Neuroadaptation, Astigmatism (one eye), and Cataract Surgery
Posted , 7 users are following.
I just finished the surgical part of cataract surgery (2nd eye was yesterday). My age is 74 and I was severely myopic (around -14 in both eyes) plus an age appropriate amount of presbyopia. My dominant eye also has moderate astigmatism but I cannot quantify that. However I do know that at this point (2nd day after surgery on the non-astigmatic eye and 9 days after the stigmatic eye) I am 20/20 in the good eye and either 20/25 or 20/30 (20/30 being the most recent measurement) in the dominant eye.
I chose fixed lOL's and being a lifetime glasses wearer I was OK with needing glasses full time. But my dominant eye vision is better than I expected here. I am wondering what are the chances that neuroadaptation will make my distance vision equivalent to 20/20 and how long should I wait before I decide that hasn't happened.
Thanks.
dave
0 likes, 18 replies
pershoot david42586
Edited
This wouldn't be so much a matter of neuro-adaptation, per se, but more a rather of further anatomical changes to see if / how much further your vision may improve and stabilize at.
Usually ~6-8 weeks for the majority of the physical healing to take place and some more weeks / months, thereafter for further anatomical healing / changes to take place, around the new lens.
We all can be a bit unique, so one tailored specifically to you and your timeline of healing and adjustment(s) therein, likely cannot be made without generalizations.
RonAKA david42586
Edited
You should have about 90% of the final vision outcome at 3 weeks post surgery. And by 5 to 6 weeks an eyeglass refraction should be valid and static enough to use to fill an eyeglass prescription. It is really not neuroadaptation, but your eye healing from the trauma of surgery. The internal pressure and swelling goes down over time. The incision healing can also induce some astigmatism either adding to or subtracting from existing astigmatism in the cornea, depending on where the incision is located.
david42586
Edited
Thanks for the helpful replies. I way well be mis-using the term neuroadaptation so let me rephrase a specific question. Assume that person A has 20/20 vision in his/her non-dominant eye and 20/30 in the dominant eye. If we define 'distance vision quality' in terms of how far away you can follow a golf ball on the golf course and/or how far away can you read a road sign (both during daylight), will correcting the dominant eye actually make a detectable (by the person A) difference in vision quality? That is what I am wondering about. I am going to have to make a call on that in about 5 weeks and it is not going to be something that I can try out directly (beyond looking at those letters in the refraction process).
Thanks.
dave
phil09 david42586
Posted
Yes, depending on the extent to which correction is possible. If the 20/30 eye is correctible to 20/15, for example, the difference would be readily detectable.
david42586 phil09
Posted
@phil09 Thanks for the response. Is a mixed 20/30 and 20/20 'detectable' vs a pair of 20/20's?
dave
phil09 david42586
Edited
I would think detectable, but slight. There would be some things that could only be seen, or more clearly seen, with the corrected vision.
pershoot david42586
Edited
While I can't speak for all myopes and how sensitive they may be to changes with regards to this, I specifically do notice a difference even as small as a -0.50 drop in power, in the distance, at my current myopic level of one of my eyes, that I am speaking of.
trilemma david42586
Edited
You can with a refraction. What distance do you see best with your dominant eye?
Why did you have low expectations? Not focused on distance, or you have some non-focus imperfection in that eye?
I think you are implying that your distance vision with both eyes is not nearly as good as it is with just your non-dominant eye. How long for adaptation? What action are you envisioning other than waiting longer?
david42586 trilemma
Edited
@trilemma You can with a refraction. What distance do you see best with your dominant eye?
I just don't have the refraction information. My IOL focus has been set at (effectively) infinity. As best as I can judge longer is better (from a focus perspective), although somewhere beyond 12 to 15'ish feet everything is long.
The astigmatism presents itself in an interesting manner. When I look at a 'point of light' (like the LED's on my audio interface box) when I am close I see a couple of vertical ghost images (through the dominant eye). Somewhere around 8' these start to spread out into kind of a square. Then as I back up more than 12 to 15' the pattern is strictly horizontal.
I also have a (small I think) astigmatism in my non-dominant eye and it also shows a much less pronounced ghost image pattern that is slightly spread out but is only seen above the primary image. When I look through both eyes I see the dominant eye pattern.
@trilemma Why did you have low expectations? Not focused on distance, or you have some non-focus imperfection in that eye?
That was just my expectation - no analysis behind that or complicating issues other than my expectations.
@trilemma *I think you are implying that your distance vision with both eyes is not nearly as good as it is with just your non-dominant eye. How long for adaptation? What action are you envisioning other than waiting longer?
Vision with both eyes vs. non-dominant eye is not that far apart but there is a difference. I am just wondering how long I wait before I decide "OK , this is how it is " and make eyeglasses decisions based on that.
dave
david42586
Posted
Well. crapola. This interface does not have an edit function. I will have to remember that and be more careful in the future. Sorry.
dave
trilemma david42586
Edited
There is, but you need to do a refresh after posting. Then expect a pencil icon to appear, and that stays active for maybe an hour.
Just to make sure, you are talking feet, rather than inches? I am surprised to see a lot of difference between 8 ft vs 15 ft, So you may be talking inches.
You can get that, but you would probably have to lay out some money. Maybe $75, but it is useful and important for planning. In particular, those trying to help will understand more what is going on.
So did they really put in the wrong lens, and you should have had a toric lens? Or they put in a toric, but missed somehow. Or is there something about your eye that is more complex than can be fixed with eyeglasses. Refraction tells you that.
The numbers you want to post are SPH and CYL for each eye. Watch the signs (negative or positive).
david42586 trilemma
Edited
I was talking feet. I did not choose a toric lens. My eyes are just astigmatism, severe myopia, and presbyopia.
dave
RonAKA david42586
Posted
Wait 5-6 weeks after surgery and then get an eyeglass prescription test done. That will tell you where you stand with each eye for sphere and cylinder (astigmatism). What you describe for drop shadows sounds like astigmatism. I have it in one eye worse than the other. Lasik quite likely could correct the astigmatism if you really want to deal with it. But the first step is to let the eye heal and then get the refraction done.
trilemma david42586
Posted
Astigmatism correction is what toric is about. Was it a financial decision to not go with toric?
Weird IMO that you see that much difference between 8 ft and 12 ft away objects.
I was assuming that David would get a new refraction before getting glasses. Suppose the refraction showed 3 D of astigmatism? Would it not be good to know that now?
Suppose one of the eyes showed CYL of +1 D? No point of knowing?
david42586 trilemma
Edited
@trilemma Toric lenses for me were not necessarily unaffordable, but the cost was enough to have a large influence. But the reality was that my history of vision (since around 1960) is that it never stays the same. So it seemed unlikely to me that I could be mostly glasses free in the long run with fixed lenses and whatever goes in now won't be 'correct' in 5 years. So I just chose the least expensive and simplest/lowest risk path.
I seriously considered having my vision fixed at about 'lap distance' just because being near sighted is what I am used to. The medical staff kind of freaked out at that thought, so I did not push it.
And I do have a comprehensive refraction scheduled for 6 weeks after my dominant eye (5 after the non-dominant).
dave
ps. Thanks for the edit tip and where is the quote function? and below is what my screen looks like when I type my reply. What does it take to create a blank line?
trilemma david42586
Edited
[Enter][period][Enter]
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Like this.