Monovision: Laser treatment for age-related long-sightedness

Monovision is a special procedure for correcting presbyopia: one eye is optimized for distance vision, while the other eye is adjusted for near vision. The brain combines both images into a single overall image.

Many patients opt for Monovision laser eye surgery because it allows them to go without reading glasses for many years in their everyday lives.

Unlike Trans-PRK, Femto-LASIK, and KLEx, Monovision is not a separate laser eye surgery procedure, but rather a strategy in which the eyes are corrected differently.

At YOUSEE, only Femto-LASIK is used for Monovision.

From around the age of 40, the lens of the eye loses its elasticity and, with it, the ability to adjust the refractive power of the eye. This means that the near point, i.e., the shortest distance at which we can still see clearly, moves further and further away.

The result: you have to hold books further away when reading, smartphone text appears blurry, and working on the computer becomes more strenuous. This is why it is also referred to as age-related long-sightedness.

Age-related long-sightedness, or presbyopia, is a naturally progressive process that affects everyone.

Monovision can also be congenital. Since Johann Wolfgang von Goethe was nearsighted in one eye and farsighted in the other, Monovision is sometimes referred to as Goethe eyes.

YOUSEE offers standard laser eye surgery procedures, which are recommended for people up to around 45 years of age. It is possible to have laser eye surgery beyond this age, but glasses would still be needed: reading glasses would still be required due to age-related long-sightedness.

Monovision is one way to live without glasses even after the age of 45.

One eye, usually the dominant one, is corrected for sharp distance vision, making it possible to drive, play sports and watch TV without visual aids.

The other eye is set to be slightly nearsighted, so that you no longer need glasses for reading, writing, and working at a computer screen for years to come.

Actual vision takes place in the brain:

After a period of adjustment, both images are combined so that it is almost impossible to tell which eye is doing most of the work.

How does Monovision work, and is it suitable for everyone? Are the results of the procedure permanent? How long does it take for the brain to adjust to the new situation?
These are just some of the questions answered by our ophthalmologist and Chief Medical Officer of the YOUSEE Group, Prof. Theo G. Seiler, MD, FEBO Ophthalmologist FMH in this video.

Monovision is generally suitable for people between the ages of 45 and 50 who want to do without glasses and contact lenses.

However: Your eyes and brain need time.

This is why the adjustment period is important. After our measurements, you should wear contact lenses with the adjusted prescription for a few days to get used to your new vision.

Around 60% of people cope well with Monovision, but various problems can arise during the transition phase.

Normally, the brain adapts to the new visual situation over time and the symptoms improve. However, if you experience a persistent feeling of uncertainty, severe headaches, or a significant deterioration in visual comfort, permanent Monovision is not recommended.

During the preliminary examination, we will work with you to determine whether Monovision is an option for you. The test phase, during which you can thoroughly try out your new view of the world, is particularly important.

Monovision affects 3D vision, because it disrupts the coordination between both eyes, known as binocular vision.

With normal vision, both eyes deliver images of approximately equal sharpness in slightly offset positions:
This creates three-dimensional impressions in the brain.

With Monovision, however, one eye is optimized for distance and the other for close-up, which means that each eye delivers images of different sharpness at different distances.

This results in the following relationships and limitations:

At YOUSEE, we only perform Monovision if you have tolerated the adjustment period well and the difference between your near and distance vision is no more than 1.5 diopters.

This keeps any possible restriction in stereoscopic vision to a minimum.

Reduced depth perception: The brain cannot combine the different images into a single spatial image as it normally would. In particular, accurately estimating distances and coordinating body movements (e.g., when playing sports or driving) becomes more difficult because the sense of distance and the ability to estimate speeds and movements are reduced.

Reduced field of vision: Studies report that the field of vision can shrink by up to a third after Monovision, as both eyes no longer work together harmoniously.

Individual tolerance: Approximately 40% of patients have difficulty with the limitations of 3D vision after Monovision, while 60% cope very well with the method in everyday life.

Monovision alters 3D vision due to the different corrections of the eyes. For most people, the difference is hardly noticeable in everyday life, but Monovision can have disadvantages for precise activities that require spatial depth and coordination.

At YOUSEE, we perform Monovision only with Femto-LASIK.

Thanks to its high precision, Femto-LASIK enables customized adjustment so that one eye can be optimally corrected for distance vision and the other for near vision for Monovision.

If a correction is necessary after the procedure, this is easiest to perform with Femto-LASIK.

If the patient realizes after the procedure that they cannot cope with Monovision, it can simply be removed again.

In terms of the procedure, Monovision surgery is no different from Femto-LASIK: Detailed information about Femto-LASIK and more specific information about the procedure and aftercare can be found under the menu item Femto-LASIK.

After we have carefully measured your eyes, you can take your time to see if you are comfortable with Monovision. You will wear contact lenses with the target prescription for at least two, preferably four weeks, so you know exactly what to expect.

Glasses for driving, glasses for reading, and perhaps a spare pair for work? For many people, this is now a thing of the past: however, the correction is not permanent, as presbyopia is progressive.

Glasses, reading glasses, sunglasses, and contact lenses add up over the years. On our Laser Eye Surgery Costs page, we have compiled an overview that shows you that laser eye surgery pays off.

There are many good reasons to have laser eye surgery: However, virtually all of our patients report above all the improvement in their quality of life that comes with their new, naturally sharp vision.

Presbyopia is a natural aging process of the eye that progresses gradually: while distance vision remains sharp after the procedure, near vision continues to change: from around the age of 45, it deteriorates by approximately +0.5 per year and stops at around +3.0 at the age of 60. The exact timeframe varies from person to person, as the aging process is different for everyone.
Depending on the individual situation, laser treatment may be repeated at a later date. Otherwise, visual aids will be required for reading again.

The limitation in stereoscopic vision is hardly noticeable in everyday life thanks to our internal guidelines at YOUSEE, but if, for example, you rely on high-precision 3D vision for your job, Monovision is not recommended.

Like all laser eye surgery procedures, Monovision is subject to certain restrictions. It is particularly important that the cornea is sufficiently thick, the eyes are healthy, and the correction is not too high.

Many patients have no problems at all during the adjustment period, while others experience headaches, nausea, or blurred vision. All possible problems subside after a while for most people, but the adjustment period can be uncomfortable.

That's why you should try out whether Monovision is the right procedure for you before the operation.