LASIK and Contact Lens Candidacy

So many presbyopes want LASIK and contact lenses. I get *at least* 3 a day asking about this. I've blogged about it before: Motivations for LASIK, Common LASIK Misconceptions but I want to add some thoughts on LASIK and contact lenses for presbyopes. Here's how I word it to patients who ask during an exam: "IF YOU SEE FINE FAR AWAY BUT BAD UP CLOSE, THEN YOU'RE NOT A VERY GOOD LASIK OR CONTACT LENS CANDIDATE". Why? Because even in "today's age" of 2013 with all of the technology that exists out there, EVERY option for seeing well up close w/o glasses involves making the near vision better AT THE EXPENSE OF THE DISTANCE VISION. Let me state that another way: YOU WILL SEE *WORSE* FAR AWAY IF YOU WANT TO SEE BETTER UP CLOSE W/O GLASSES. It's an unavoidable fact. Monovision LASIK and contact lens fits make 1 eye blurry far away. "Multifocal (or "bifocal") contact lenses (and implants) make BOTH eyes blurry far away in order to gain the reading. Most long time contact lens wearers are ok with this. They've spent much of their life a) seeing blurry and b) wearing contact lenses. But people who have always seen AWESOME and are 45 and having trouble reading things up close...MOST of THEM are NOT OKAY with making the distance vision blurry in order to gain the reading. They are sometimes VERY UPSET, and incredulously ask "is this the best you can do?" They sometimes even doubt the knowledge/experience of the doctor on this point, even going so far as to explain *exactly* what they're experiencing with their vision (which the doctor very much already understands) and telling anecdotal stories about their freinds/neighbors/coworkers who had LASIK or wear contacts at their age and are perfectly happy. But a lot of those patients are missing the point in their own anecdotal evidence: most of the people they know who are happy in monovision or multifocal contacts ARE LONG TIME CONTACT LENS WEARERS who have a lot of experience being blurry. Anyway, I digress. To reiterate, if you have always seen fine far away, then you are not a LASIK candidate, no matter what you've read or heard. Don't be too shocked if you don't think contact lenses work all that well, either. The good news is...THIS IS AN EASY FIX IN GLASSES!


  1. Hi,
    I am with RE -16 and LE -14, i am using contact lens can continue or go for LASIK?

  2. no. to much minus. if you do surgery you'll be directed towards ICL ("implantable contact lens")

  3. "most of the people they know who are happy in monovision or multifocal contacts ARE LONG TIME CONTACT LENS WEARERS who have a lot of experience being blurry"

    Do you mean that those who wear contact lenses (not multifocal) have blurry vision compared to glasses?

    1. basically, yes. myopes who are contact lens wearers experience blur without their glasses and contacts, and they have also experienced and had to deal with blur even thru glasses and contacts (old rx's, old contacts, etc). emmetropic (at distance) presbyopes have never experienced blur at any distance until recently, and and loathe to accept any. basically they're "high acuity demand"


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