Can someone help me better understand astigmatism please?
Posted , 7 users are following.
I understand that the cornea is shaped differently with astigmatism and that it makes your vision blurry. Does it affect distance vision more than near vision? Is it different with a monofocal IOL? Seems I have read having some astigmatism may help you see near better. Not sure if that is always the case or just with an IOL. I have 2 monofocal IOLs and am halfway through the lens exchange process to different monofocal IOLs. In my right eye at my one week lens exchange postop, I was -.25S and -.25 or-.5C (phoropter vs autorefractor) at 130 degrees. I am now 2.5 weeks post op. It's hard to tell for sure, but it seems my best vision is in the mid to far intermediate range. I haven't measured exactly but about 3 ft to 6 ft maybe. I realize my vision could still be changing, but I am also wondering if the astigmatism is playing into it. My distance vision is manageable but definitely blurry. Part of what I am trying to figure out is what to target for my left eye IOL exchange. I want distance. LE is currently .25 no astigmatism. I'd prefer 0 to -.25 but am wondering if I would see blurry with -.25 since my RE is blurry. Thanks in advance 😃
0 likes, 15 replies
beryl68139 Deb03
Posted
I was interested in the above and would ask you do you continue with the eye drops and is there an alternative ie oral as I have trouble with putting them in.
beryl68139 Deb03
Posted
I mean the eye drops after cataract surgery for the healing and inflammation I was given Dexafree as I am allergic to the preservatives.
Deb03 beryl68139
Posted
Beryl, I am currently on steroid and anti-inflammatory drops for 1.5 more weeks. Plus I use artificial tears.
W-H Deb03
Posted
Deb, I think Beryl is looking for a non eye drop solution as she is struggling to put drops in her own eyes.
Beryl, my wife is taking Dexafree steroid drop too as she had suspected allergic reaction.
I don't think oral will work, you need it directly on the eye for proper healing.
W-H Deb03
Posted
Deb,
So your RE with B& L new exchanged silicon IOL is @ -0.25. Astigmatism is -0.25 to -0.50
Your LE has Alcon IOL currently but will also get B&L Silicon lens exchange, correct?
Your RE astigmatism should not be having such a big impact on your blurriness. Your usable vision is between 91cm to 182cm roughly? I would have thought a -0.25 eye would have usable vision bit or lot further away. When are you planning to measure it again?
My wife has -0.75 Astigmatism 1 week post OP in her left -1.50 near eye. With this near IOL eye she is able to see slight blurry 200 cm away (but usable quality) and definitely more sharp at 100cm.
Super eagle eye sharp range is 40cm to 55cm (1.2 weeks post OP).
Now her eye shape etc is not same as your eye so lot of variables but I would have thought -0.25 in most normal eyes would give better far vision, well -0.25 is what my wife's IOL will be set for in the right far eye and Dr Zeiss said it will give good far vision. It could end up at -0.5 though for my wife! Such a lottery this is!
If I remember your aim for exchanging the Alcon IOLs to B&L was to...
1- Get rid of Alcon lens..along with it's possible glistening and other issues.
2- Work out if Alcon lens or PCO is causing problems before you commit to do YAG.
You will completely get rid of Alcon lens soon and it seems you need a YAG. So in a way you have achieved your aim.
Now you question is also what number you should target for your LE! Do you know which is your dominant eye?
Deb03 W-H
Posted
Thank you W-H. Excellent summary. LE is my dominant eye. My goal was to go slightly myopic in my RE to get by with "casual" closer in reading. I want to maintain good distance vision in my LE.
Guest Deb03
Posted
As I understand it, astigmatism gives a sort of the same effect as if your lens is making you nearsighted, the lens and cornea combined is what makes the optics for focusing the light on the retina.
So astigmatism do make you more nearsighted, but as I understand it, astigmatism has a lot less effect than the diopter in the iol.
0.25 astigmatism is really nothing, this is what you find in most of the population with healthy eyes as well, so I don´t think this is having any effect on your vision, but off course I am not an expert.
I have 0.25 astigmatism in both eyes now, and I am so happy it ended up there, before surgery I had 3.0 astigmatism both eyes, so the toric lenses worked really well in my case.
As I understand it, healing takes longer time after iol explant, so I guess your eye could still change a lot due to healing, if the eye have been measured to -0.25 diopter, it should give you almost perfect far vision, so something is off somehow.
Deb03 Guest
Posted
Thank you Danish. That is very helpful. I also had a vitrectomy which could add to the healing time. The target was -.4/-5 (different formulas I guess). So it's possible that my eye is settling more myopic. I am on my laptop about 2 feet away not wearing glasses. My LE can't see anything - even larger text so it's all from my RE. I also have a fold in my RE capsule causing maddox rod effect. Not sure if that could be affecting other aspects of my vision. I will be getting the RE YAG 3 weeks before my LE operation, so I will see if that changes anything also. I guess at this point I am trying to decide if I want dr to target LE more in the plano range or more in the -.25 range. I have achieved my goal of being able to get more useful vision in the intermediate range. Prior to exchange I had blurry vision from about 6 feet in.
Guest Deb03
Posted
Well, sounds a bit odd that you have that good intermediate/near and not much far vision, I understand why you have doubts about selecting target for the second eye.
I don´t know the reason, with -0.5 I believe you should have somewhat more usable far vision and not quite that much near vision you have now, so something is slightly off, I guess it could very well be the fold in capsule.
In any case I think the result is somewhat misleading for some reason, I don´t think you can use the result from the right eye as a direct basis for targeting the left eye.
-0.25 should give perfect far vision, lenses often jumps in steps of 0.5, so if your choices are -0.25 or +0.25 according to your measurements, I would have no doubt, I would go for -0.25.
But - I am not an expert... 😃
Deb03 Guest
Posted
thank you again! after first surgery with 21D alcon monofocals in both eyes, I was LE .25 0C, RE .5S .5C. LE saw better at all distances. Now RE has B&L 21.5D. RE sees better from about 6 ft in. From about 6-9 ft it seems to fluctuate between the two, and beyond that LE sees best. I'll post again with my 4 week update and YAG.
julielyn Deb03
Posted
hi deb, previous to cataract surgery i had a .25 astigmatism in my right eye . i had lasik done in 2001 and opted not to correct it then as it was so minute that the chance it would not hit plano wasnt worth it. now after having 3 different iol surgeries i have .75 astigmatism with a toric multifocal in that eye. i notice it more in my distance vision, say beyond 30 feet. now i believe i still have options, because there were mutilple surgeries/exchanges, my cornea has changed at the incision area. i think prk could improve my astimatism a smidge, or what the dr could do is make small incisions else where on the cornea ( im forgetting the name of this procedure right now) to manipulate the cornea to a more usable shape. obviously this takes a lot of talent from the dr. after my last go round of exchaged surgery, my vision wasnt settled until at least 2 months, and even today 6 months out i find that i need daily drops to maintain consistent vision. i work outdoors quite a bit, and windy days are the worst ( dry eye) luckily i live in a humid climate but keep the ac running year round in the house.
anyway, give yourself the time to heal up properly, ive decided to wait one year before contacting my surgeon about any tweaks that might be beneficial. my vision is 20/25 individually which gives me as close to 20/20 together is excellent lighting conditions with a small halo. i have restor 3.0 multifocal in both eyes with the added toric in right eye
my one year on right eye is in november, and final exchange of left eye was april
good luck to you and please keep us informed
Deb03 julielyn
Posted
Thank you Julielyn! I read all about your experience. That seems to be what I am noticing is an effect more in my distance vision. I also have dry eyes/blepharitis since the surgeries so that could be affecting it also. I am happy so far and am just trying to understand it and also figure target for my LE since my I want clear distance vision in that eye.
soks Deb03
Posted
astigmatism affects distance vision and make near vision better. I have -0.5C in the IOL eye. I wear glasses for it to fine tune distance. However without the glasses it is not terrible.
Deb03 soks
Posted
Thanks soks. Based on the comments, I've been researching folds in the capsule and seems that they can distort vision so maybe that's a factor. Will see after the YAG. Are you still going to see Dr. Safran? Seems like it was this month.
soks Deb03
Posted
yes i see him on the 18th. my coworker with the maddox rod has retired else i would ask him if his acuity was affected.