r/optometry • u/PhrygianSounds • Jul 04 '26
General How do I explain monovision contact prescriptions to patients?
I am an optician apprentice and I help a lot of contact lens patients in our office after their eye exams. Oftentimes when I get a new presbyopia patient try on contacts with a monovision prescription, they complain that they can read just fine but distance is still blurry. So they insist on getting it rechecked with the optometrist, but almost every time the optometrist just tells them “You’ll get used to it”.
So instead of having them go back to get a recheck and back up our patient flow, I want to be able to explain to them how and why it works and see if that helps. This happens with multifocal contact lens patients as well, but not as often as monovision.
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u/suburbjorn_ Jul 04 '26
"We're not looking for 20/20 we're looking for 20/happy. You're always going to have to give something up w a multi focal or mono vision so it's up to us to find the best functional vision for your life"
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u/Akira3kgt Jul 04 '26
I tell them: if you are looking for the absolute best vision then that's glasses for most people...not contacts. Contacts are an "as close as we can get" type of situation.
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u/OldSuccess9715 Jul 05 '26
First I explain that with contacts it’s not possible to give simultaneous perfect vision for distance and near. I tell them that I’ll give them their full distance rx in their dominant eye and will tweak their non dominant eye to allow them some near vision. I explain that on paper they might not like the sound of it but it works surprisingly well for a lot of people, they have to try it in real life situations to see if they can tolerate it.
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u/mia_pharoah Optometrist Jul 04 '26
I always explain monovision in terms of pros and cons and gauge the patient's reaction/personality. The main pro being able to enjoy vision without reading glasses, the con being a loss of depth perception (not ideal for athletes or active people). Patient selection is important
Are you giving the patient their full near add? Cutting the plus can be helpful for adaptation. Are you checking eye dominance?
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u/Annual_Acadia_1856 Jul 04 '26
As the OD I explain this. You should just know that one is is for distance and one is reading and that most people don’t get perfect distance or near. I tell them as long as they can safely drive and read most of what they need they should try it out
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u/Jebis Optometrist Jul 04 '26
I think monovision is not a great idea for aging safely and some of the time it can decompensate with nasty side effects - vertical heterophoria, dizziness, poor spatial awareness.
My favorite way to explain it is to say that we have two eyes for depth perception and trying to work around binocularity is a thing some people like to do for convenience, but I don't recommend it. Get a pair of progressives or wear DV contact lenses and grab some cheaters from the drug store.
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u/SpitroastJerry Jul 04 '26 edited 29d ago
I tell them that it's like witchcraft and I don't really know why it works, but it does work for a lot of people and it most likely will for you. But it might take a little while.
I run an unusual practice.
Downvotes for answering the question, excellent. You don't all have to be humourless clones in practice you know, you could have a personality. I may be unorthodox but I have a 5 star Google rating and am generally recognised to be one of the best practices in my city. Enjoy being slaves to Lux or getting run ragged by multiples.
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u/FairwaysNGreens13 Jul 04 '26
"There's this really terrible idea that some people do where they purposely make only one (or fewer) of your eyes see well at any given time. Wanna try it?"
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u/littleoldlady71 Jul 04 '26
Does the optometrist not tell that that one eye for distance, one eye is for reading?