Monovision Contact Lenses for Presbyopia

Monovision is the name given to the art and science of fitting contact lenses on a patient who has developed presbyopia. Presbyopia is the unavoidable change in vision that usually occurs at around 40 years of age, causing difficulty in reading the small print and focusing on near objects. Most people are familiar with reading glasses, bifocals or progressive lenses as options for correcting presbyopia. Somewhat less familiar, however, is the vision correcting method of "monovision." With monovision, one eye is fit with a distance lens (if needed) and the other eye is fit with a near lens, providing clear vision for both distance vision and near.

How Does Monovision Work?

At first glance, monovision seems very strange. But unusual as it seems, most people receive amazing results. Here's how it works:

We all have a dominant eye as well as a non-dominant eye. (You can easily determine eye dominance with this quick eye dominance test.) When we look into the distance, we are actually using the vision from the dominant eye more than we are using the non-dominant eye. The non-dominant eye still functions, but the dominant eye sort of takes over. Our brain pays more attention to the visual information received from the dominant eye. So if the non-dominant eye is fitted with a near-powered lens to correct our near vision, our distance vision will not be disturbed that much.

Monovision works because the brain is tricked into thinking that the contact lens is actually a part of the natural eye. (For this reason, monovision does not work in an eyeglass prescription for most of us.) Although it takes a week or two to adapt to monovision, it beats reaching for reading glasses every time you want to read.

Computer Monovision

With computer monovision, a person will be able to see at the distance of a computer screen. Most people who work on a computer daily enjoy this type of correction, although reading glasses may still be needed. Computer monovision is not generally recommended for people who like to do a lot of reading.

Modified Monovision

This type of monovision has the patient wear one contact lens that is bifocal on the weaker eye. This lens is used for viewing objects that are close-up. Depth perception and distance vision are achieved by wearing a single-vision contact lens on the other eye. 

Monovision LASIK

Patients who have enjoyed monovision with their contact lenses may have success with monovision LASIK. Monovision LASIK aims to achieve the same corrected vision that you receive from monovision contact lenses, without the contact lenses in your eyes. In monovision LASIK, one eye is corrected for distance and the other for near. The LASIK surgery is performed directly on the cornea. Recovery and healing are usually quick. Changes in vision are usually noticed right away. If you think you might like to try monovision LASIK, it's a good idea to first make sure you are comfortable wearing monovision contact lenses. Surgery is a major commitment and results are difficult to reverse.

A Word From Verywell

Although monovision does not work for everyone, it is a viable option for people who have presbyopia. Monovision can help you achieve good, functional vision at distance and near. It is not "perfect" vision, however. There is usually some compromise between clarity at distance or near to allow patients to fully adapt to monovision while at the same time providing adequately corrected vision. As a result, patients who require the sharpest corrected vision possible at distance or near may not be the best candidates for monovision. In fact, people who have never had to wear glasses typically don't do as well with monovision compared to people that have worn glasses previously. Furthermore, monovision may decrease depth perception, which could affect athletic or job performance. The best way to determine if monovision might work for you is to ask your eye doctor. If monovision is not right for you, your eye doctor may suggest bifocal (multifocal) contact lenses, or simply contact lenses for distance and reading glasses to wear over your contact lenses.