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Hi, the reason to use Blended Vision is that with both eyes open the person can still see the smallest line that they would normally see, but can also see at near better than they would with both eyes set to Plano. The actual number of lines each person can read with each eye depends on how well they can see beforehand, what level of blend is selected, what type of IOL is used, and will vary from person to person. Generally the 'distance' eye can see 6/6 (20/20) if is was capable of 6/6 pre-op with glasses. The 'near' eye is about 2 to 3 lines less on a distance chart, but much, much better at midrange and near tasks. As always, you should consult your surgeon to discuss what is best for you and your occupation, hobbies, and take into account what your eyes are capable of.

@@iLASIKwithDrTGray I definitely will. Thank you for explaining it to me, I had no idea. I’m very myopic -7.5, -8.5 before cataract now -11.5 (only one eye affected. I can see 6/6 in my -7.5 eye in glasses and nothing much is my right eye. They asked me to think about options of: monovision -1.5, mini-mono vision -1 or less before the appointment and I had no clue. Thank you for explaining it to me. I wouldn’t like 2-3 lines less between the eyes, no way on Earth. 1 line at the most for me. So I think it will be hard for me at the appointment. At the moment my right eye sees zero lines and I live with 1 eye, I hate it so much. I want my eyes to be sort of more equal as before when my right eye was slightly weaker but still 6/6 in glasses. And then cataract came. I’m even thinking to set both eyes for 6-7 lines and put glasses on if I need. At the end of the day I wore glasses all my life.

Choosing Low myopia in both eyes is a valid choice and will feel familiar for you. All the best with your procedures.

Sorry to hear that - You should go back to your surgeon in London to discuss this. -0.50 in the non-dominant eye can be helpful to delay the symptoms of presbyopia, but if it doesn't suit you usually it can be corrected.

​@@iLASIKwithDrTGrayThank you for the feedback Sir.

Truly accommodating (full focus range) IOLs are still a long way away….. if ever. There will never be a perfect replacement for the natural human lens. Multi focal IOLs will always have some sort of compromise, and while Blended vision is a compromise, glasses for detailed tasks work better with blended vision than they do with Mutlifocal IOLs. I’m sure when the perfect IOL is available it will be well publicised.

Hi there - Yes, a lazy eye can make blended vision hard and it’s not suitable for everyone - but the focus of the near eye can be reset to distance vision for you safely and easily. If you are in NZ Re:Vision would be happy to help, or if you are overseas reach out to them anyway for advice on how to proceed.

I'm wondering about seeing the instrument panel in my car while not having to have glasses to drive

Visual acuity is measured in 20/20 or 6/6 notation (20 feet is basically 6 meters), meaning you can see at 20 feet what you should normally see at 20 feet away - '20/20'. What you probably mean when you ask "How much off 20/20 do you prescribe" is how much myopia do you leave in the near vision eye (or even in the distance vision eye sometimes). The answer is... it really depends on what the person wants and what will work best for them! We take into consideration the distance and near tasks a person does, how far way they hold things, their height, whether they were shortsighted beforehand, how strong the eye dominance is, and whether they are having an Extended Depth of Focus Lens in either eye. Generally having the dominant eye Plano (or "20/20" in the distance) and the non--dominant eye -1.25 ("20/20 at 65 cm" and a good focal range from 40-80cm) works well. In good light this gives a good range of focus for most day to day tasks without much distance vision compromise. But I do strongly recommend you discuss your needs very carefully with your surgeon or optometrists as there good reasons to go a little more (or less) myopic than this in may cases.

@@iLASIKwithDrTGray When I had monovision contact lenses, I'm pretty sure I was corrected to 20/20 in my dominant eye, and only .50 off 20/20 in my non-dominant eye. So I think it was -4.50 and -3.50. It worked pretty good and I could see distance clearly and most close-up tasks except maybe the smallest print. Then one day I woke up and my brain stopped doing it. Optomaetrist said that sometimes happens. Went back to a regular prescription until multifocal lenses came out. I've been enjoying them ever since. I weat Acuvue Oasys Multifocal lenses and they work great for distance and most close-up tasks except the smallest print. Eventually, I may have to do cataract surgery so I will have to decide between mini-monovision, monovision or a multifocal IOL. Thanks!

Hi, PRK is a great procedure but LASIK has advantages for higher prescriptions. Both procedures have a role, and the choice between them should take into account not just the prescription and corneal thickness, but also the age, sports and lifestyle of the patient. Generally if the prescription is over -6.00 LASIK or Implantable Contact Lenses are a great choice. Feel free to reach our to us directly via the website if you have clinical question about your eyes and what procedure you are best suited to.

Hi Brad, it really depends on what vision range is most important to each person and how much difference between the eyes a person can be comfortable with. For example a 6 foot tall farmer might prefer one eye fully distance focused and the other at -1.00, for a near range of 700 - 1200mm. A 5'2" teacher who likes close up art and craft might prefer one eye -1.75 and the other -0.50, which will be great indoors and near but might require glasses for driving.... An important part of the pre-operative discussion and assessment is working out what tasks a person most wants to be glasses free for, and what difference they can adapt to. Sometimes Extend depth of Focus Lenses can be very helpful to increase the blended vision focal range while keeping the difference between the eyes mild. It's always best to tailor the focus range and lens choice to the individual person, and typically the results work well. At Re:Vision we do like to spend quite a bit of time on this.

When you speak of intermediate vision, if you do both eyes for distance with the standard monofocal lens, can you still see some up close “ computer like” vision- like arms length?

@@alanzemsky7695 Not an eye doc but the answer should be no as you have a choice of near, intermediate and far/distance lens. Distance with 20/20 would be 20' and not close to the 2' or arm's length for an intermediate lens. With an intermediate you probably can still use a phone but not be able to read tiny disclaimer text without readers.

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Yes, as long as it is well controlled and your eyes are healthy.

The short answer is that even if you are well adapted to Monovision/Blended Vision, you can still use reading glasses instead form time to time. As the ability to focus up close gets worse in your 40's and 50's, it can feel like using glasses and Cl makes your near vision worse - but that's really not the case - it is going to get worse regardless... just like getting more wrinkles and grey hair...

@@iLASIKwithDrTGrayDoctor, I think he was asking about if you don’t use the weaker eye it will eventually deteriorates even further and becomes even more weaker. Is it possible after the IOL cataract replacement surgery? Or, it may even start looking away from the direction of the Dominant eye. Is it possible? What is the difference in how many lines you see with each eye we are talking about?

What did you end up doing?

We don't normally offer medical advice in the comments - we prefer you reach out to us via the website - but SmartSurface PRK should be an excellent choice for that prescription and lifestyle. Reading glasses will still be needed afterwards though as you are approaching the age where presbyopia starts to effect your near vision.

@@thebird9766 apologies I didn’t see this. I ended up getting PRK. I I am seeing somewhere in the vicinity of 20/15, however, the vision is not stable. I am a year postop and am having ghosting and higher order aberration that come and go, and halos, starburst at night. The ghosting and higher order aberration I am almost certain that it’s due to dry eye. The halos and starburst at night I think it’s due to scarring of the cornea.

You spent time with a legit question.. But you know they never answer specifics, or at all...so why bother@

There's a very simple test to determine which eye is dominant. Find a vertical object roughly twenty feet (six meters) away. It can be anything--a tree trunk, a door jam, the ede of a building, or the corner of a room--as long as it's clearly visible. Focus on that line or object. Now hold up one finger at arm's length and align it with that vertical object. Next, alternately close each eye. For your dominant eye, the finger and vertical object will stay aligned. For the non-dominant eye, the line will appear to jump away from the finger.

@@ajs11201 Determining the dominant eye should be a part of pre-cataract surgery testing. This is vital information for determining the prescription for intraocular lenses, especially if monovision is being used. (I had cataract surgery two months ago using a mini-monovision approach with Eyhance lenses and it's taking me some time to get used to the differing prescriptions after 50 years of great distance vision in both eyes with contact lenses.)

@@MGrant-dx2tj Totally agreed.

Usually the adaptation is within a few weeks - it depends on the type of vision the person had before the procedure, and whether they have had any previous experience of blended vision with contact lenses before this. Often a patient can try this with contacts beforehand to see if it is a good option for them.

Only some can overcome this transition...better to pass, Stay safe

@@Itsme-ni9jk Most can overcome the transition, but you're right that not everyone can. And as the doc said above, patients can often test the waters by trying it out with contact lenses before committing to a surgical implant.