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Medical Forum / General / Vision / January 2006Switching eyes for monovision.
I am a 42 y/o male with very mild myopia and a slight astigmatism in my left eye. (Yet I can see well from 2 feet to 5 feet pretty clear without correction). My progressive lens eyeglass prescription is: SRX SPH CYL AXIS ADD ___________________________________________ OD: -.75 DS 1.25 OS: -.50 .50 170 1.25 I decided to start wearing contacts again, and my OD said that because I have such a weak prescription, monovision would probably work well for me. So, I decided on Acuvue 2 (the Acuvue Advance hurt my eyes)... and I'm wearing a -.75 in my right eye (supposedly my dominant eye) and a +.50 in my left. I'm having no problems adapting, even at night. I also have -.50 lenses for my left eye in case I want both eyes set for distance correction. My question to the pros here is: When I don't wear vision correction (which is often), my right eye is fairly blurred at a distance and my left eye sees pretty well. Close up is the opposite; my right eye sees well, but my left eye is blurred (unless I move whatever I'm looking at further away). My OD has my right eye corrected for distance, although I am used to my LEFT eye seeing more clearly for distance. I guess I've been doing a sort of monovision when I'm not wearing glasses or contacts. Would it be bad if I switched my lenses and just enhanced my current vision, making my left eye better for distance and my right eye better for close up? The reason I ask is that I have heard that correcting the NON-dominant eye for close-up can cause problems. Thanks! -Tom in Scranton, PA USA concerning monovision/contact lenses: Most people, but not all, will have one eye which is dominant for both distance and near vision. That being the case, the dominant eye is corrected for distance and non-dominant for near. You can be tested for dominance and, of course, you could try the lens correction for optimized distance for each eye separately and see which one "feels" the best for you. Another option is to try an aspheric lens (such as O2Optix or Focus Night&Day (silicone), one of the HEMMA soft lenses or RGP lenses available as aspheric). Oftentimes aspheric lenses provide +.75 to even +1.25 add power and that might be all you need for excellent distance and near vision. Sometimes using this technique with a little under-correction of one eye is the best answer. LB, O.D. Thank you for the very prompt reply, Larry. I tried AV Advanced silicone lenses and they were extremely uncomfortable. Made my eyes "sting" and were blurry after a few hours. For this reason, I'm hesitant in asking my doctor to try other silicone lens designs (like O2's or N&D's). But I'm willing to try anything at lest once:) When you mentioned aspheric lenses, how would they be worn? I'm not sure I understand what you mean by the +.75 to +1.25 add powers? When I wear lenses (or glasses) corrected for distance only (OD: -.75 and OS: -.50), I can't see close up at all. As for RGP lenses, I tried them last year. I couldn't keep them on my eyes more than 2 minutes. My doctor tried a different type, and I encountered the same thing. I'd put them in and they hurt so bad, I'd have to pop them out immediately. AV2 seems to be the most comfortable lenses I've ever had. And lastly, what do you mean by "under-correction"? Does this mean wearing a -.50 instead of a -.75? Thanks again, Tom in Scranton, PA USA > Thank you for the very prompt reply, Larry. > [quoted text clipped - 3 lines] > lens designs (like O2's or N&D's). But I'm willing to try anything at > lest once:) The other silicone lenses are not all that similar to AV Advance which, IMHO, is inferior to the others, including the newest AV lens called Oasys. The Oasys is a great lens, one of my favorites, but does not have aspheric optics. > When you mentioned aspheric lenses, how would they be worn? I'm not > sure I understand what you mean by the +.75 to +1.25 add powers? When > I wear lenses (or glasses) corrected for distance only (OD: -.75 and > OS: -.50), I can't see close up at all. They are used just like any other lens. The plus powers indicate the add powers---how much ADDitional plus (or less minus) power you need for near vision. > As for RGP lenses, I tried them last year. I couldn't keep them on my > eyes more than 2 minutes. My doctor tried a different type, and I > encountered the same thing. I'd put them in and they hurt so bad, I'd > have to pop them out immediately. AV2 seems to be the most comfortable > lenses I've ever had. The AV Oasys lens is built on the same mold as AV2, so it should be as comfortable or better, and certainly healthier. But again, not aspheric, so you would have to go with monovision or use plus 1.25 readers over them, a very reasonable alternative. > And lastly, what do you mean by "under-correction"? Does this mean > wearing a -.50 instead of a -.75? Exactly! You can under-correct to skew the power for better near vision. In theory, the aspheric optics will provide some "automatic" plus add power so that you will need no, or at least less under-correction. The only way to tell what will work best for YOU is to try it! > The other silicone lenses are not all that similar to AV Advance which, > IMHO, is inferior to the others, including the newest AV lens called [quoted text clipped - 3 lines] > add powers---how much ADDitional plus (or less minus) power you need for > near vision. I was reading up a bit on aspheric lenses. The way I understand it, since they flatten out from center to edge, this creates an almost multifocal effect? So if I tried aspheric-type lenses, I would go with a minus in both eyes, possibly undercorrecting one eye? > The AV Oasys lens is built on the same mold as AV2, so it should be as > comfortable or better, and certainly healthier. But again, not aspheric, > so you would have to go with monovision or use plus 1.25 readers over > them, a very reasonable alternative. I don't mind that. I've done that for 2 years with my previous contacts. > Exactly! You can under-correct to skew the power for better near > vision. In theory, the aspheric optics will provide some "automatic" > plus add power so that you will need no, or at least less > under-correction. The only way to tell what will work best for YOU is to > try it! I know that ANY minus lens in either eye, whether a -.50 or -.75 results in worse close-up vision. So I'm not so sure undercorrection would help. Then again, maybe it will with aspheics?? Thanks again for your input! -Tom in Scranton, PA USA > I know that ANY minus lens in either eye, whether a -.50 or -.75 > results in worse close-up vision. So I'm not so sure undercorrection > would help. Then again, maybe it will with aspheics?? There's little value in -0.25 lenses (considering when they get dirty or dry they can hinder, rather than help). So the most natural next step for "undercorrection" is _no_ lens in one eye. It certainly wouldn't be hard to try it... -MT Mike Tyner wrote:\ > It certainly wouldn't be hard to try it... You DO have a point there! -Tom > The reason I ask is that I have heard that correcting the NON-dominant > eye for close-up can cause problems. Eye "dominance" isn't as hardwired and physiological as "handedness." Many people don't have a "dominant" eye and there are few reasons for adhering to _any_ rule concerning monovision, except to predict the best starting point. My advice to patients with your prescription is they should try it both ways and decide which is better for which task. Driving could be better one way and reading the other. Who am I to dictate how they do it? Likewise I like to point out that they have the option of wearing -075 in both eyes on those occasions where they need to see well far away, like driving at night. They can carry a $10 pair of drugstore +125s to sign credit cards at the gas station, driving at night. -MT > Eye "dominance" isn't as hardwired and physiological as "handedness." Many > people don't have a "dominant" eye and there are few reasons for adhering to > _any_ rule concerning monovision, except to predict the best starting point. Got it. > My advice to patients with your prescription is they should try it both ways > and decide which is better for which task. Driving could be better one way [quoted text clipped - 4 lines] > driving at night. They can carry a $10 pair of drugstore +125s to sign > credit cards at the gas station, driving at night. Thanks for this info! -Tom in Scranton, PA USA |
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