Correcting “Reading Vision” with LASIK/PRK (“Monovision”)

Our eyes are naturally designed to see at infinity. If you imagine our eye working like a camera, for someone who has perfect vision, the camera is naturally focused to take a picture from something which is miles away. Now imagine if you’d like to take a picture of a newspaper (up close) with the same camera (still focused for far), the image will be extremely blurry. In this situation, one would have to turn the camera’s lens to zoom the image for the newspaper up close. This, in our eyes, is the function of the natural lens: it’s a soft bag, filled with liquid crystal, and it is connected to muscles that change its shape and help the camera focus for up close.

When we’re young, this lens is very soft and has a high degree of “accommodative power” allowing us to see very nicely up close. In fact, if you notice children doing homework, they can sit very close to the page and still see great! This does NOT happen in a 60-year-old. So what happens is that this soft lens becomes harder and denser as we age, and loses its ability to flex; as a result, people over ~40 usually find themselves keeping things farther and farther away to read them and eventually require reading glasses.

For those who do not like wearing reading glasses, contact lenses, or bifocals, there are currently two good options: they can elect to have one eye corrected with laser to see far (the dominant eye), and the other to see near. This is called “monovision” and in the right patient, works extremely well. In a patient who does not have cataracts or high hyperopia (>+4.00D), this can be easily achieved with LASIK or PRK and works well for 10-15 years until they develop a cataract (usually after 70-75 years of age).

The other option is to perform a “lens based” procedure where the natural lens is removed (exactly like a cataract operation), and replaced with a multi-focal or accommodative lens that allows one to see great for near AND far out of EACH eye (not monovision!); this is called a “clear lens exchange.” Although this surgery works extremely well, it’s more involved, involves more surgery, and it is more expensive. We usually reserve this surgery for those who either have cataracts, or are in the “pre-cataract” age (usually >70 years-old), or are hyperopes with >+4.00D of hyperopia.

Dr. Soroudi is an expert on treating presbyopia utilizing both of the above technologies. He will discuss all your surgical options with you in great detail and