|
Monovision is one clinical technique used to deal with the correction
of presbyopia, the gradual loss of the ability of the eye to change focus
for close-up tasks that progresses with age. The intent of monovision
is for the presbyopic patient to use one eye for distance viewing and
one eye for near viewing. This practice was first applied to fit contact
lens wearers and more recently to LASIK and other refractive surgeries.
With contact lenses, a presbyopic patient has one eye fit with a contact
lens to correct distance vision, and the other eye fit with a contact
lens to correct near vision. In the same way, with LASIK, a presbyopic
patient has one eye operated on to correct the distance vision, and the
other operated on to correct the near vision. In other words, the goal
of the surgery is for one eye to have vision worse than 20/20,
the commonly referred to goal for LASIK surgical correction of distance
vision. Since one eye is corrected for distance viewing and the other
eye is corrected for near viewing, the two eyes no longer work together.
This results in poorer quality vision and a decrease in depth perception.
These effects of monovision are most noticeable in low lighting conditions
and when performing tasks requiring very sharp vision. Therefore, you
may need to wear glasses or contact lenses to fully correct both eyes
for distance or near when performing visually demanding tasks, such as
driving at night, operating dangerous equipment, or performing occupational
tasks requiring very sharp close vision (e.g., reading small print for
long periods of time).
Many patients cannot get used to having one eye blurred at all times.
Therefore, if you are considering monovision with LASIK, make sure you
go through a trial period with contact lenses to see if you can tolerate
monovision, before having the surgery performed on your eyes. Find out
if you pass your state's driver's license requirements with monovision.
In addition, you should consider how much your presbyopia is expected
to increase in the future. Ask your doctor when you should expect the
results of your monovision surgery to no longer be enough for you to see
near-by objects clearly without the aid of glasses or contacts, or when
a second surgery might be required to further correct your near vision.
- Bilateral Simultaneous Treatment
You may choose to have LASIK surgery on both eyes at the same time or
to have surgery on one eye at a time. Although the convenience of having
surgery on both eyes on the same day is attractive, this practice is riskier
than having two separate surgeries.
If you decide to have one eye done at a time, you and your doctor will
decide how long to wait before having surgery on the other eye. If both
eyes are treated at the same time or before one eye has a chance to fully
heal, you and your doctor do not have the advantage of being able to see
how the first eye responds to surgery before the second eye is treated.
Another disadvantage to having surgery on both eyes at the same time
is that the vision in both eyes may be blurred after surgery until the
initial healing process is over, rather than being able to rely on clear
vision in at least one eye at all times.
If you are considering refractive surgery, make sure you:
- Compare. The levels of risk and benefit vary slightly not only
from procedure to procedure, but from device to device depending on
the manufacturer, and from surgeon to surgeon depending on their level
of experience with a particular procedure.
- Don't base your decision simply on cost and don't settle for
the first eye center, doctor, or procedure you investigate. Remember
that the decisions you make about your eyes and refractive surgery will
affect you for the rest of your life.
- Be wary of eye centers that advertise, ”20/20 vision or your money back” or ”package deals.” There are never any guarantees in medicine.
- Read. It is important for you to read the patient handbook
provided to your doctor by the manufacturer of the device used to perform
the refractive procedure. Your doctor should provide you with this handbook
and be willing to discuss his/her outcomes (successes as well as complications)
compared to the results of studies outlined in the handbook.
Even the best screened patients under the care of most skilled surgeons
can experience serious complications.
- During surgery. Malfunction of a device or other error, such
as cutting a flap of cornea through and through instead of making a
hinge during LASIK surgery, may lead to discontinuation of the procedure
or irreversible damage to the eye.
- After surgery. Some complications, such as migration of the
flap, inflammation or infection, may require another procedure and/or
intensive treatment with drops. Even with aggressive therapy, such complications
may lead to temporary loss of vision or even irreversible blindness.
Under the care of an experienced doctor, carefully screened candidates
with reasonable expectations and a clear understanding of the risks and
alternatives are likely to be happy with the results of their refractive
procedure.
Advertising
Be cautious about ”slick” advertising and/or deals that sound ”too good to be true.” Remember, they usually are. There is a lot of competition
resulting in a great deal of advertising and bidding for your business.
Do your homework.
If you want to know more about advertising ethics, do's and don'ts, or
want to report on false advertising, explore the following websites:
|
