If you have LASIK and get "perfect" results (zero distance refraction) then
you can expect the same trouble as with your contacts.

Possible solutions include leaving one or both eyes a little
"undercorrected," like your glasses.

Don't discount monovision until you've tried it with (temporary) contacts.
At your age (same as me) I seldom fit contacts "perfect" in both eyes. Most
people can tolerate _some_ degree of undercorrection in one eye, and "some"
is lots better than "none".

-MT

If you elect to go with monovision LASIK, make sure that you try it out
first with contact lenses.  Some surgeons neglect this important step.

DrG

Anyone 51 years old has presbyopia, regardless of whatever other eye
problems you have. If you wear contacts, you will either have to wear
reading glasses over them to read, or multifocal or monovision contacts.

No, Lasik does not cure presbyopia at all. If you have Lasik to reduce your
myopia, you will still have to wear reading glasses to read. Or you can have
the Lasik done in a manner similar to monovision contacts. If so, you should
try the monovision contacts for quite a while first, to see how you like
that.

It is unusual that you say you cannot read the speedometer in the car with
your contacts on. I doubt that is due to presbyopia, as the speedometer is
not very close to your face, and the characters are large. It may be due to
your astigmatism. The contact lens prescription you have might not be as
good as you think. Are they soft lenses? You might then need toric soft
lenses, to correct the astigmatism, at least in that one eye.

You say you had an eye exam this last summer, in which you were prescribed
the contacts. The eye doctor didn't say anything about your presbyopia, and
possible solutions with the contacts to deal with presbyopia? If not, I
would suggest going to a different eye doctor next time.

With monovision one eye is purposely under-corrected for the myopia, so it
can be used for reading. One eye becomes dominant for distance, the other
for reading. Strange idea, but the mind becomes used to it. Of course it's a
compromise, but the only non-compromise is to wear reading glasses over your
contacts or Lasik. The only way to have Lasik and to be able to read without
reading glasses is to have the operation done with monovision,
undercorrecting one eye, similar to how it is done with contacts.

There are also multifocal contact lenses now, in many different designs. I
am sure if you did a search on Google Groups, you will find many discussions
about them on this newsgroup, different kinds, etc. They are supposed to
correct presbyopia as well as your other vision problems. Many different
ways of doing that. All far from perfect. Your distance vision with those
will not be as good as wearing single vision distance contacts, your reading
vision will not be as good as with wearing reading glasses. But you might be
able to get by, for both vision and reading, without glasses. Hopefully
better designs of multifocal contacts will be developed in the future. Both
the multifocal and the monovision methods for presbyopes to wear contacts
and read without reading glasses, are compromises, and far from perfect, but
you might get by with them. The only way to have the best vision at both
distances is to wear contacts fitted only for distance (or have Lasik only
for distance, if that is your preference), and wear reading glasses for
reading. But reading glasses are a hassle, so it's a trade-off.

Bob wrote in message news:

From the way you describe things, Bob, it is very possible your
contact lens Rx is "overminused."  That is, it leaves you slightly
farsighted and you use your remaining accommodation ability to bring
your effective Rx to plano.  In middle-aged people, this often results
is truly excellent distance vision, but compromised middle-distance
vision, as well as horrible close-up vision.  This overminusing occurs
because some people like the super-crisp distance vision they get by
using their accommodation ability to fine tune a slightly plus Rx.
They don't realize that by doing this they exacerbate any existing
presbyopia.  Even though they know better, ODs often go along with
this because the patient wants it and it doesn't damage the eye in any
way.  Of course, it is also possible you just suffer from an
age-accelerated form of presbyopia, but I don't think so, because if
that were the case spectacles that give you good close-up vision would
result in quite significant myopia and very poor distance vision, but
from what you say that does not appear to be the case.  I suggest you
go to your OD and have him fit you with a set of contact lenses that
have the weakest Rx necessary to bring your distance vision up to a
clear 20/20.  It is likely this will solve your middle-distance
problem, and improve your close-up vision noticeably.  This is also
the vision you are likely to get with LASIK surgery.  Also, as others
have pointed out, you could also opt for monovision LASIK, though a
contact lens trial is a must, as many people do not like monovision
even though it works.

Bryce Carlson, PhD