non dominant)
will be identified and selected to be made slightly short sighted
for better closer up vision. Your strongest (dominant) eye remains
untreated (unless you need treatment for distance vision as well).
The result is that one eye sees well in the distance and the other
sees close up objects well. Good vision for both near and far
objects at the same time without glasses is achieved.
Monovision treatment is a compromise and not everybody likes it.
Some people will take to it quickly while others will take a
considerable amount of time before they get used to it.
Acquiescence is necessary and Monovision treatment will not suit
the impatient, the depressive or the perfectionist person. Those
who can relax and wait for their brain to adjust to Monovision can
reap the rewards and will be delighted with their new found vision.
You need the right attitude to get used to Monovision and as you
will read later, it is a compromise which works wonderfully for
most patients.
Treatment Results
The aim is to give patients independence from glasses and is
achieved in all patients who persevere. Patients are usually
delighted with the treatment. Patients can read the newspaper or
smaller print following treatment and will not need glasses for
walking around, swimming etc. and everyday enjoyment of life. When
the difference between eyes is large (say 2.5 and above) occasional
contact lenses may be used for difficult conditions such as driving
at night or skiing in cloud.
Suitability for Monovision Laser Eye Treatment
You should be suitable for treatment if you have healthy
eyes and good sight with glasses. Monovision cannot make your
vision better than with glasses therefore people with damaged or
diseased eyes will not benefit from Monovision. A list of
conditions which make the Monovision Laser Eye Treatment
inadvisable is given on the last page.
Common Visual Problems Explained
The need for Reading Glasses only (Presbyopia)
Many people only need glasses for reading when they reach 45 or
thereabouts (this is called Presbyopia, with no need for distance
glasses). If you have had normal vision all your life and do not
want this need for glasses you can consider having only one eye
treated to achieve Monovision. Your prescription will look like
this: - Sph and Cyl boxes will read 0 or plano (=plane glass or
zero) and will have a positive number (e.g. + 1.5) in the near
box.
Poor distance vision as opposed to the need for reading glasses is
usually caused by one of the following conditions: Long Sight
(Hyperopia); Short Sight (Myopia) and Astigmatism often
colloquially called Stigma. Some small amounts in your prescription
(.5 or less) can be ignored and Monovision can be successfully
achieved without treating these small distance corrections
prescriptions.
Long Sight
Long sighted people are able to see better at long distance than
seeing near things. If you are long sighted and need glasses for
good distance vision you will need treatment to both eyes to
achieve Monovision. The stronger (dominant) eye is treated to get
good distance vision and the weaker eye is treated to be
deliberately short sighted to achieve clear close up vision. Laser
treatment for long sight up to + 4.5d is very effective and
patients get good results.
Your prescription will read plus (e.g. + 2) in the Sph box and have
Add and a number (e.g. + 1.5) in the near box. When you were
younger you could use the elasticity in the eye muscles to see
clearly in the distance and you probably only needed occasional
glasses. However this can cause eye strain and headaches as the day
wears on because using the eye muscles all day makes the eyes tired
(these muscles are designed to be used only for reading and not all
day).
Short Sight
People with short sight have much better sight at short
distances than at long distances. If you are moderately short
sighted you can take off your glasses and read well. You can have
your short sight corrected by laser but if you have both eyes
corrected for distance and you are over 45, you will immediately
need reading glasses unless you choose Monovision. Treatment for
short sight up to -10d is very effective and patients get good
results. Your prescription will read minus (e.g. -2) in the Sph box
and have Add and number (e.g. Add +1.25) in the near box.
Astigmatism
People with astigmatism have blurring of vision at all
distances and will need treatment to both eyes to achieve
Monovision. Small amounts of astigmatism (up to 1 or thereabouts)
are common and can often be ignored especially when young.
Astigmatism is often combined with short and long sight and is
treated at the same time at no additional cost. Treatment is very
effective, and patients with severe astigmatism are the most
pleased. Your prescription will read plus or minus (e.g. +2 or
-1.5) in the Cyl box and have Add and number in the near box (e.g.
Add +1.75).
The Level of Correction Required
As you get older stronger glasses are needed as the eye muscles
gradually lose their remaining elasticity. Reading glasses are
available in powers of up to +3. The average person will have the
following progression of strength of reading glasses as they get
older, but it varies between individuals:-
At 45 +1 correction required
At 50 it goes to +1.5
At 55
,, +2
At
60 ,,
+2.5
At
65 ,, +3
Your eye will stop getting worse at around 65 and +2.5 to +3 should
give good reading for the rest of your life. The level of
correction will be discussed with you on consultation. The level given depends on how old
you are, how long you can wait until you get comfortable vision and
the number of years you want to have pin sharp close
vision.
The correction given will be greater than you currently need to
allow for future deterioration. A higher correction will take
longer to get used to but near vision should remain good for a very
long time. A correction of +2 may only last 10 to 15 years and a
smaller correction of say +1.5 may only last up to 10 years before
additional correction is needed. The level of correction will be
discussed at your consultation, but there is nothing to stop you
having further treatment in the future. A typical 45 yr old will be
recommended +1.75 of correction in the one eye, an older person of
say 55 the correction will be corrected to say +2.25.
Becoming Comfortable with Monovision
The time it takes to feel comfortable with Monovision depends on
the difference in the prescription between your eyes after
treatment. A small correction (of say 1) could be tolerated in a
few days to a month, and there isn’t usually any problem with
differences up to 2. A large difference (of about 3) can take 6
months or more to get used to. For this reason you will be offered
a simulation of Monovision with a contact lens.
Contact Lens Trial
Monovision can be achieved by wearing a contact lens in one eye
(or one of less power if you already wear them for distance
vision). When you visit Optimax on consultation you will be offered a
free trial with disposable contact lenses. The Optometrist will put
a lens in your non dominant eye and ask you to go away for a period
from a few hours to a period of a few weeks. This period depends on
how long you wish to try it for, you may find after a few hours
that you like it but on the other hand you may wish to try it for
much longer. If you have a trial for longer than your visit to
Optimax the necessary training will be given to teach you how to
insert and remove these lenses. The strength of the trial lens will
to suit your current need for reading glasses. This trial will give
you a sense of what Monovision will feel like.
Finding Your Dominant Eye
We all have a dominant eye in the same way we have a dominant hand
and dominant foot. Your dominant eye is the one you subconsciously
rely on and is usually has the better vision of the two. For
Monovision this is the eye that will be used for distance vision
and the weaker non dominant eye to be corrected for close up
vision. To determine which your dominant eye is, close one eye as
if to aim at an object, the eye remaining open is your dominant
eye. This will be confirmed on consultation.
Safety of Monovision Laser Eye
Surgery
LASIK is the most performed elective eye
operation in the world with almost 20 million procedures carried
out since it was invented about 10 years ago. However, no surgery
is completely safe or without complications. You will be told of
all the potential problems before you go ahead and a very detailed
consent form is signed before you can be accepted for laser eye
treatment. As most Monovision patients only have one eye treated
the risks of sight threatening complications to both eyes are
eliminated.
Treatment Options
LASIK is our standard laser treatment which
gives a permanent fixed change to your prescription.
A surgical alternative to Monovision is RLE (Refractive Lens
Exchange). If you have a family history of
cataracts or you are severely long or short
sighted you should consider lens implants. The lenses inside the
eye can be replaced with multi-focal lenses which can give both
good distance and close up vision.
Permanency
As you get older stronger glasses are needed and then quality of
close up vision will very gradually get worse as you near the limit
of your correction.
LASIK is permanent and if you have full
correction of plus 2.5 to 3, the benefit of sharp reading
vision should last for ever. However, lower corrections may not
always give full reading correction permanently. Monovision can be
described as turning back the clock on your eyes and depending on
how far you turn back the clock, determines how long it lasts, i.e.
the level of your correction will determine how long you can read
without glasses. The advantage of treatment is not lost
completely; a treated eye will always have much better close
up vision than the dominant eye, even if the very fine sharpness of
close up work has diminished. Further treatment can be given if
desired at your request.
Optimax Medical Team
Treatment is performed by one of our highly experienced laser eye
surgeon who is a qualified doctor and who is registered with the
GMC. All
Optimax Doctors are specialist LASIK surgeons
who have dedicated their careers to
refractive
surgery (surgery to eliminate the need for glasses). They are
passionate about their speciality and this is combined with their
experience of hundreds of thousands of
vision correction treatments.
Optimax Optometrists are similarly enthusiastic and are dedicated
to helping patients achieve their dream of natural sight without
glasses. The field of refractive surgery attracts a special and
academic profile of eye care professional.
Your Consultation
Your laser eye surgery consultation is performed by an Optometrist
who is experienced in all aspects of vision correction which
includes
laser eye surgery and Monovision. They will test
your eyesight, examine your eyes to ensure they are healthy,
determine your dominant eye and advise you on the strength of
treatment recommended. They will also offer to fit a contact lens
for you to experience Monovision. Optimax Optometrists work to
guidelines of, and are supervised, by
Optimax
Doctors in refractive surgery who will perform your
treatment.
Treatment Day
LASIK involves changing the shape of the front
surface of the eye to make focussing images more clearly. A very
thin flap is created by a laser and a second laser then re-profiles
the underlying tissue. This flap is replaced after treatment
leaving little or no surface wound and therefore recovery is rapid
and your vision is improved almost immediately. The eye may be
weepy and blurred for a few hours after treatment. LASIK to one eye
takes about 10 minutes and is pain free. For more detailed
information, please see our
Laser Eye Surgery Information Pack, which is
sent to all enquirers.
Monovision Treatment
Recovery
LASIK
treatment is usually pain free with only minor discomfort in
the majority of cases. You should notice an immediate improvement
in reading vision and you can return to normal activities without
much delay. Because of the difference in your eyes, driving in
the first few weeks can be uncomfortable and you should not drive
if you are not confident to do so.
Free Lifetime Aftercare
You will need two to three visits in the three months following
treatment to ensure all is well before you are discharged.
Aftercare for life is included in our fees which
means that should any complication occur as the result of
treatment at any time you will be offered remedial treatment
without charge. This does not however cover the natural
deterioration of your eyes with age.
Practical Considerations
After Monovision laser eye surgery you should not
rub your eyes and ladies should not wear eye make up for five days.
We recommend that you do not drive after treatment while you get
used to your new vision. Please see our main leaflet on
LASIK eye
treatment as it will all apply to you.
Optimax Laser Eye Surgery Specialists -
the Company
Optimax was established by Mr Russell Ambrose in
1992 in the very early days of laser eye correction. His vision is
to provide the very best and safest laser eye treatment at an
affordable price. Optimax has specialised in the
laser eye treatment, doing nothing else in these
18 years and by and by
using the best equipment and keeping up to date with the latest
technology gets unbeatable results. As a result about half our new
patients come by personal
recommendation. Optimax has since provided
over 350,000 laser
treatments to correct the need for glasses. As at January 2009 this
is the largest number of laser
vision
correction treatments in the UK performed by any company.
Optimax is registered with the Healthcare Commission, a government
organisation which oversees and regulates all private medical
clinics.
The Personal Experience of the Owner of
Optimax
I, Russell was the first
Optimax patient in 1992 and in those
early days (in the interest of safety) we did treatment to one
eye at a time, with a six month wait before treating the second
eye. Being in my forties and short sighted, treatment would have
meant swapping distance glasses for reading glasses but I had never
heard of Monovision Laser Eye Surgery at that time. It became
obvious that on having my second eye treated I would need
reading glasses immediately. By six months I was getting used to
Monovision but unfortunately because Monovision was not planned my
non dominant eye had been treated first so I had to get used to my
left eye taking over domination as well as Monovision. It took me a
year or more to get to the point where I did not notice the
difference between my eyes but it has been worth it many times
over. I will not say it is easy, but in those days I had no choice.
Because I did not want to wear a contact lens in my untreated eye I
got used to it.
It becomes automatic and seamless that one eye is used for
close up vision and the other takes over for far distance. I
have completely forgotten the difference in my eyes and I never
think or realise my eyes are working independently. It’s fantastic;
at almost 60 and being -3 in one eye I can see the tiniest print in
the smallest of fonts and being 20:20 in my treated eye it means I
can see the leaves on the trees far away. I have not worn glasses
since 1992 and I should never need glasses ever again and I can
state that laser treatment and Monovision has changed my life and
lifestyle.
Because it is time consuming and complicated to explain and in an
age when patients expect instant
results, eye care professionals and patients do
not give Monovision laser eye treatment proper consideration. It is
not practical to give glasses for Monovision and bifocal lenses and
reading glasses are prescribed.
Contact lens wearers on the other hand are routinely given
Monovision using different powered lenses. Because lenses are
easily interchanged it does not cause expensive changes of
glasses when the patient is impatient or
dissatisfied. Those who enjoy Monovision have found this
wonderful secret from the insight of a caring optician who makes a
special effort with contact lenses. Because it is invisible
and a silent advantage it is not widely known about, but if you ask
your friends it is usual that one of them who wears contact lenses
already enjoys Monovision, so please ask around.
What happens if I don’t like
Monovision?
Some people do have the patience to forget about the
difference between their eyes and and give up before adjusting. If
you were short sighted prior to laser treatment it is simple to go
back and make both eyes for distance vision, but then you will need
reading glasses. If you were long sighted or wore no distance
glasses prior to treatment (and you were made deliberately
short sighted in one eye) you will need to have this reversed by
further Laser Eye Treatment. Because we have to leave six months
before any laser re-treatments you must be prepared for this
period of disturbance but it is most likely that you will be used
to it by then and not bother. There is no charge for a reversal
treatment if you do not like Monovision.
Monovision
Treatment Cost
Because consultation is very thorough and time consuming a charge
of £60 is made. We make a special price for Monovision to cover
costs and possible re-treatments involved.
LASIK
treatment costs between £1000 and £1500 per eye. We have a
range of
easy payment plans to suit you and no one with a
bank account is refused our non status in house credit. Many
patients remark that it is the best money they
have ever spent.
The Next Step
To discuss treatment or book a consultation call our customer
services department today on 0800 093 1110. If you have been
prescribed glasses by an optician please have your prescription
details handy. If you have bought your reading glasses off the
shelf look on the inside of the arm where the strength is
usually written. It will be a number like +1.5 or +2.5.
Independent Laser Eye Surgery
Advice
If you wish to talk to some of
Optimax’s previous patients you are welcome to
have some telephone numbers of people who have given their
permission to give out their details. Please call customer services
on 0800 093 1110.
It is a big decision to have Monovision Laser Eye Treatment
and we advise you to research it as much as you can. Some of your
friends probably already have Monovision, so please ask
around. The following links have useful independent
information:-
Reasons for not having Monovision Laser Eye
Surgery (Contra Indications)
Some professions such as HGV drivers and Airline Pilots require
good distance sight in both eyes. This will mean that glasses may
need to be worn to reach these standards after treatment.
About 20% of the population are unsuitable for any
LASIK
treatment because of underlying medical conditions. LASIK
absolute contra indications include:-
Amblyopia; Partially sighted; Chrons disease; Compulsive disorders;
Collagen disease: Glaucoma; Herpes in the eye; Lupus; Prism;
Rheumatoid Arthritis; Squint, SLE
Conditions which might be reasons not to have treatment
(relative contra indications) usually depend on degree and whether
the conditions are under good control. A consultation is
required:-
Blepharitis; Depression; Diabetes; Dry eyes; Epilepsy; Eye
infections; MS; Raised internal eye pressure;
RLE may be an option if you are not suitable for LASIK.
Contact Lenses can give Monovision, please ask your contact
lens practitioner.