I have worn contacts for over 20 years, but switched to glasses about 5 years ago because my eyes were fairly dry and often red. My perscription is stable at RE: sph -4.00, cyl +2.00, axis 120; LE: sph -4.75, cyl +2.75, axis 60. I do not know my pupil size, but the consent form I must sign for the lasik procedure says that I must not have pupils larger than 7mm in dimly lit rooms.

I have pretty poor night vision. In very dark situations I often bump into things even with my glasses on as my depth perception seems poor. Sometimes I see very slight halos at night, but it has never bothered me. I sometimes have trouble reading far away signs at night, but I don't know if it is worse than anyone else. I also experience some slight ghosting effect even when wearing glasses indoors. I feel like I should see sharper indoors. I see excellent outside and in bright light situations (probably 20/15 or so). I do not wear reading glasses or bifocals, but can not read well without my glasses on. I am 42 years old, so I know I will encounter reading problems someday soon.

My doctor is Jim McNabb in Austin, Texas who I have been going to for over 10 years. He has a lot of lasik experience and uses the VISX laser. I trust his judgement.

My next pre-lasik evaluation is Monday, but the doctor has already suggested that I ought to think about going with monovision. I was really pumped up about the possibilites but I am starting to get nervous about monovision in particular and lasik in general after reading many negative comments on the internet. Seems like a lot of people see 20/20 on a chart but are concerned about the quality of their sight.

I would love to get rid of my glasses as I am active and find them to be annoying. I would like to see as good as I do with glasses when the procedure is completed, but I don't know if that is realistic.

Monovision appeals to me because I understand that it can be enhanced for sharper distance vision if I didn't like it. At the same time, I really enjoy playing golf and worry about my depth perception and ability to see well enough to play. I am also worried that my poor night vision will only get worse.

I have seen some comments by doctors which discourage going the monovison route. Some seem to be indicating that other procedures are coming down the pike in the very near future which will better solve the reading problem. This would tend to want me to get my distance vision corrected as sharply as possible at this point.

Can anyone out there offer any advice for me or suggest some questions that I need to get answered before proceeding ? Should I get a second opinion by another doctor ?

I apologize for the long, rambling note. I really want to do this, but I am going through the cold feet stage. Thanks in advance, this is a great website.

Dear Don,
Your prescription is a good one for Lasik.
Your symtoms at night might be related to pupil
size but not necessarily. Since you already have
some of the symptoms noted by patients after Lasik
you would probably tolerate mild symptoms well.
I would definitely consider slight monovision
because you will very shortly have problems at
near. If you only undercorrect by 1/2 diopter it
will delay the need for reading glasses and will
probably not bother you. I have many patients in
contact lenses who are mono fit and since doing
Lasik have recommended slight monovision
especially for patients in their late 30's and
early 40's. It sounds like your surgeon
understands this and if he is experienced doing
Lasik you should do well. Make sure you discuss
how much difference he plans between the two eyes.
Also make sure you know which eye is dominant and
undercorrect the non dominant eye.
Leonard Friedman M

Dr. Friedman:

Thank you so much for taking time out from your busy day. Physicians like you, who are willing to contribute your time to help, are an extreme credit to your profession. I wish you and your loved ones the best. Thanks again. This must be an exciting time to be involved in an eye specialty.

If anyone else has any concerns, thoughts or ideas, I would love to hear them as I imagine there are many people in the same boat with me.

I am 56 and had bilateral lasik May 19th. I elected to try monovision. At day one I was
20/30 left 20/20 right At week one I was
20/60 left 20/30 right dominant eye

My refractions OS -1.50 -.75 x 042
OD -.25 -.25 x 167

Since my surgery, I have read just a little on the Web about a new procedure being tested outside the country for presbyopia. Where can I read more about this?

In two months I must decide whether to leave my eyes as they are or correct the left for better distance vision.

Will my reading ability continue to diminish in the future? If so, would I not be best to get used to glasses for reading now. My left eye seems cloudy at times and for bookkeeping type duties I find this a problem. Otherwise it is wonderful to see distance and also be able to use the computer, read the newspaper and do cross stitching without glasses.

Are the corrections for presbyopia working equally well for people in their 50-60-70s as the articles would indicate they are for those in their 40-52s? If so, it would seem wise to correct this left eye for distance, use reading glasses and hope the new procedure is quickly approved for presbyopia. Any thoughts?

First, why do you have to make your decision just 3 months after surgery. Most doctors will let you have 1-2 or more years to have a free enhancement.

As for the surgeries to corret presbyopia, they are at this time completely under study with unclear results. I am as excited as you are about the possibility, but the results have yet to show that the procedures (there are more than one) will work. I hope they do, but we must wait. I would not base my decision on having presbyopia correction surgery, because the surgery may never be approved.

I hope this is helpful

Bill Trattler, MD
Miami, FL

I made the choice, even though as a professional pilot my eyes are perhaps even more important to me than to others.

I opted against monovision; had both eyes done at the same time and asked Dr. Dulaney to emphasize distance. I now (after 2 months) am 20/20 each eye, 20/13 both eyes, and very pleased with the results. Yes, I still need reading glasses.

Monovision is certainly one viable option. As I recall from my brief discussion about it, that means doing only one eye. What's to lose? Do one eye, and if your depth perception goes bad, do the other.

Night vision was a concern for me, too. I still have haloing, but not as bad as when I was wearing contacts. During a recent trip to California, neither I nor my wife were able to read the fine print on a map in the dim light of the car, even with reading glasses. Next time I'll take stronger reading glasses for the evening ride.

--jim