Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 02/01/21 11:00 AM
Sometimes, only one eye needs LASIK. I’d estimate that’s the case for about one in every twenty or thirty LASIK patients we see here at Hunter Vision. The majority of time these are people that have glasses or contacts for both eyes when we meet them. So why get LASIK in only one eye?
The short answer is that we are aiming for the maximum amount of vision for each patient rather than the maximum amount of LASIK. For max vision, we’re talking about near, distance, and that intermediate / computer vision in the middle. There are two types of people who wear contacts or glasses for both eyes, but only need LASIK in one eye in order to get maximum vision.
The first type are those 40 and over who wear correction to help with both distance and near. That’s accomplished with multifocal contacts, and bifocal or progressive glasses. Every now and then, one of these patients will have one eye with exactly the prescription that would be aiming for with LASIK. In those cases, nature has already taken care of half the work! LASIK on only one eye will give them the best uncorrected vision possible at all distances.
The second kind of person that needs LASIK for only one eye is fascinating to me. More accurately, their glasses prescription is fascinating to me. There isn’t a month that goes by where I don’t see at least one person that has a glasses prescription that’s unnecessary. Usually for one eye, but every now and then, for both! Why does this happen? I’ll tell you.
If you ask a person younger than 40 to look through a mildly minus-powered lens, they’ll usually like what they see. It shrinks everything just the tiniest bit. In doing that, it makes everything a bit bolder and higher contrast.
That’s not a problem if you are looking through it for a few minutes. But with glasses, your eye has to do the work of focusing through that lens all the time. So it’s relatively common that someone will get prescribed a lens that is a little more powerful than necessary because it looked good during the “better one, better two” test at the eye doctor’s office. Slightly less common, that person will actually have an eye that requires zero correction, but they choose a very mild correction during that test. Next thing you know, they’ve been wearing that prescription (unnecessarily) for years.
All of these fun variations in prescriptions and individuals and their eyes are why a thorough consultation matters. History matters, imaging diagnostic matters, and the conversation matters. Everyone’s eyes are unique, so it makes sense that the treatment choices should be unique as well. Sometimes it means only one eye needs LASIK, sometimes both, and — maybe most important — sometimes it means waiting on vision correction altogether.