Definitely an Ey(en)hance for me!
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I thought I was going blind before, wearing my glasses, and even at times with my contacts; everything was so shaded and blurry. My prescription a year ago was -13 D (left eye), and -12.5 D (right eye), with about -1.0 of astigmatism. It used to be stable for the past decade at around -11.50 D (LE) and -10.25 D (RE) until at least a year ago. I went in for my bi-yearly checkup (instead of yearly thanks to Covid and OHIP ripping off optometrists in Ontario), and my optometrist couldn't figure out why I wasn't get my usual sharp distance vision with gas permeable contact lenses -- my eyes kept fluctuating a lot just in the hour I was there, so she did more tests and discovered early stages of cataracts. Because of my high myopia, these cataracts were really messing with my vision, despite being relatively early on in terms of developing. She sent me to a cataract clinic, who started the ball rolling -- as into my deep dive into the dark recesses of the world of IOLs, lol. Choices, choices, and yet more choices... yet still somewhat of a crapshoot in the end.
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I had the cataract replaced in my first eye (RE) yesterday (06-03-23) with an Eyhance IOL targeted to -1.25 D. Just prior to yesterday's surgery on the right eye, I discussed it again with the surgeon who was thinking of -1.25 to -1.50 for that eye (RE), but I told him that I didn't want to take the chance of going as high as -1.50, but was okay with -1.25 if he could hit that. He responded that the increments for this lens was .33 to .50 and that he would do his best, but it wasn't an exact science (actually felt good to hear him say that, lol). He wasn't sure until he opened the eye(s) and used the ORA scan whether or not he'd need to use a Toric lens, but which he did ending up using for my right eye. I'm scheduled to have the left eye done tomorrow (08-03-23) with another Eyhance lens, with a target of -0.50 D (see first comment).
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I was given three eye drop prescriptions to fill the week before my surgery (an antibiotic, an anti-inflammatory, and a steroid), and instructed to start the first two the day before surgery and then again the morning of the surgery -- didn't start the steroid til afterward. I'm supposed to use the antibiotic for a week, and the other two for a month after the surgery. On the day of the surgery itself, I was given a combination of drugs via IV to just relax me during the surgery (not to put me out), and they put seven types of drops in my eyes prior to surgery (antibiotics and for freezing) -- all of which I was told about, and given handouts about, weeks before the surgery itself. They had also required that I fill out a detailed list of previous medical conditions, and any prescription medications I was on. After they took me into the surgery room, they applied more drops, then the surgeon draped a protective shield over my face and upper body, and then he cut an incision in the shield over my eye and inserted some other type of protective wrap around the area. He did the insertion by hand instead of using the laser system "package" (which cost another $1100 CAD which I couldn't afford). A lot of what this laser package does was already done in the pre-op tests already. The surgeons usually do the insertion of the lens by hand anyway when cataract surgery is done in a hospital in Canada, at least, since most hospitals aren't equipped with that level of technology, so my surgeon wasn't bothered by me not paying for the extra tech.
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The surgery itself, was both weirdly cool and unnerving. They shine a bright light into the eye being operated upon (the other eye is covered by the surgical shield), and although my eye was completely frozen, I was worried that I'd be aware of the knife cutting into my eye, or the surgeon breaking up the old lens, but I wasn't aware of either. It seemed only maybe five to ten minutes before I was told to look at a red light, which was the ORA taking a scan of my opened eye, which meant the part I was worried about was already done. I'd been instructed to keep looking straight up to where the light (mostly) was, and at times I could see what looked like small shards floating above me (the broken lens??) and even after the lens must have been removed, I still had a sort of "ghost" image of the surgeon sitting beside me -- I could see his outline, but the "filler" was grey. So can we actually see something even without our eye's lens? It didn't seem to take very long before the surgeon said, "Okay, we're done, you can close your eye if you want.". I'd been told the actual surgery took about twenty minutes, and it looks like it was. When I sat up, of course I felt kinda woozy and since my pupil was huge from all of the drops they'd put in it, so the vision was blurry (completely blurry in my left eye since I wasn't wearing glasses), and they assisted me walking out to the recovery room where they went over again, what to expect, about following the rest of the eye drop schedule, what to be concerned about, and what I could and should not do for the next two weeks. I was given a pair of black sunglasses that I was told to always wear outside for the next two weeks, whether it was sunny out or not.
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I was able to walk out of the clinic about ninety minutes after I'd first entered the clinic, accompanied by my support person. Vision was of course still blurry, and my depth perception was wonky, but I could still see a lot better than when I walked in wearing my thick glasses early. Hours later after I'd gotten home, just out of interest, I put the lens of my glasses up to my left eye (-13.0 D) and opened the "new" right eye to look into the mirror at the same time, and immediately wished that I hadn't -- I almost threw up. So definitely no wearing of glasses with a lens removed for me. In general though, after the surgery yesterday, and today, there was very little discomfort in the surgery eye itself. It felt like there was maybe a tiny bit of something in the eye, but nothing that made me want to rub it, or feel that I needed to flush it out, etc -- pretty minimal. It took til this morning for the pupil to return to it's regular size (about 2mm), so my vision was a lot more stable today. I've been putting lubricating eye drops in my eye after I finish the prescription drops, so my eyes aren't feeling dry or itchy at all -- though from what I've read, that could change. I had bought a pair of non prescription (plain glass) glasses to wear around until I got used to the new eyes -- and to protect them from dust or anything else that might fly around, especially since I was told to be careful to not rub my eyes for at least three weeks, as I could dislodge the new lens). So earlier today, I cut out a piece of a Kleenex box to fit into the left lens of them, and I'm preferring that to the completely blurred vision from my left eye messing with the good vision in my right eye. Depth perception is better this way, as is looking at the computer screen or anything else.
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And oh yeah, have I mentioned yet, how amazing it feels to have the pretty much sharp, clear, vibrant vision that I'm experiencing today in at least one eye!!! I am so very happy with this lens and my current results. Although my near vision isn't quite what I had hoped for (maybe 8"), as is my distance vision (seems about 20/40 right now - was hoping for 20/30), this is only the first day after the surgery, and right now, if it even stays at what it is, I'll be as happy as can be, especially with the left eye being targeted tomorrow more towards distance. Definitely a game changer for my life! Thanks to everyone here who contributed towards my final choices, whether you're aware of it or not. Sorry if this is too long, but I was trying to give a full cohesive picture.
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My vision (right eye) first day after surgery...
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Sharpness (print):
- I can read the letter sized page I hung on the wall containing a multi-coloured chart for my eye drops pretty clearly at 5' (print: black on white, black on medium yellow, white on medium teal, and white on medium brick red). Not sure what size the fonts are but the chart fills about 2/3 of the page vertically, and 3/4 horizontally.
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- Reading print via my computer browser zoomed to 110% is sharp and clear from about 19" to over 40" (using a MacBook Pro laptop - screen size 15" / 1680 x 1050 resolution). Decreasing the zoom to 90% still gives me sharp print (black on pale grey) over the same distance. I just reduced the font size in my menu lists from 15pt to 13pt which is sharp and clear.
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Overall clarity:
- Contrast quality in daylight is excellent, even in a dimly lit closet, as is image clarity. Contrast was still good inside the house as the sun started to go down (around 5:30 pm EST). Colours are true. The pictures on my walls are full of detail and the subtleties are easy to see (now from about seven feet with right eye only). I used to do desktop publishing and design as well as make my own clothing, so I'm very particular about colours. I'm always correcting people about the subtleties between shades of colours.
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- Haven't been walking outside in the dark yet, depth perception is too off between the two eyes until I get the second eye done. HOWEVER, I'm noticing a huge drop in contrast, and vision in general, in an almost completely dark room. I'm used to walking around in near darkness in my home, but I just walked into the living room with my left eye blocked, and closed the blinds before turning on a lamp, and could hardly see anything in the room. If I hadn't already known that there was a brown coffee table sitting about a foot in front of me, I wouldn't have known with the Eyhance eye at that level of light. When I removed the block from my untouched left eye, everything might have been blurry, but the contrasts in that dark room showed up far far better. I probably would be able to navigate that room far better with just my highly myopic blurry left eye then I would with just the new Eyhance eye. Whites looked mid grey and dark objects were almost undistinguishable. Good to know before I head outside with both eyes using the Eyhance lens. Unfortunately, this probably will not improve so I will need to make sure that I carry a flashlight at night. Sure hope it doesn't affect my night driving very much.
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- I haven't noticed any "transition" problems. The accommodation appears to be very smooth in this one eye. I'm not noticing any real delay in focus when say, looking up from the laptop screen to a picture on the wall (from 19" up to 60"), or even from the laptop screen to the light switch on the wall in the hall (from about 19" up to 10').
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Near & Intermediate Vision: Can read my cellphone (6" screen) clearly at about 12". However, I can clearly see the small print on a small hand cream bottle (about 3.5" tall) from around 12" to 22". And interestingly enough, the instructions on the side of a large bottle of Tylenol are sharp and clear at 2'. Am needing cheap readers of about +1.75 for some closer things though.
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Distance Vision: According to a printed Snellen Chart at 10', I'm about 20/40 for distance right now, although I can see some of the 20/30 line. My hallway is medium lit, and it's a little sharper when I turn the light on. My bird feeders are about 35' from where I sit on the deck, and they are pretty clear, not completely sharp, but I can determine what small bird is eating on them (couldn't do that with my glasses, which were only giving me barely 20/50 in the right eye -- left eye was blurry even at 20/100). I can even see the bird feeder at the back of the yard (approx 110') -- it's a little fuzzy, but I can see if something is sitting on a perch attached to it. The windows are pretty sharp on the two-story brick house behind me that's about 200' behind me. And I could read the street sign earlier this afternoon clearly at approx 35'.
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Visual Distortions:
- Mild floaters started day after surgery:, which I expected as I had them before. They were only really noticeable before if I had been straining my eyes and not getting enough sleep. They got quite strong today after putting in the required trio of drops (see above), but then eased off considerably about two hours later to a mild occasional state again.
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- Noticing a small flickering to the outside bottom left of the right eye from time to time, mainly when in bright light (inside house), but it's not constant at all.
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- Light sensitivity increased, though I always have been sensitive and it was a lot better the next day, after my pupil had gone back to it's regular size (around 2mm). Needed to put on a pair of light tinted sunglasses to wear inside this morning when I first opened the blinds and curtains, but that eased off a couple of hours later. No distortions when looking at a bare led or fluorescent bulb.
1 like, 62 replies
karbonbee
Edited
I wonder if I've discovered an unexpected caveat to having both eyes done so close to each other in terms of the brain defining which eye is doing what? It seems that the distance vision in my right eye (targeted for near & intermediate) was quite good until after I had the left eye done (targeted for distance) two days later. I know that they are both going to fluctuate for at least the first month or so, but it just seems strange that I was reading subtitles so clearly on a 42" TV ten feet away with the RE, then after the surgery done on the LE, the same text with the one eye is now blurry. On the other hand, the distance vision with the left eye still seems to be very close to the 20/20 result when tested the day after the surgery on it. My distance vision with the right eye still seems to be somewhere between 20/30 and 20/40 and it's near and intermediate vision is still as sharp as it was in the beginning. Although I've been loving how well the blended vision has been working in my case, I then started to wonder if maybe both of my eyes were working together a bit too well? To the extent that they had kinda accepted their assigned roles and weren't going to push for more range?
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I started thinking about Spoo's comment about "the monofocal vision has really great range for the first days because the capsular bag and the eye are still trying to figure out what's going on" and then about children with Amblyopia (lazy eye) being able to potentially retrain the lazy eye by patching the strong eye, making the weaker eye work more and thus retraining the brain to recognize and remember the weak eye's previously untapped ability. When the second eye is done a month or so later, then the brain has a period of "alone time" with that first eye and possibly pushes it's visual range? Although that potentially doesn't track up for people who aren't myopic and or use contacts, etc, in the other eye until it's time for the second surgery. Although, I've read quite a few reports of people not being happy with the results of the lens replacement of the second eye, and maybe this is why? So I've started experimenting with patching one eye for a couple of hours a day, and making the other eye do some extra work.
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I thought that it was kinda weird that the intermediate vision in my LE that had been set for distance (targeted for -0.50D, and ended up around -0.35D) didn't seem very good, especially since that the Eyhance is supposed to give some extra intermediate vision even when targeted for plano, thus I should have had better range there. However, I had only really tested it briefly a couple of times by covering the other eye (which is giving me amazing near and intermediate vision thus filling the gap beautifully), and giving myself targets around me to focus on. The results that way weren't very good, but after the near vision eye had been patched for about fifteen minutes or so, the results improved a lot. The near and intermediate vision still isn't as good as the right eye, and I didn't expect it to be, but it was a heck of a lot better than what I had initially thought it was. I found that I could negotiate easily around the house, doing chores like vacuuming, washing dishes, etc. I could see the dishes easily in the sink, didn't bang (or break) anything. It was a bit harder doing things in dimmer light with just that eye, like pouring water into the coffee machine which is in a dark corner under the cabinets, but negotiable. I've been doing some work on my laptop like this and can see it's 15" screen quite clearly from about 3' feet away -- it's blurry any closer than that, although I've been trying to force the issue by doing some general surfing type of activity -- my left eye does get tired more easily this way (can see the same screen clearly 18" away with the "near" eye). My phone screen is a bit blurry at 20" with the "distance" eye, but I can figure it out. I only have been doing this inside the house with the distance eye, didn't try walking around outside what with the snow and ice on sidewalks -- my depth perception isn't as good with just that one eye.
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I usually go and sit on the back deck and drink my coffee (yes, even in the winter -- we Canadians are tough, lol) and watch the wee birdies at the feeders, so I've started patching the "distance" left eye when I go outside to do this, making my right "near" eye do some distance work. I can walk around outside somewhat easier with just the right eye as it has better depth perception with the better near and intermediate vision. Doing this outside with the right eye works quite well also as there's lots around to keep focusing upon -- from near to distance. And once again, after about ten to fifteen minutes, I do see some improvement in my distance vision with that eye. I'm doing the same also when watching TV with the "distance" eye patched. I do find that the picture and subtitles do clear up somewhat and become sharper the longer I do this. After un-patching either eye, the vision in that eye is a bit blurry and takes a few minutes to readjust it's self. I'm not noticing any long-term decrease in the original vision in either eye though. Once readjusted, they go back to what they were doing before.
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Anyway, I thought it was worth trying this for the next month or so (depending upon whether I see any repeated improvement). I read that the vision in a particular eye will improve in the short time when you're making your brain use it specifically, but when you go back to using both eyes, that "gain" appears to be lost. Which is what I'm noticing now. So it will be interesting to see if by doing this type of exercise regularly for a period of time, my brain will eventually remember what the two eyes gained when working separately, and apply those gains when both eyes are working together. Worth a try, I think.
karbonbee
Edited
Dark road drive test results (two days after left eye surgery -- five days after right eye surgery):
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I am not noticing any problems with the Eyhance in dimmer light at all. Of course bright is better, but I'm able to read smaller print at intermediate distances in a dimmer room -- say a shaded part of a room in the late afternoon into early evening when the sun isn't as bright. I'm not quite sure what people are expecting from either an IOL or their own eyes, but I don't remember ever really being able to read black print on white, or anything else, with any real clarity in dimmer light at any point in my life. I'm finding the contrast with these lenses, even in an almost completely dark room has been very good. There's no natural light in the stairway at my house, and no outlet to plug a night light into near them, so I pretty much always have to turn the staircase wall light on, especially when going downstairs, even when it's bright and sunny outside, with light pouring into the hallway itself from the windows in the bedrooms on either side. Since the surgery, I'm finding that I can see the stairs well enough now to go down them with no extra light, even when it's not a sunny day. And as long as I haven't been sitting in a brightly lit room for a long time, I'm navigating around my house at night via night lights just fine. If I have been sitting in a bright room, then I need to give my eyes some time to adjust first (almost as usual) and then I'm fine. Well at least as long as I've remembered to first take off the pair of blue light glasses that I'd been testing with the computer, lol. The instruction leaflet that came with them stating to not wear them when driving at night did so for a very good reason -- I thought I was having a relapse, could hardly see anything in the dark room I accidentally wore them into. I thought, crap, then walked into the bathroom, turned on a light, and saw what glasses I was wearing in the mirror. Duh. With regards to reading on a mobile device, well, I never leave the setting on them to "automatic brightness" anyway, as I always find it's terrible, no matter who makes the tech -- always too dim in bright light, and still too dim in low light -- so I'm used to manually adjusting my screen's brightness to suit what I need at a particular time. Though I've tested turning the brightness down on my phone to the minimum in a dark room, and haven't had any trouble still reading the screen at 12 - 14". The same with outside in the sun -- I still adjust it to something brighter as I usually do and have no problems reading my screen, even when wearing lightly tinted sunglasses.
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I did my first night time driving test about an hour after the sun had set (no moonlight and the sky was a bit hazy) two days after the left eye was done, and had no problems. I made a point of going down (non busy) dark backroads, driving slower speeds so I could check out what was visible on either side of the road, then finally went onto a dark paved road that I could drive at highway speeds on (no white lines down the side), and once again had no problems. Everything around seemed clear and defined. I felt very comfortable driving. There wasn't much snow in the ditches either as it has been warmer the last couple of weeks and a lot of the snow had melted down, and what was left in the ditches was pretty dark from salting and grit. On some of the backroads, I pulled over so I could look into the fields beside them, and could define brush etc sticking above the snow at more than a hundred feet away. I could see a satellite that was covered by the haze in the sky through the sunshaded part at the top of my windshield -- and could see some night clouds in the sky itself despite it being little hazy out. A number of the roads I was driving slowly down were lined with old growth trees on either side, and I could easily see at least fifteen feet into them. Not much snow in there either to make things lighter. Tops of the trees were easily defined against the not so bright sky of that night. I could easily see the shape of a house set back from the road that had no lights on it or around it. I was really nervous starting out, but ended up being very happy because of the results. I don't know if I could see this well on dim roads with my contacts before the cataracts hit. I guess the real test though will be once the snow is gone for good, but this is a good start in my opinion.
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There was a small amount of glare around the headlights of oncoming cars, more so with the weaker right eye, than the distance eye, but that mostly cleared up as the cars got closer to almost nothing. At the worst the glare maybe added one to two inches around the perimeter of the headlight's real size, diminishing in opacity towards the edge. In general, I'm used to seeing a lot worse over the years when driving with my contacts, such as halos that didn't resolve with distance, even before the cataracts started in, so the small amount glare I'm seeing now is nothing in comparison. There was the same small amount of glare around the street lamps or house lights in town, mostly with LED lights. I use LED light bulbs in the house though, and don't see any glare around them, even the bare ones. I did find that I was actually less bothered by the bright lights of oncoming (or following) cars on the road (driven by those idiots who apparently don't know that they're supposed to dim their brights when approaching or following another car). That surprised me as I'm very sensitive to light, and in the past have been almost blinded at times when this happens on the highway. I went out into the backyard (in a small town) the next night when it was clear (but still no moon) and could see the stars pretty clearly, also cirrus looking night clouds scattered through the sky. There was once again a little bit of glare edging the stars, but I could define clusters of smaller ones in the sky in addition to larger individual ones.
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A week since the surgery of the second eye, and I have to say that I am still in love with these lenses and my vision.