Other than bifocals, how can you correct your vision when you're both nearsighted and far-sighted?
By
"farsighted" you probably mean "presbyopic." Nearsightedness
(myopia) is where your vision is blurred at distance but typically good at
near when not wearing glasses.
As
the natural lens hardens in middle age, it can no longer change shape so as to
focus up close. If your distance vision is sharp (i.e. not
nearsighted), the presbyopia will require you wear some sort of reading
glasses. But if your distance vision is blurred from being myopic, the near
focus without glasses can be pretty good. This is because "near" is the default
focal distance in a nearsighted eye. In other words, you can still be
presbyopic but have good near vision -but only at the expense of the distance
vision. If you then put on glasses or contact lenses (or have LASIK), the
distance vision clears up but you lose the near vision because you are now at
the mercy of the presbyopia!
One
way around this is monovision: where one eye is corrected for
best distance vision but the other is left a little nearsighted so as to
preserve at least some of the near vision that comes with being myopic.
Monovision can be achieved with contact lenses, LASIK, or with intraocular
lenses (IOLs) if there is also the presence of cataract.
Another
approach is PreLex®. This is where the natural lens, no matter how little
cataract there might be in it, is removed and replaced with a special IOL that
can focus at both near and far in the same eye. The latter is generally
employed, though, in older patients who have at least some sign of cataract.