Monovision: a review

Abstract

In presbyopia, patients can no longer obtain clear vision at distance and near. Monovision is a method of correcting presbyopia where one eye is focussed for distance vision and the other for near. Monovision is a fairly common method of correcting presbyopia with contact lenses and has received renewed interest with the increase in refractive surgery. The present paper is a review of the literature on monovision. The success rate of monovision in adapted contact lens wearers is 59-67%. The main limitations are problems with suppressing the blurred image when driving at night and the need for a third focal length, for example with computer screens at intermediate distances.Stereopsis is impaired in monovision, but most patients do not seem to notice this. These limitations highlight the need to take account of occupational factors. Monovision could cause a binocular vision anomaly to decompensate, so the pre-fitting screening should include an assessment of orthoptic function. Various methods have been used to determine which eye should be given the distance vision contact lens and the literature on tests of ocular dominance is reviewed. It is concluded that tests of blur suppression are most likely to be relevant, but that ocular dominance is not fixed but is rather a fluid, adaptive, phenomenon in most patients. Suitable patients can often be given trial lenses that allow them to experiment with monovision in real world situations and this can be a useful way of revealing the preferred eye for each distance. Of course, no patient should drive or operate machinery until successfully adapted to monovision. Surgically induced monovision is less easily reversed than contact lens-induced monovision, and is only appropriate after a successful trial of monovision with contact lenses.

Comparison of binocular through-focus visual acuity with monovision and a small aperture inlay

“…The efficacy of small aperture monovision [4,5,21,22,26] and traditional monovision [20,[27][28][29] has been investigated in several studies. However, no direct comparison has been performed so far.…”

Balanced Eyes See Stereopsis More Quickly, but Not More Finely

“…Accurate determination of ocular dominance is useful in clinical decision-making, as it relates to monovision management of presbyopia [37][38][39] with intraocular lens implant in cataract surgery, 40,41 contact lenses, 39,42 or LASIK. 43,44 The determination of ocular dominance has mainly been based on sighting dominance, which takes little time to perform.…”

10.5937/mckg48-3905 = Influence of dominant laterality limbs and senses on dyscalculia

“…Zdravi desnoruki pokazuju od 71% (27) do 80-90% i desno lateralizovano oko (28). Naši rezultati su u skladu sa ovim nalazima jer je u našoj kontrolnoj grupi osam desetina ispitanika imalo desno lateralizovano oko, dok ih je u grupi sa diskalkulijom bilo nešto manje, oko dve trećine.…”