Mono vision glasses?

[Happylady]

Does anyone ever do monovision glasses for their patients that wear monovision contacts? If you have, what was the outcome?

I always have done progressives/bifocals or just single vision(for myopes). I had a patient ask for her glasses to be done in monovision and I was wondering if anyone else ever does that.

[Grubendol]

I've done it for readers over mono contacts and it's always worked well.

[Ory]

I've done it. Some people will not tolerate it despite their mono CLs. Remember to decenter the near lens PD based on a monocular PD measurement.

There was a discussion not too long ago that brought this idea up: link

[Framebender]

When I worked in a Laser center. . .

We often made mono glasses for people who had mono surgery. The point there was to give them back their depth perception for driving at night. It almost always worked. Probably only 1 in 10 puked. So not bad.

Good luck!!

[Happylady]

I wasn't clear enough. I meant doing monovision glasses for when they aren't wearing their contacts. Does anyone do this rather then progressive or bifocals?

[Dave Nelson]

You can do monovision glasses, but with essentially the same limitations as with contacts, or horrors, monovision refractive surgery. The spectacle add plays a big part in determining success. There is a limit to what disparity people will tolerate, independant of image size, although it varies from one person to the next, but in my experience many people are uncomfortable with a disparity greater than about 1 D, and can often adapt to 1.5D. Emerging presbyopes can benefit from monovision spectacles the most, with absolute presbyopes being very poor candidates due to the higher add powers in the rx. Eventually, presbyopes must be introduced to progressives, and, as you know, its an easier road to start with lower add powers and work your way up, than to jump into them with a 2.50 add. I think there is a very limited benefit from monovision spectacles, and its limited to emerging presbyopes who want to "put off" the progressives for a year or two.

[eyeglsman]

We have one patient in our practice that wears monovision glasses, when his cl are out. He has been very sucessfull for the last 12 years with monovision glasses.

[chip anderson]

If the patient is capable of steropsis (and you are talking about a pair of glasses to wear without contacts in lue of bifocal glasses) it ain't got a snowballs chance in ...... Think again about distortions and mental confusion that will result as patient looks down from center. Concider the image size difference (if the add is over .75). Sell 'um some bifocals.

Chip

[Happylady]

If the patient is capable of steropsis (and you are talking about a pair of glasses to wear without contacts in lue of bifocal glasses) it ain't got a snowballs chance in ...... Think again about distortions and mental confusion that will result as patient looks down from center. Concider the image size difference (if the add is over .75). Sell 'um some bifocals.

Chip

But many patients have rx differences of more the .75 diopters with no problems. I can see problems if the rx differences is very great, more then 2.50 or so, but not with .75.

Also, since they would be single vision the patient can lower their head and look through the center just like patients do that wear distance rxs with lots of differences in the prescription. I never use slab offs in single vision even with significant prescription differences because of this.

[chip anderson]

I still say it ain't gonna work.
However I have a question: Why in the H would anyone want to make a pair of monovision glasses (glasses to offsett the effects of monovision contacts [which I also think is usually a bad solution to presbyopia] I understand. But why monovision glasses, it surely can't be because the optician is too lazy or lacking the skills to make bifocal glasses. Why not let the patient see both distance and near with steropsis?
Or phrased more delicately, what's the point of monovision glasses?

And I certianly wasn't advocating a slab off in "monovison glasses."

Chip

[Happylady]

I still say it ain't gonna work.
However I have a question: Why in the H would anyone want to make a pair of monovision glasses (glasses to offsett the effects of monovision contacts [which I also think is usually a bad solution to presbyopia] I understand. But why monovision glasses, it surely can't be because the optician is too lazy or lacking the skills to make bifocal glasses. Why not let the patient see both distance and near with steropsis?
Or phrased more delicately, what's the point of monovision glasses?

And I certianly wasn't advocating a slab off in "monovison glasses."

Chip

Okay, this is what made me think of this. As I stated, I have never done it, but I have a patient that is very happy with her monovision contacts. She wanted a pair of glasses for when she wasn't wearing her contacts. She assumed they would be monovision just like her contacts. I told her I have never done that and we use progressives(or bifocals). I made her some progressives.

I ran into her at my doctor's office(she worked there)and she told me she was having problems with them. I was thinking that perhaps she might be happier with the monovision glasses and wanted to get others imput.

By the way, I wear monovision contacts with few problems. I do use my eye corrected for near at distance also. I just got back from Disney(fun!) and saw all the 3D movies just fine with the monovision contacts. If I closed the eye corrected for near I couldn't see 3D anymore.

I think it is a widely held fallacy that people with monovision contacts don't have depth perception and don't use both their eyes togeather.

[chip anderson]

Happy: Wait til you have a two or more add. Then if you compare distance only with mono or bifocal with mono you will come to know about depth preception. But it's still a bad idea and a horrible idea in spectacles. And there is absolutely no reason to do this in spectacles.
Unless you have a really dense old blond who wants to say: "I don't need bifocals, I just need one eye for near and one eye for distance."
I don't know how many such women have told me: "I don't need bifocals I just have a pair of glasses for distance and another pair for near."
What this accomplishes beyond possibly allowing them to think they are aging more slowly, I can't begin to imagine.
Or course you could use this as a ploy to keep the patient from realizing in spectacles what they are missing in mono-vision contacts by not having binocular vision.

Chip

[orangezero]

I'd agree with most that optically its a pretty bad decision. However, I think there are some instances where it may be acceptable and even work better than progressives, bf, or tf. Not too many, but there could always be exceptions.

I do have quite a few monovision contact patients that ask that question about monovision glasses. I think for the vast majority of these patients bf or PALs are still the way to go.

[LENNY]

Acoording to our OD monovision does not work in glasses.
My experience is opposite. Isaw quite a few Myops that are way over 40 and for some reason were undercorected in one eye.
Guess what were the results!
Monovison!
Tried to give them a full correction in both eyes and multifocals and some of them kicked my ...

[Happylady]

Happy: Wait til you have a two or more add. Then if you compare distance only with mono or bifocal with mono you will come to know about depth preception. But it's still a bad idea and a horrible idea in spectacles. And there is absolutely no reason to do this in spectacles.
Unless you have a really dense old blond who wants to say: "I don't need bifocals, I just need one eye for near and one eye for distance."
I don't know how many such women have told me: "I don't need bifocals I just have a pair of glasses for distance and another pair for near."
What this accomplishes beyond possibly allowing them to think they are aging more slowly, I can't begin to imagine.
Or course you could use this as a ploy to keep the patient from realizing in spectacles what they are missing in mono-vision contacts by not having binocular vision.

Chip

My add is +2.25. I have binocular vision with my monovision. If I close my "reading" eye, everything looks flatter and lacks depth. I wear two distance contacts on rare occasions. Yes, the distance is slightly better, but I can't see anything up close. It's a trade off.

Monovision is not perfect, but neither are progressive/bifocal glasses. There are flaws with each. I wear progressives, too, I know the good and bad of each. I don't think monvision contacts are a bad idea at all. They work very well for many people. I have tried bifocal and multifocal contacts and I still perfer my monovision. I have tried distance only contacts with reading glasses and I perfer my monovision contacts.