Does my lens choice plan sound okay?
Posted , 4 users are following.
So thankful to have found this forum. It isn't found easily!
I am extremely nearsighted (-13 in left eye and -10 in right eye). Right eye does not need surgery at this point so it gives me some time.
I've worn progressive lenses for several years (Alcon Dailies contacts). I've worn contacts for 50 years and frankly my eyes are just tired of them. I take them out about 5 pm and put on my progressive eyeglasses. Unfortunately even with excellent quality lenses my vision still is not clear. On a good day I can barely read road signs like other people can.
I'm concerned about what my close vision will be like after surgery but I've been unable to see clearly for so many years I think I will welcome surgery on my left eye. My best vision ever was when I wore genuine glass lenses. Everything is so very clear and crisp.
After reading all this and more, I think I am leaning toward the mono lens for distance correction on my affected left eye. I'll have time to diddle with my right eye and figure it out. I'm thinking I can get mono vision contact for my right eye (undercorrected) to see if my brain can figure it all out.
I've done so much research the last few days and frankly I am scared of the multi focal. My doctor did suggest them but told me right up front of their drawbacks. He explained why the halos were there and about the light source being divided, etc. He didn't mention Vivity.I have negligible astigmatism I think.
Does my plan sound okay?
0 likes, 5 replies
RonAKA nancy03915
Posted
I take it you have a cataract in your left eye that is impacting your vision? And possibly one in your right eye that is not as bad?
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Assuming this is the situation I think your plan is basically good. Monofocal IOLs are the lowest risk, and even in monovision they are easily corrected to best full vision with progressive glasses.
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The one check you should do is to determine which eye is the dominant one. With both eyes open and your arm extended point at a small object across the room. Close your left eye. If you are still point at the object, then your right eye is dominant. If not, then left eye dominant. This usual practice is to use the dominant eye for distance and the non dominant for closer up when doing monovision. This can be reversed, but it is better to have the non dominant eye as the close eye.
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It is also best to test drive monovision with contacts before you jump into it with an IOL solution. Since you are already using contacts that is easy. Just reduce your correction in the eye you are going to use for close vision by -1.5 to -1.25 D. For example with your right eye as the close one, use a -8.5 or -8.75 D contact instead of -10 D.
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It can be difficult to accurately measure high myopia eyes for an IOL. You may want to search for a doctor that has experience in doing high myopia surgeries.
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I am currently simulating monovision with one distance IOL corrected eye, and by wearing a contact in the other eye. I have tried many different contacts including the Alcon Dailies Total 1. I found it to be OK, but the best ones, and the ones I pretty much use for a full day are the Costco Kirkland Daily lenses. They are made by CooperVision, and I find them to be more comfortable than the Total 1 and Acuvue Oasis 1-Day, although those two were my second best choices. If you want to simulate monovision I find Costco to be quite cooperative in giving me free samples to try, after I explain to them what I am trying to achieve.
nancy03915 RonAKA
Posted
Thanks for your reply. Yes, I learned from here how to test for dominant eye and it is definitely my left eye (the cataract one).
With the Alcon multifocal contacts I am wearing the right eye under corrected so I do not have to wear reading glasses. My doc is quite helpful and does have experience with eyes like mine.
Would my brain be able to process a multi focal contact in my right eye after my left eye surgery? Or should I go ahead and ask for a prescription for mono vision under corrected from the doc?
I already cannot see at night and I'm very concerned about lack of contrast because I already have that with my contacts.
RonAKA nancy03915
Posted
With this information, I would recommend going with a monofocal in your left dominant eye set for distance. The normal target is -0.25 D. You do not want to go over into the + side as it impacts close vision. For maximum night vision I would not go with a Vivity in your distance eye. It may be an option down the road for the close eye.
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You should not have any issue continuing to use a contact in your better right eye. To get a better idea what a monovision solution using monofocal lenses would look like, it probably would be better to try a monofocal contact in the -8.5 to -8.75 D range. The Costco I go to is OK with using a full prescription for the eye, and then under correcting by the amount to achieve monovision.
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I have not used MF contacts and don't know what they are like. I wonder if they could be part of the reason for poor vision? MF IOLs do have issues with them especially at night.
rwbil nancy03915
Edited
Not much to add over Ron's advice.
Due to your long eyes I would get a few IOL Master Measurements on different days and different machine and look for a doctor with experience dealing with very myopic patients.
You might also be a great candidate for the light adjustable IOL, which allows you to adjust refractivity post surgery, so you might also look into that.
Sue.An2 nancy03915
Posted
Wishing you well. sounds like you have a good plan. i would do as others suggest and get several measurements on different days. finding a good surgeon is as important as deciding on an IOL.
My own surgeon didn't stress too much over dominant eye. Doing tests Ron mentioned I thought it was my Left that was dominant. I had cataracts both eyes with RE a bit worse than LE. Doing same tests now my RE is dominant - likely LE compensated at the cataract was not as bad in that eye.