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Monovision contact lenses are routinely prescribed for patients with presbyopia. I have found that monovision glasses and contact lenses are also useful in some presbyopic patients with chronic, intractable, small-angle binocular diplopia who have been referred to me after numerous attempts at prism therapy. In such patients, the strabismic deviation is usually 2 prism diopters or less in the primary position and there is no incomitant deviation amenable to strabismus surgery. The patients are tested with the monovision prescription in a trial frame for acceptance. Usually the distance correction is placed over the dominant eye. Patients are given the option of using contact lenses instead, if desired.
In presbyopic patients with poor vision in 1 eye and large strabismic deviations, I have had some success with modified monovision glasses when the patient declines strabismus surgery. Monovision is superior to patching because it does not compromise the patient's peripheral vision. With
Ing E. Monovision Therapy in Patients With Presbyopia and Binocular Diplopia. Arch Ophthalmol. 1997;115(8):1086. doi:10.1001/archopht.1997.01100160256030