So Why Not Monovision?

[Hoddy44]

Assuming that you have the ability to adjust to it, what are the negatives associated with monovision and the new aspherical monofocal lenses after cataract surgery?

[Forum-OD-MP]

the big 3 negatives for monovision IMO:

1) no middle distance: your far away vision is good in one eye, your near vision is good in the other eye...so what do you do at the computer?  or at any distance that is farther than say 16" but closer than 10 ft?  there's a "hole" in your vision...multiple "intermediate" distances where neaither eye is clear.

2) "interference": you have one blurry eye at *all*distances.  when you look far away, your non-dominant eye is blurry.  when you look up close, your dominant eye is blurry.  at no time do you see well with both eyes at the same time.  a lot of people actually see blurrier out of BOTH eyes open at the same time than they do when they SHUT or cover the other eye.  thats what i call "interference", and for some people its very difficult to get over or get used to.  you cant easily go around shutting or covering an eye.

3)  loss of binocularity/stereo/depth perception: dpeth perception is thrown off at all distances, but especialy up close.  it is sometimes very difficult for some people to guage distances, even after years of monovision wear.  they "miss" threading the needle when they sew, for example...not b/c its blurry but b/c their eyes dont work "together" to aim at an appropriate distance

*POSITIVES* of monovision iols:

1) cheap & easy: low incidence of surgical problems
2) clear vision at near and distance w/o reading glasses (but again, no "intermediate"
3) low incidence of night vision "halos" or debilitating glare

[JodieJ]

I used monovision contact lenses for several years, and my experience was a little different from what the moderator described.  With monovision I was able to drive at night (no glare, no halos), use a computer and read small print without glasses.  (I've asked other monovision users, and they also report having good intermediate vision.)  I had the sense that I was using both eyes to see at all distances, although my brain was actually suppressing the blurred image from one eye.  My depth perception must have been impaired, but it was honestly not something I noticed.  I do remember closing one eye to thread a needle, so I guess I unconciously made adjustments in certain situations.

I had to stop monovision when it started causing problems with double vision.  (I did have about four problem-free monovision years.)  This is a fairly rare complication, although some Lasik surgeons now routinely screen for binocular vision abnormalities before doing a monovision correction.  (I probably wouldn't have passed the screening.)  I'm currently using two distance contacts and reading glasses, and I can't say I'm thrilled with this arrangement.  I especially miss having good intermediate vision, and not just for the computer.  It's essential for cooking, grooming and so many other daily activities.

[JodieJ]

Unfortunately, my ability to wear multifocal contacts was limited by astigmatism and a macular pucker in one eye.  The pucker's effect on my visual acuity was small, but the wrinkling of my retina turned those multiple concentric zones into one big blur.  (And those thick gas perm lenses weren't real comfortable, either.)  After trying (and failing) with a number of brands, I was so frustrated that I decided to have retinal surgery to remove the pucker.  Shortly before my surgery date last January, I discovered a multifocal that may have worked for me, even with a wrinkled retina.  Triton soft bifocals by Gelflex have a translating design (no concentric zones of vision), and the manufacturers claimed to provide everything I was looking for:  crisp vision at all distances, wearing comfort and astigmatism correction.  But with my vision changes post-retinal surgery and then a developing cataract, I haven't been able to try them yet.

Wearing monovision contacts left me totally unaware of my worsening presbyopia.  It was a rude awakening to find myself suddenly engulfed in a bubble of fog, unable to perform the tasks I was used to doing.  I'm hoping that those Triton lenses worn over aspheric IOLs (plural if I go for a clear lens exchange) will restore the vision I miss so much.

[Ag-i-doc]

jodie:

have you tried multifocal contacts?