Monovision

Monovision is a method of correcting presbyopia in which the two eyes are intentionally prescribed different levels of refractive error. Typically the dominant eye is corrected for distance vision and the nondominant eye for near vision, with the brain integrating the inputs to provide usable vision at multiple distances. Monovision can be achieved with contact lenses, refractive surgery, or intraocular lens implantation.

Standard monovision uses a larger intereye difference, often around 1.0 to 2.0 diopters, to balance near and distance. Mini-monovision reduces the intereye difference to about 0.25 to 1.0 diopters to improve stereoacuity while still providing near vision. The approach can be implemented with contact lenses, laser refractive surgery such as LASIK or PRK, and in some cases SMILE, or with monovision intraocular lenses during cataract or refractive surgery.

Advantages include reduced dependence on reading glasses and applicability across multiple treatment modalities. Monovision relies on neural adaptation to fuse the two slightly different images into functional binocular vision and is commonly used for presbyopia management and in some cataract or refractive surgery plans.

Limitations include possible reduction in depth perception and stereoacuity, potential night vision issues, halos or glare, and a period of adaptation. It is not suitable for all individuals, particularly those with poor binocular function or occupations requiring precise depth cues. Successful outcomes depend on careful patient selection, testing of ocular dominance, and tolerance; if monovision is not well tolerated, alternatives such as multifocal or extended-depth-of-focus lenses may be considered.