LASIK & PRK are highly successful procedures, intended to reduce or eliminate the dependence on glasses or contact lenses. Patients who are happiest after the procedure are usually those who start out with realistic expectations. For example, if your goal is to see much better nearly all of the time without dependence on glasses or contacts, you are very likely to be very happy with your correction. If your expectation is to see even better after the procedure than you presently see with your best glasses or contact lenses correction, you may be disappointed with your results.
The vast majority of patients undergoing the procedure will see well enough after the procedure to pass a driver’s license vision test without glasses or contacts. Legal driving vision is considered 20/40 or better, and most patients actually can achieve 20/20 or even higher. Individual results can depend on a number of factors, including how your eye heals after the procedure. One eye sometimes response with a slightly different result than the other, but may not affect your overall vision.
Patients should understand that the quality of vision after the procedure might be different from your quality of vision with glasses or contact lenses. For some patients, objects may seem less “crisp” after the procedure, however most patients still report extreme happiness with their post-operative vision quality.
Laser Vision Correction and Presbyopia (for patients over 40)
At around age 40, most people who don’t wear glasses for distance vision develop a need for glasses to read or to see things up close. This age related loss of close-up focusing power in the eye is called “presbyopia.” People who are moderately nearsighted can often continue to read up close without glasses after age 40, despite the onset of presbyopia. They simply take their distance glasses off in order to read or see up close. This is possible because their nearsighted eye is “built” to see best up close in the first place. The procedure is designed to improve distance vision by reducing nearsightedness. The decrease in nearsightedness means that the eye is no longer “built” to see well up close without glasses. If you are over 40 and nearsighted, the procedure may improve your distance vision dramatically, but you likely will need ready glasses for near vision. Results may vary in patients, but you should be prepared for the possibility of the altered close vision should it occur.
Monovision (for patients over 40)
One possible option to help correct presbyopia is to consider monovision. Monovision is the term used when we correct one eye for distance vision and the other eye for reading, or close-up vision. The dominant eye is fully treated with LASIK or PRK to achieve the best possible distance vision, while the second non-dominant eye is treated to allow for reading or close-up vision, or may be left untouched if it is strong for close vision already.
Unfortunately, monovision correction is not the best solution for all patients to eliminate the need for reading glasses. Some patients report poorer distant vision with the single eye, as compared to when both eyes are corrected for distance. Loss of depth perception is also a possibility, making it hard to determine how far away objects are. With only one working for close vision, excessive eyestrain when reading is also a concern.
Even when monovision is successful, there may be certain times when reading glasses are still helpful, such as when trying to read very small print (i.e. maps, phonebook listings, and menus in dim restaurants). Some patients who choose monovision may also benefit from a pair of reading glasses to wear on occasion when they want the two eyes to work better together, such as when driving at night or reading for long periods of time.