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Even with all the advancements in multifocal implants and soft contact lenses, monovision is often still the preferred method of correction for the presbyopic population. Monovision is when we correct one eye (typically the dominant) for distance, and one eye for near (non-dominant). Depending on the amount of anisometropia (difference in the prescriptions between the eyes), there can be some loss of depth perception. If the monovision discrepancy is kept to a minimum, the brain is able to blend the two fields well and adaptation is typically very easy.
The reason some patients don't adapt well to multifocals is because they tend to degrade the contrast sensitivity of the vision at ALL distances. In contact lenses and IOLs (Intraocular lenses), the lens moves with eye at all times, so there must be both the near and distance prescription in the aperature window to enable the multifocal effect. This doubling or overlay of the optics may cause some "shadowing" or "ghosting" of the image in question. Overtime most individuals will adapt to this, but will still measure a reduction in their contrast sensitivity threshold. We've been very successful with monovision Ortho-K, soft contacts, and gas permeable lenses in our office. We will fully correct the distance eye and slightly under correct the reading eye (or overcorrect in the case of farsightedness) to provide good vision at all distances. Most patients are happy enough with this that they no longer use glasses for any activities. Call us at 407-647-2020 if you'd like to schedule an appointment to be evaluated for monovision. See better, live better Dr Schott
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Ryan Schott, ODMaitland Vision Center Archives
January 2026
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