Cataract - I Should Have Chosen Near Vision

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Hello - I hope someone can help me or offer some advice.  I recently had a Toric IOL lens put in my Right Eye for distance after removing a cataract about 10 days ago.  I had a choice of Near, Mid Range or Distance.  My doctor didn't want to chance a multifocal due to my astigmatism and prior history years ago of "corneal erosion" (right eye only) which I've been free of the condition for over 10 years.  So, we went with a monofocal alcon lens which gives the "clearest" vision without risk of halos and other things.

The problem is when given the choice of Near, Mid Range or Distance everyone said go with distance.  I never really thought this through at all. If I could turn the clock back, I'm quite certain I would have gone with near vision in a heartbeat.  I've been nearsighted for over 20 years and I don't mind wearing glasses to look at a computer (mid range) or for driving.  I have NOT done (cataract surgery on) my left eye as of yet.  The very next day after the surgery I thought I made a big mistake.  I kind of feel like my life has been "on hold" for the last week and I'm not sure what to do.  My left eye is my dominant eye and the cataract is not bad at all yet in that eye. I'm thinking about holding off on doing that eye until I know what I want to do.  I just can't imagine always having to wear reading glasses to see things up close. I've been in tears off and on since the surgery.  Overall my distance vision is very good and the surgeon did an excellent job.  However, I should have carefully thought this through rather than just gone with the hype "almost everyone chooses distance."  There are so many reasons to choose near vision I keep compiling a list of all the reasons I want my near vision back in my right eye.  I'M STUCK.  Has ANYONE else gone through this?  Will I just get use to this?  Should I consider a lens exchange, piggback, laser or something else?  My fingers are blurry even as far as 12 inches from my face.  How long do I have to wait until my near vision will get as good as it is going to get?  Maybe it will get a little better but I do not know.  What should I do?  Thank you all for your input. 

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  • Posted

    I find myself in the same situation. Nearsighted most of my life and then cataracts at 52, I wasn't really offered a choice of lens. Now my near vision is so poor I feel like I need reading glasses all the time, it's quite depressing actually when you can't see the food on your plate. Any ideas on your end?

    • Posted

      My doctor resolved it for me.  See my other posts in this thread.  When I had my other eye done, we chose mini mono vision and he set it for distance but moved it in 1/2 diopter to get a better range of vision.  I see great at all ranges.  I'm not sure if you already had your other eye done.  Sometimes I wonder if when setting for distance, some doctors set it too far out (making people farsighted) and thus their near vision is even worse than it would otherwise be if they just set it for distance

       

    • Posted

      Even though the surgeons don't aim for farsightedness, aiming for plano and missing the target by about 0.5 diopter is quite common. That, of course, results in farsightedness (in half of those cases), which makes the useful range of good vision very narrow.

      I think that a little bit of nearsightedness is a lot easier to live with than farsightedness. Thus, my suggestion is to always target about --.25 D, which significantly reduces the chance of the useless farsightedness.

       

    • Posted

      At201 - thank you for clarifying.  That's kind of what I meant to say but I had no idea in about 1/2 the cases it results in farsightedness.  I have read that the error factor can be about .5 diopter.

       

    • Posted

      The -0.25D was the target my eye surgeon chose as well for my right eye with a Tecnis toric monofocal IOL. 

      After  over 3 months now, it looks like my eye ended up very close to that target somewhere between -0.25D and 0D with 0.50D or less residual astigmatism.

      I told the surgeon in advance I wanted to avoid any farsightedness too.

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