Hi - I'm hoping a professional who understands the options can help me with my monovision situation and tell me which options make sense.
I've been using monovision B&L Torics for several years and am finally tired of the fact that there's so much compromise involved. My nearsightedness is about -6 and -4.5.
My right eye (-6) is dominant and has been my distance eye in monovision, with my left doing near distance with about +2 for the presbyopia. I have a small amount of cylinder taking care of the astigmatism. With the monovision lenses, my distance clarity is especially weakened at night, so much so that I resort to glasses for night driving.
On the other hand, the correction for near vision in the other eye doesn't really do the job for really close work. (With my basic bifocal glasses, I have great distance and close vision) One of the great things about the monovision contacts is the balance between the two eyes allows for good medium-distance vision for computer use.
I'm ready to see if I can improve the monovision distance by making the other eye mid-range, with a +1 instead of the current +2. If I do this, I hope to have better distance clarity and will still have good mid-range but poor short-range vision (reading) unless I add reading glasses. So - my question is, what type of reading glasses will I need to use to allow me to see up close? If I use full-screen drugstore glasses of +1, I guess my distance eye would become mid-range, and my mid-range mono eye becomes close-range .... but is that reasonable and acceptable? Should I instead consider bifocal glasses that are clear across the top but add +1 in one eye and +2 in the other in the segment? In other words, looking straight ahead, I'd be looking only thru the contacts for distance and mid-range, but looking thru the segment I'd be seeing up close in both eyes? (+1 added to the mid-range mono gives me up close, and +2 in the distance eye also gives me up close). Do wither of these options make sense and are they supported by the professionals? Is there another combination I should consider?
Yes, with my astigmatism and the difference in Rx from one eye to the other, I know I won't see great with monovision, and I've lived the compromise for several years. Reading small print is much better with glasses, and seeing distance at night is also. If I try to improve one or the other with mono contacts, the other side suffers.... i.e., improving distance kills near vision, and improving near vision makes distance worse.
This is a dilemma for most people with defective vision, particularly from about 45 years of age onwards. You have a fairly strong degree of short-sightedness so it is important that you find the best compromise between distance and reading correction. If you are considering bi-focals, I would suggest you go one step further and look at progressives. They are more expensive (3-4 times the cost of plain lenses) but they are easier to adapt to than bi-focals and will give you seamless correction at all distances. The adaptation can involve a few days of wooziness but the effort and the expense is really worthwhile.
The main problem with strong prescription bifocals is that the difference between the reading and distance parts of the lenses is so great that you lose focus at intermediate distances. I am long-sighted (+5.50d) but the effect is the same. I found that things like the car instrument panel, price labels in shop windows and watching TV were all very difficult with bifocals, whereas progressives restored my sight to close to perfection at all distances.
Last edited by TopGeek; 03-19-2010 at 02:10 AM.
Reason: extra detail
I'd recommend that monovision contact lens wearers over age 50 have 2 pairs of progressive glasses--one for wearing over their monovision contacts and one for wearing without contacts.
If you are used to having some near vision with monovision contacts, the loss of all near vision may be significant (although it will definitely improve your distance vision.) You might consider sticking with full monovision and wearing progressive glasses over them for night driving, prolonged reading, etc. Progressive glasses would also work well with the mini-monovision correction which you described above, but your near vision will be quite blurry without them (which may be extremely irritating.)
Thanks, Jodie -- I'm familiar with the adaptation required for progressives and am curious if I'd have a tough time adapting since I'd only wear them occasionally, like for night driving or up-close reading, etc... but the idea is interesting. In the situation you describe, I'd keep my full monovision as I have now, but the progressives would add just enough to improve the distance and also improve the near as well? So, the progressives would have very small Rx all the way top to bottom?
When you wear your contacts, the script in each lens of your progressive glasses would be different. The glasses would essentially eliminate monovision and give you excellent vision at all distances in both eyes. I don't think you'd have any problem adapting, and you wouldn't have to wear them all the time--only when you needed sharper distance or near vision.
For the night time driving problem have you considered going to a stronger distance lens? As I aged, my distance vision improved to the point that I no longer need any correction for it. However, I didn't like what I was giving up overall with the reading lens in. So we went to a minimum correction for the right (dominant) eye and when I had them both in I could see perfectly for driving, etc even at night. Don't know what to tell you about the rest.