What are monovision contact lenses?

As you age, natural changes in your eyes can make it harder to see things up close. You might struggle to read a menu or find yourself holding your phone at arm’s length to see it clearly. Luckily, there are several effective options to improve your vision, including monovision contact lenses.

Monovision contacts offer a convenient solution to this common age-related vision problem — known as presbyopia — and can help reduce your dependence on reading glasses. Read on to learn more about this condition and what to expect if you’re considering monovision contact lenses for vision correction.

What is presbyopia?

Presbyopia, meaning “old eye” in ancient Greek, is the gradual loss of near vision that occurs with age. Also called age-related long-sightedness, it is a common refractive error that develops when the eye’s crystalline lens loses its flexibility. This makes it harder for your eyes to focus on close objects.

Most adults experience presbyopia, which generally begins after age 40 and levels off around age 65. As it progresses, the need for corrective lenses for reading small print, using your phone, and completing other close-up tasks becomes more common.

How monovision contact lenses work

Monovision contacts correct vision using two lenses, each with a different focusing power. One lens corrects for distance vision in one eye and the other for near vision in the other eye.

Note: Although some people call these “monocular vision contact lenses,” the correct term is monovision contact lenses. This is because monocular vision involves seeing with only one eye. It typically occurs due to vision loss in the other eye or covering one eye for therapeutic reasons.

With monovision contacts, your eye care specialist determines the focusing power that each eye receives. In most cases, this is based on your dominant eye vs. your non-dominant eye. Your brain prioritizes visual input from your dominant eye (which provides the sharper image) and suppresses input from your non-dominant eye (which provides the blurrier image).

This natural process allows monovision to work by pairing the following:

• Dominant eye – The lens worn on your dominant eye corrects your distance vision. 
• Non-dominant eye – The lens worn on your non-dominant eye corrects your near vision.

While this may seem like an unusual approach to vision correction, it can be very effective. Your eyes still work together to help you see clearly at all distances, making the term “monovision” somewhat of a misnomer. Monovision is also referred to as “blended vision.”

What to know if you're considering monovision contacts

Monovision contact lenses can effectively address age-related long-sightedness. If you’re considering this option for vision correction, keep the following points in mind:

Convenience

Monovision contacts can be more convenient than wearing reading glasses, bifocals, trifocals, or progressive specs. They also prevent the need to switch between regular glasses and sunglasses or to buy prescription sunglasses.

Accessibility

Monovision typically uses standard, single-vision contact lenses. A variety of contact lens types can be used, from daily disposable lenses to monthly contacts, enhancing their accessibility. This can also make monovision contacts more cost-effective compared to other contact lens options.

Temporary trial

It’s often possible to try monovision contact lenses on a temporary basis before purchasing a larger lens supply. If you find they don’t work for you, there are other presbyopia correction options to explore. 

It’s also beneficial to test out the contacts before committing to longer-term monovision solutions, such as vision correction surgery or monovision IOLs placed during cataract surgery. 

Follow-up visits

No matter what your vision needs are, routine eye exams are essential. If you choose monovision contacts, you may need more frequent visits to your provider. This allows them to check your vision and how you’re adjusting, especially after you first start wearing the contacts. 

Adjustment period

There’s generally an adjustment period associated with monovision contact lenses. Your depth and contrast perception may be decreased, which can be challenging in certain job settings and sports. 

How to get used to monovision contact lenses

With monovision, your brain eventually adapts to differences in visual input to process information. While some people acclimate to these changes rather quickly, it can take others a few weeks to adjust. 

Consider these tips when adjusting to monovision contact lenses:

• Wear your new monovision lenses during your normal, daily activities. 
• Alternate between your monovision contacts and previous lenses until you feel more comfortable. 
• If necessary, wear your glasses for near or intermediate vision.
• Be patient with the process and give your eyes and brain time to adjust. 

Consult your eye care professional for further guidance on the adjustment period. Be sure to let them know if you experience any vision problems or ongoing issues.

Alternative monovision contact lens strategies

After age 50, it often becomes harder with monovision to get your non-dominant eye to focus both at close reading distance and intermediate (computer) distance. If standard monovision contact lenses don’t work, your provider might prescribe the following alternative monovision strategies:

Mini-monovision

This approach adds a lower focusing power to the near-vision lens worn on the non-dominant eye while correcting the dominant eye for distance. It helps reduce the disparity in vision powers between the eyes.

Modified monovision

Modified monovision combines different types of lenses to balance near and distance vision. It uses the following strategies:

1. A single-focus lens is worn on the dominant eye for distance. A multifocal (MF) lens is worn on the non-dominant eye to correct vision at all distances. (More on multifocal lenses in the next section.)
2. An MF lens with a low addition of power is worn on the dominant eye for distance. An MF lens with a high addition of power is worn on the non-dominant eye for near vision.
3. An MF lens with a centre-distance design is worn on the dominant eye (centre-distance means distance correction is at the centre of the lens). An MF lens with a centre-near design is worn on the non-dominant eye (centre-near means near vision correction is at the centre of the lens).

Alternatives to monovision contacts for presbyopia

While monovision works for some people with presbyopia, it may not be ideal for everyone. Another option includes multifocal contact lenses.

Multifocal contact lenses — also called varifocal or progressive contacts — improve your vision at all distances. They have multiple zones of optical power, correcting for near, intermediate, and distance vision within a single lens. They typically feature a gradual power change across the lens surface for a smooth visual experience.

Your eye care provider can help you determine if monovision contact lenses or another vision correction option will best suit your needs and lifestyle.

Find everything you need for contact lens wear and care at Lenstore. You can also book an eye test or contact lens check through our trusted partner, Vision Express.

SOURCES:

1. Presbyopia. Cleveland Clinic. July 2023.
2. Your eyes in your 40s and beyond. Association of British Dispensing Opticians (ABDO). Accessed July 2024.
3. Monovision. Cleveland Clinic. March 2024.
4. Adapting to monocular vision (using the sight from one eye only). Hull University Teaching Hospitals. NHS Trust. December 2023.
5. Commentary: Leap forward in presbyopia management – correcting beyond spectacles. Indian Journal of Ophthalmology. May 2023.
6. Monovision contact lenses for presbyopia. Verywell Health. April 2022.
7. The option of monovision. Stanford Health Care. Stanford Medicine. Accessed July 2024.

What to know about monovision correction and how to adjust. Healthline. March 2020.