3 ms·

Related question: When I looked into LASIK/SMILE recently, they said that after onset of presbyopia, they now routinely recommend "monovision", that is, regulat

by FabHK 1y ago

Related question: When I looked into LASIK/SMILE recently, they said that after onset of presbyopia, they now routinely recommend "monovision", that is, regulate one of your eyes to 0 diopters, but the other to mild myopia of about -1 diopter. Then you look at far things with the former, and near things with the latter. Good old stereo vision is somewhat impacted, but not too badly apparently. Anyone got experience/comments on that? (Presumably one could replicate it with contact lenses, in particular.)

altairprime 1y ago
I was born with -4, +2 left and right eyes respectively (inherited), and as I get older towards reading glasses age, we have indeed found I get better corrective results from lenses when we tilt my right eye slightly better at distance and let my left eye pick up slightly more of reading. My depth cohesion barely functions to begin with as a result of one eye being a legally-blind blur past three feet until I was 18, but I can confirm that once you have depth perception, it isn’t going to fail you just for a slight shift in focal efforts.
jsdalton 1y ago
My father had his eyes fixed like this about a decade ago and purports to be happy with it. IIRC they did actually require that he wear contact lenses that replicated the effect for some amount of time (a month or so I believe) because there are people who are not happy with the arrangement. So they sort of force you to try before you buy.
joshstrange 1y ago
My parents tried this with contacts and hated it, then tried again a year or so later and adjusted quickly and liked it (no clue why the first attempt was unsuccessful). They still use contacts (not interested in LASIK, I’m not sure why or if they have considered it) that do this and seem happy with it.
heikkilevanto 1y ago
I was doing that for a few decades. Had to wear contacts for my astigmatism. Had my right dominant eye optimized for long distance, and the left with +1 or so for reading. I started to use cheap reading glasses on top when reading a lot. Had to give up the monovision trick and get multifocal glasses when my eyes aged more. But even with them, I kept a bit of monovision since I was so used to it.
fluxist 1y ago
I've had monovision after LASIK for about 5 years now. The brain adjusts in a few weeks and you cease to notice it. It rises to my awareness when I close one eye. Occasionally I'll notice it when trying to focus on something outside the center of my field of view but generally, no. It's an effective way to preserve near and far vision simultaneously. That said, I've heard a fair number of people hate it and I get that.
JumpCrisscross 1y ago
Look up Evo ICL [1]. It’s an implanted lens using the same procedure as cataract surgery. Its major advantage over LASIK is reversibility. (Also lower incidence of dry eyes, a shorter healing time, no reduced night vision and UV protection for your retina if you’re outdoors a lot.) The major downside is it’s a bit more expensive. [1] https://us.discovericl.com/ https://us.discovericl.com/
- atombender 1y ago
  From what I can tell, the regular ICL does not treat presbyopia, but a new version called Viva does. [1] [1] https://www.presbyopiaphysician.com/issues/2023/december/evo-icl/ https://www.presbyopiaphysician.com/issues/2023/december/evo...
Revisional_Sin 1y ago
That sounds absolutely awful.
nerdsniper 1y ago
I've been doing this my whole life (about 20 years now) with contacts. I started in high school for fun after noticing that my contacts made it harder to see super-fine details at very short distances. I read an article about how some motivated people wore custom glasses which inverted the world upside-down, but their brains eventually compensated and flipped the image they perceived. I started wearing just one contact (alternating right, both, or left eye) and despite a diopter of -3.5 my brain learned to use the blurry color of my uncorrected eye to provide an acceptable level of depth perception while only giving me the sight picture from the corrected eye. Thanks to an ophthalmologist with flexible practices, I'd later also managed to get some variety in my contacts - a bit higher power for sailing, where extreme long distance sight is helpful. For activities which require precise stereo vision and/or maximum fine detail (soldering, foosball, skiing, sailing, etc) I prefer two contacts (or none, in the case of soldering). For general daily life I still enjoy one contact - my brain will use the picture from the uncorrected eye for close-up stuff, including computing, and the corrected picture for farther things, like driving. It's not perfect; I have to turn my head a lot more in one direction to check for traffic/etc and sometimes objects in the foreground create a large block of blurry vision. But it's quite nice for daily life where I constantly switch from activities which are close (computers/reading) to far (everything else). Like 'heikkilevanto, I may have to go back to stereo vision soon - my eyes are reaching the age where they're not as quick to focus and I don't see as much detail. Close-up work is getting much more difficult with just one eye. I can no longer solder at all with mono-vision, depth perception now only works for longer distances and not shorter ones. And far-vision is losing detail, so having two contacts makes it much easier to ascertain what I'm seeing faster because the detail from one eye fills in blurry spots of the other. Some people have said that correcting vision prevents the eye from adapting and fixing itself to see better again. I haven't found this to be true. Contacts stay in my right eye better and tend to fall out of my left eye more frequently, so for the past decade I've almost always corrected in that eye and uncorrected in my left. My prescription for both eyes has not changed at all in the past decade - for me there seems to be no long-term change, good or bad, caused by correcting my vision. I also wear contacts that you can keep in 24 hrs/day for 2-4 weeks, and have not seen any damage over the past 15 years of sleeping in my contacts for up to a month straight. I have annual "digital retinal exams" going back 15 years which can see the types of damage that are caused by sleeping in contacts too much (capillary growth due to lower oxygen, calcium deposits, etc) and there doesn't seem to be anything to note, as well as no significant difference between my right and left eye.
tim333 1y ago
I guess you could simulate the effect but getting a 1 diopter pair of reading glasses and knocking one of the lenses out. I have a stack of £1 reading glasses - I'll see if have have a pair that has independently modified itself thus. Actually you can simulate it just by holding the current pair to one side. Kind of works but is a bit annoying compared to normal reading glass useage.
- jimmydddd 1y ago
  A family member used this strategy with contacts many years (30?) ago and they said it worked great.
yencabulator 1y ago
This has been recommended to older people for a good while now (like, 60+). The biggest reason to avoid it would be if you need stereo vision for sports or hobbies. You lose some precision on your depth perception, so e.g. catching a ball might get harder. Doing intricate detail work might get harder.

by FabHK 1y ago

altairprime 1y ago

I was born with -4, +2 left and right eyes respectively (inherited), and as I get older towards reading glasses age, we have indeed found I get better corrective results from lenses when we tilt my right eye slightly better at distance and let my left eye pick up slightly more of reading. My depth cohesion barely functions to begin with as a result of one eye being a legally-blind blur past three feet until I was 18, but I can confirm that once you have depth perception, it isn’t going to fail you just for a slight shift in focal efforts.

jsdalton 1y ago

My father had his eyes fixed like this about a decade ago and purports to be happy with it. IIRC they did actually require that he wear contact lenses that replicated the effect for some amount of time (a month or so I believe) because there are people who are not happy with the arrangement. So they sort of force you to try before you buy.

joshstrange 1y ago

My parents tried this with contacts and hated it, then tried again a year or so later and adjusted quickly and liked it (no clue why the first attempt was unsuccessful). They still use contacts (not interested in LASIK, I’m not sure why or if they have considered it) that do this and seem happy with it.

heikkilevanto 1y ago

I was doing that for a few decades. Had to wear contacts for my astigmatism. Had my right dominant eye optimized for long distance, and the left with +1 or so for reading. I started to use cheap reading glasses on top when reading a lot. Had to give up the monovision trick and get multifocal glasses when my eyes aged more. But even with them, I kept a bit of monovision since I was so used to it.

fluxist 1y ago

I've had monovision after LASIK for about 5 years now. The brain adjusts in a few weeks and you cease to notice it. It rises to my awareness when I close one eye. Occasionally I'll notice it when trying to focus on something outside the center of my field of view but generally, no. It's an effective way to preserve near and far vision simultaneously. That said, I've heard a fair number of people hate it and I get that.

JumpCrisscross 1y ago

Look up Evo ICL [1]. It’s an implanted lens using the same procedure as cataract surgery. Its major advantage over LASIK is reversibility. (Also lower incidence of dry eyes, a shorter healing time, no reduced night vision and UV protection for your retina if you’re outdoors a lot.) The major downside is it’s a bit more expensive. [1] https://us.discovericl.com/ https://us.discovericl.com/

atombender 1y ago
From what I can tell, the regular ICL does not treat presbyopia, but a new version called Viva does. [1] [1] https://www.presbyopiaphysician.com/issues/2023/december/evo-icl/ https://www.presbyopiaphysician.com/issues/2023/december/evo...

Revisional_Sin 1y ago

That sounds absolutely awful.

nerdsniper 1y ago

I've been doing this my whole life (about 20 years now) with contacts. I started in high school for fun after noticing that my contacts made it harder to see super-fine details at very short distances. I read an article about how some motivated people wore custom glasses which inverted the world upside-down, but their brains eventually compensated and flipped the image they perceived. I started wearing just one contact (alternating right, both, or left eye) and despite a diopter of -3.5 my brain learned to use the blurry color of my uncorrected eye to provide an acceptable level of depth perception while only giving me the sight picture from the corrected eye. Thanks to an ophthalmologist with flexible practices, I'd later also managed to get some variety in my contacts - a bit higher power for sailing, where extreme long distance sight is helpful. For activities which require precise stereo vision and/or maximum fine detail (soldering, foosball, skiing, sailing, etc) I prefer two contacts (or none, in the case of soldering). For general daily life I still enjoy one contact - my brain will use the picture from the uncorrected eye for close-up stuff, including computing, and the corrected picture for farther things, like driving. It's not perfect; I have to turn my head a lot more in one direction to check for traffic/etc and sometimes objects in the foreground create a large block of blurry vision. But it's quite nice for daily life where I constantly switch from activities which are close (computers/reading) to far (everything else). Like 'heikkilevanto, I may have to go back to stereo vision soon - my eyes are reaching the age where they're not as quick to focus and I don't see as much detail. Close-up work is getting much more difficult with just one eye. I can no longer solder at all with mono-vision, depth perception now only works for longer distances and not shorter ones. And far-vision is losing detail, so having two contacts makes it much easier to ascertain what I'm seeing faster because the detail from one eye fills in blurry spots of the other. Some people have said that correcting vision prevents the eye from adapting and fixing itself to see better again. I haven't found this to be true. Contacts stay in my right eye better and tend to fall out of my left eye more frequently, so for the past decade I've almost always corrected in that eye and uncorrected in my left. My prescription for both eyes has not changed at all in the past decade - for me there seems to be no long-term change, good or bad, caused by correcting my vision. I also wear contacts that you can keep in 24 hrs/day for 2-4 weeks, and have not seen any damage over the past 15 years of sleeping in my contacts for up to a month straight. I have annual "digital retinal exams" going back 15 years which can see the types of damage that are caused by sleeping in contacts too much (capillary growth due to lower oxygen, calcium deposits, etc) and there doesn't seem to be anything to note, as well as no significant difference between my right and left eye.

tim333 1y ago

I guess you could simulate the effect but getting a 1 diopter pair of reading glasses and knocking one of the lenses out. I have a stack of £1 reading glasses - I'll see if have have a pair that has independently modified itself thus. Actually you can simulate it just by holding the current pair to one side. Kind of works but is a bit annoying compared to normal reading glass useage.

jimmydddd 1y ago
A family member used this strategy with contacts many years (30?) ago and they said it worked great.

yencabulator 1y ago

This has been recommended to older people for a good while now (like, 60+). The biggest reason to avoid it would be if you need stereo vision for sports or hobbies. You lose some precision on your depth perception, so e.g. catching a ball might get harder. Doing intricate detail work might get harder.