I'm 41 and want to try LASIK (RX is -7.5 both eyes, astigmatism is 1.5 and 1.25, pupils are 6 and 6.5). I frankly don't want to spend time or money to try out monovision with contacts-would I be taking a big risk to have monovision in one eye done when both are initially done, and then if I don't like it, I can have monovision eye enhanced to match the other. I guess this means I'd have to carry around reading glasses?

dear mary,

i often advise my patients to do just what you suggest. i have only had to go back on a monovision eye twice out of hundreds of cases that were originally intended to be near vision eyes. most people seem to adapt very well.

there is no question that the less surgery done the better, but enhancements are very successful, if needed.

good luck

debra tennen md

I give any patient who is interested in trying out monovision in contact lenses a chance to do so at no cost prior to having LASIK. Your surgeon may offer the same. I think it's very important to "try it out" first. You can always go back and "touch up" the monovision eye, but as Dr. Tennen said, the less surgery the better.

Parag A. Majmudar, MD
Chicago

Dear Mary,
For your age I would suggest slight monovision,
perhaps one half diopter. I also will try my
patients in contacts at no charge to see if they
will tolerate it before surgery. If you are going
to do more than one half diopter of monovision at
your age then I would definitly try the contacts
first. Sometimes when you are not yet
experiencing presbyopic symtoms yet you won't
appreciate the need for stronger monovision and
might not tolerate it as well.
Leonard Friedman MD Washington DC .

I never give the patients the option of monovision surgery without trying out first. My number one cause for enhancement surgery used to be monovision patients who couldn't tolerate it. Now, I never have enhancement for that reason. I might sound like a bit of a hardliner but unless you try monovision in contacts, you won't get monovision with me. You really owe it to yourself to take the time to do it right the first time. Take your doctors advice and don't try to take the short cuts.