Does this strategy make any sense?
Posted , 9 users are following.
Hi,
I'm hoping to get some input as to whether the strategy I'm about to describe makes any sense.
Initially, my consultant/surgeon suggested I get a mono-focal lens for distance in my bad left eye and leave my right eye, which is quite good at near vision, intact. Thus I would get the mono-vision effect. But he did say I would be separated by slightly more than two diopters as a result and that I may not adjust to that wide a separation. He also then suggested the Tecnis Symfony lens in BOTH eyes. But I'm now thinking maybe I could achieve reasonable results getting the Symfony in just the (bad) left eye, and keep the right eye intact. I reason that I would still have the benefit of the reading vision for the right eye, with the advantages of distance and intermediate with the Symfony in the left eye, along with some Symfony support for reading as well.
I saw a YouTube video of a vision doctor who himself was implanted with the Symfony in only one eye, but his other eye was good for distance and he had good overall results. In my case, my "good" eye is not good for distance, but rather good for reading.
Has anyone tried or heard of this strategy being successful in a similiar/same situation as mine? Thanks much.
Kind Regards,
?IG
0 likes, 35 replies
lynne75659 indygeo
Posted
Oops, sorry. I meant to direct my previous question to j89867 rather than indygeo. I see now that I probably should've started a new thread.
michael74313 indygeo
Edited
I have two mono focal lens that I got almost a year ago (three weeks apart for each eye). My doctor set the first mono focal to distance and the second one in 1/2 diopter from distance for mini mono vision for a better range of vision. Full mono vision would drive me crazy but almost everyone should be able to easily tolerate 1/2 diopter without even noticing it and depth perception should not be compromised much if anything at all. I see just great at all distances and almost never need reading glasses. I did have to retrain my brain to hold my phone about 16" away from my eyes rather than 5" prior to surgery (I was very near sighted and used to seeing everything up close). Perhaps not everyone can expect these results but it worked out great for me. I have no glares, starburst or any halos whatsoever.
I will say that things are still a little blurred up very close (within a few inches) but it has gotten MUCH better over time and continues to do so. I just now tested and was able to read the letters of an address in a window envelope only 5 inches from my eyes (probably an 8 point font). Although I don't hold anything that close to my eyes anymore and would now naturally hold it around 14" -18" away, I do believe that trying to find that "sweet spot" for reading (without glasses) has improved my near vision over time (rather than going straight for reading glasses).
One thing to consider is there can be an error factor of up to 1/2 diopter so in hindsight if you consider mini mono vision it might make sense to set the first eye 1/2 diopter in from distance and the second eye 1 diopter in from distance. If distance is more important to you then you could set the first eye at 0 diopter and the second eye at 1/2 diopter in which is what I did. Any range is possible but by setting the two eyes about 1/2 diopter apart, you'll get a better range of vision with mini mono vision.
Second thing to consider is what is easily fixable and what is not. If you can't see well at a certain range such as near, mid range or distance then it's easily fixable with glasses. I don't know of any easy fix for halos and starbursts which bother some a lot while others not at all.
I can't say for sure, but I think starbursts and other artifacts would drive me crazy (it's just not natural to me). I never have any problems with night driving and I'm in front the computer a lot during the day and my mid range vision is excellent. The challenge after my second surgery was trying to find ways to continue to improve my near vision so as to be as glasses free as possible. I have a very flexible silicon case for my iphone and I keep a credit card magnifier in there (between the case and the back of my phone) that I use once in a while for reading really tiny print but I'm finding I need that less often also. I can even read the print now on a medicine bottle (so long as it's in sunlight or I have the led light on from my phone).
I will say that after my first eye was done, I was quite upset about losing my near vision. That's when my doctor suggested setting the second eye 1/2 diopter in for mini mono vision. I tried a "test contact lens" for the second eye after the first surgery. But, that was a bad test for me because my IOL works much better than the contact lens did (probably because the cataract makes things worse at all ranges). So, I'm glad I ended up going only 1/2 diopter in and no more than that. Over time I have found various ways to continue to improve my near vision.
Good luck to you.
indygeo michael74313
Posted
Hi Michael, Thanks so much for your response.
What you're experiencing is really what I hope to experience. Tonight, I spoke with my father who had mono-focal lenses put in about 2 months ago and he said he has quite good vision at almost every distance, but with occasional need for reading glasses. He said he feels 50 years younger due to his better vision these days. He's suggesting I go with a mono-focal lens. I'm really inclined to do what you did and go for the mini-monovision ultimately if I find my brain can't handle the degree of diopter difference with my existing uncorrected, nearsighted right eye, and my left cataract-effected left eye. Sort of a 'step by step' process. I just don't know how I would adjust to bursts and halos if they were to be present after a final outcome with the Symfony. Maybe I'd be okay with it, but then again maybe not. I'm not sure I want to risk it since I do see myself doing quite a bit of night driving. I also enjoy astronomy/star gazing. Ugh...this decision process is so mind-numbing. Thanks again for replying.
IG
michael74313 indygeo
Posted
Right - for me after my right eye was done and set for distance I could not tolerate the vast different being so nearsighted in my left eye. My left eye had a mild cataract and nothing compared to my right eye. So I decided to have my left eye done since the cataract would only get worse over time and I could not stand the full mono vision. Also, poking the right lens out my glasses to try and "even out" the vision did not work so well for me. But, it (the full mono vision) was all temporary until I got my other eye done. Best advice I can give you is to make sure you have a really good doctor.
Mike
Night-Hawk michael74313
Posted
Michael, have you gone to an optometrist to get a refraction recently to determine how close to the target you achieved for each of your eyes?
Your getting good vision at 16" distance is amazing with only a -0.5D offset unless you actually got a bigger offset, I would expect -1.0D or more would be needed to get that.
michael74313 Night-Hawk
Posted
No I haven't but given my distance vision is 20/20, I suspect we came pretty close. Also, my ophthalmologist's office can easily test that when doing a follow up visit.
Regarding good near vision - that's why I suggested one could consider mini mono vision at -0.5D and -1.0D. Mine were set to 0 and -0.5D and I think we pretty much hit that target even though I know there's an error factor of 0.5D. At my last checkup (my six month checkup in October) as I best recall I was seeing 20/20 for distance in my left eye and 20/20 (minus a few letters) in my right (so on that day my right eye was seeing either 20/25 or better than 20/30 but I can't recall exactly).
My right eye was set for 0D but usually does not see as well for distance as my left which was set for -0.5D because the toric lens shifted slightly in my right eye. For near vision they have me using both eyes and didn't test each eye individually. I think it was either 20/30 or 20/25 but I can't recall. But, I'm positive that my near vision is even better today than it was back then in October. The only thing I can really attribute it to is that I try to be free from glasses. In the beginning, I didn't want to struggle or strain. Rather, I just had to reprogrammed my brain to start hold things further away than I was used to (which was 5 inches). It just got easier over time.
Every so often, when I'm reading something small, I'm curious if one eye is better than the other so I'll place my hand over each eye to see which is the "good eye" for near vision. Surprisingly, it seems to vary depending on the day. Today, when I was reading the small print on a medicine bottle (with the sun shining through the window which helps a lot) I was surprised to find it was my right eye that was slightly better today than my left to read such small print and my right eye is set for 0D. My near vision out of that eye was terrible a year back when I had cataract surgery.
Sue.An indygeo
Posted
Sue.An michael74313
Posted
michael74313 Sue.An
Posted
Right - that could also be the reason they say that symphony for it's multi range of vision is best when used in both eyes. But, based off of what I have read here, I'm glad I have mono focal lens in both eyes set for distance with mini mono vision and a difference of 1/2D.
Sue.An michael74313
Posted
In the end glad they’ve worked out for me and surgeries are behind me.
indygeo Sue.An
Posted
Hi Sue.An, Yes, good point about the NHS. It would indeed cover the cost of a mono-focal. In fact, I initially started with an NHS appointment and they suggested a monofocal lens (of course, that's all they provide). They didn't go into whether it would be an "aspheric" monodical lens though. I've got a call into them to find out exactly what kind of lens they would consider for my situation. Thanks again!
G
j_89867 indygeo
Posted
Night-Hawk j_89867
Posted
Ah, yes pupil size - that could be a big factor between different individuals getting different focus range results with monofocals! Pupil size does descrease with age, so focus range should get a little better the older you get then.
My pupils are larger than what is average for my age from a table of pupil size vs age I found, so my right eye with a monofocal toric IOL set for distance vision, I can see clear and sharp from about 3or4 feet or farther, but I need a little correction (+0.75D to +1.25D) for computer or smartphone distance of about 20 to 28"
indygeo j_89867
Posted
Thanks j898, That's good to know. I wasn't even aware pupil size came into play.
Kind Regards,
G