eyhance review

"the option to use progressive glasses that has a range of about +- 1D which is not as irritating as using thick progressives when iols are set for distance or near"

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My experience does not totally match that. I think it would be wrong to think that your progressives would be "thick" if you have an IOL set for distance. Yes, if the IOL is set for close, with a -2.5 D residual, the lens will be somewhat, but not excessively thick. That is kind of a standard myopic correction with eyeglasses. It is not at all like a highly myopic correction of -10 D or so. Keep in mind that myopic corrective lenses (minus numbers) are thin in the middle and thick at the edges. Far sighted lenses are the opposite. You notice lenses that are thick at the edges and not those thick in the middle so much.

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As an example I have an IOL in my right eye set for distance. My left eye is mildly myopic and with mild astigmatism. Since it will be some time until I get cataract surgery in my left eye, I have gotten progressive glasses to wear when I want the very best vision (like driving at night). Here is my current eye glass prescription:

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Right: Sphere 0.00, Cylinder -0.75, Add +2.50 (IOL eye)

Left: Sphere -1.25, Cylinder -1.25, Add +2.50 (non operated eye)

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So what do the glasses look like? Well, overall these are the thinnest and lightest eyeglasses I have ever worn since I started wearing eyeglasses as a child. I used to get high index (1.75 or so) lenses but these are just the standard 1.6 material. In the past before presbyopia and more recently cataracts I was getting glasses in the more medium myopia range of -4.0 D. With age and now with cataracts my vision has actually gotten significantly better from a required power of correction point of view.

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Of these two lenses the right one is much thinner and lighter. You cannot see the thickness of the lens projecting out beyond the fairly thin eyeglass frame. However the left one is noticeably thicker and the lens thickness does project out.

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Long story, but if the objective is a light thin lens the best way to obtain that is to go with an IOL that is fully corrected for distance (no myopia). Since my plan is to go with a -1.25 under correction in my left eye for mini-monovision my left lens is probably not going to change much. I do hope the degree of astigmatism will be reduced and the lens will be a bit thinner, but it will not be as thin as my right eye lens.

Hi Peterfox thanks for the encouragment. Your surgeon suggested the both eyes -1 route? that is a good sign i hope i made the right choice. I think if my Eyhance eye stays at the 10 day today mark I wont need vision correction at worst indoor -1.25 reader for tiny print. The real test is both eyes seeing that same -1 together after his week second eye surgery day. Did you have cataract surgery done yet and how were your eyes before and which lens did you choose?

Hi Peterfox thanks for the encouragment. Your surgeon suggested the both eyes -1 route? that is a good sign i hope i made the right choice. I think if my Eyhance eye stays at the 10 day today mark I wont need vision correction at worst indoor -1.25 reader for tiny print. The real test is both eyes seeing that same -1 together after his week second eye surgery day. Did you have cataract surgery done yet and how were your eyes before and which lens did you choose?

rwbill when you say with cataracts your vision has gotten better do you mean that second sight stuff or when wearing corrective glasses. you are right about thin lens for no myopia cause when i got temp glasses to wear for just the week before cataract measurements when you have go without contacts those glasses were so damn thick instant fun house effect myopic glasses. When will you get that left eye correction? How long have you gone with a contact in just one eye? Im going on ten days and its functional but the blur wasnt noticable as much before the surgery on the first worst eye now the blur in soon to be operated eye seems so much worse with combined with eyhance eye

sorry rwbill i meant say how long with glasses on both eyes. If you have one iol and one uncorrected eye do both eyes work together with glasses at same time

I have gone just over a year now with a contact in my left eye. I suspect I will not get the go ahead to have the second eye done when I am due for my annual eye exam soon. I see a bit of a double image now, but my corrected vision is probably still 20/20, so that will be a no go. Will probably mean another year with one IOL eye, and one mild cataract eye. I don't mind it all that much except for the part of the day when I give my contact eye a rest and wear progressives. Wearing glasses has become annoying.... Seems like it is impossible to keep them clean.

Yes both eyes work together even when wearing glasses. I do get a bit of a dizzy feeling when I first switch from wearing one contact to wearing the progressive glasses. But that goes away fairly quickly. I do see a bit sharper image with the glasses on as both eyes get fully corrected for spherical and astigmatism.

Wearing glasses has become annoying.... Seems like it is impossible to keep them clean.

Do you have any sort of anti-scratch/anti-glare or other coating on the lenses? They make keeping glasses clean well nigh impossible; my optometrist confirmed this. For my latest pair I got them without any sort of coating, and now they're very easy to keep clean.

Yes, they have the anti-reflective and anti scratch coating. They are Kirkland Signature™ HD Digital Progressive Lenses. I can't remember if the lenses were available without a coating, but I think not. I expected these glasses would be temporary and didn't want to blow big bucks on them. I had decided the same a long time ago about coatings. The only glasses that have ever gotten scratches were ones that had this so called anti-scratch coating. I kind of think it is all a scam. If you buy glasses at a optometrist with all their recommended options the price can easily get up over $1,000 a pair. In any case when I get my second cataract eye done and get progressives I will attempt to get lenses that are not coated as the coating does make it very hard to keep them clean.

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Due to this problem in previous pairs of glasses I have ended up making my own cleaning solution and I may have not perfected that yet.... I was not happy with the solutions sold at Costco, but I kept the spray bottle dispensers and now use 80% distilled water, 30% isopropyl alcohol, and 1 drop of Dawn dishwashing detergent. It seems to work better than the name brand stuff I bought. Part of my problem is that I have a collection of cleaning cloths that are likely in need of a thorough washing.

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The bottom line is probably that I have become spoiled by being eyeglasses free for about 95% of the time. As soon as I put glasses on, I immediately focus on the smudges on them....

Hi Mary.

Yes he says -1D both eyes give the best satisfaction rate as most monofocal lenses still give you 20/32 at distance with -1D. As RonAKA has said before, that is still considered good vision Although not perfect distance you gain so much close vision that it is worth it and having both eyes the same setting gives you almost perfect 3d perception. If you are happy with your distance vision in the first eye I would recommend the same for the second, or if you want to get slightly better distance then I would think -0.5D would be the perfect sweet spot for the second eye. Ps. my cataracts are still very small so I have not done it yet as I have perfect accommodation still...from far all the way down to 7cm. So I am not yet willing to lose my accommodation for better clarity.

I wish you the best and hope your second eye turns out even better!

Thank you Peter Fox, what do you mean about accomodation and how does that work with seeing? what is 7cm? I meet lot people who are just diagnosed and they have no idea about choice of premium or monofocal iol about tweaking prescription about mono or plano. I would have gotten distance plano both eyes probably the zcboo not the just approve eyhance without this forums advice and reading about others experience. Read so many funny points on forum about most just go with surgeons decision. In the end that might be best but for any myopics ask Dr about leaving a little myopia instead of plano and ask about monovision or same diopeter of myopia for both eyes and real important dont end up with a + diopeter

There a string of stores i found looking for temp glasses for one week before surgery couldnt wear contacts. called Americas best stores all over country. cost me 69 bucks for two pairs and exam included. huge choice of glasses and very transparent in pricing for upgrades. For our Canadian buddies not sure if they have a sister chain there too.

Hi Mary

Accommodation is the ability of your natural lens to focus from far to near and any distance in-between. Presbyopia is when your lens looses the ability to do it when you get older.

All implants generally used by surgeons has no accommodation as the IOL is a stationary piece of plastic.

Hi Peterfox

I have always been cursed with myopia. I guess even with age I dont know if I would have noticed presbyopia everything beyond my extended arm elbow get blurry with cataract worse. This is an important question. Do monofocals not have accomodation? Is that why some multi focals are called accomodating?

Hi Peterfox (posting again sometimes forum doesnt list post in order)

I have always been cursed with myopia. I guess even with age I dont know if I would have noticed presbyopia everything beyond my extended arm elbow get blurry with cataract worse. This is an important question. Do monofocals not have accomodation? Is that why some multi focals are called accomodating

Hi Mary.

Yes monofocals has zero REAL accommodation. The lens you have and many others try to replicate a little accommodation without any movement with some "tricks" which in turn causes loss of contrast and many other negative effects especially when it comes to multi focal lenses as they also has no ability to move like a natural lens and has to split the light to different focal points.

In your case prior to surgery, when you are young the natural eye still has accommodation even if you have myopia but of course the range of focus is very limited with myopia.

Your natural lens can change shape and change the way it focusses. The popular monofocals as well as multifocal and EDOF (like the Eyhance) do not change shape. They are fixed. Essentially all they do is present multiple images to the eye for different distances and your eye/brain is expected to pick the one that is in the best focus. There are some lenses, like the Crystalens and Trulign, that try to accommodate and change focus, but they have not really become mainstream.

Multifocal, which I have in one eye, are not accommodating. The only FDA approved accommodating IOL I am aware of is the Crystalens. That IOL has fallen out of favor being it did not work as promised.

I think what might be at the heart of the confusion is that even though a monofocal focuses the light at a single point, it does not meant that distance is the only place you can see. For lack of better words there is a natural EDOF effect. In other words it is not like at 200 feet you see 20/20, but at 199 feet you see 20/200.

That is where the defocus curve comes into effect. In your case you set your Eyhance to see the best at -1 (D), which I think is around 40" off the top of my head; I might be off but for argument sake it does not matter as just using it for an example.

So you will see your best at 40", lets say that is 20/20. As you move closer in or further out your vision will slowly degrade. So you will still be able to see distance but it will be degraded vision from 40". From the defocus curve the average person would see 20/32 with -1 (D) myopic setting.

A true accommodating IOL, which as I said does not truly exist, would adjust the IOL shape to redirect the focus point. The only thing that does that is your natural lens, that is removed during cataract surgery.

All other IOLs use some trickery to get EDOF, but none are accommodating IOLs.

Not sure if that is clear or not.

I have always been cursed with myopia. I guess even with age I dont know if I would have noticed presbyopia

People with myopia need glasses to see clearly in the distance with their eye at rest but can still read 9" from their face with their glasses on when they're young. That's because their eyes can refocus. As you get older and lose that ability you have to take your glasses off to read because your eyes are no longer able to refocus enough to overcome the distance correction in your glasses. So that's how myopes start to notice presbyopia… they notice they have to start taking their glasses off to read.

Yes visual acuity is a gradient. Just think about manually focusing a camera. It's not like the image in the viewfinder snaps from a total blur to tack sharp in an instant. The image gradually becomes more or less in focus as you turn the focus ring.

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As for accommodating IOLs, they don't exist yet. Crystalens doesn't count. It doesn't work.

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A monofocal IOL focuses 100% of incoming light at one fixed point. That point will have the best focus. Objects closer or farther from that point are not a complete blur, they're just not as sharp.

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A multifocal of EDOF IOL focuses portions of the incoming light across various points at the same time. Instead of shifting 100% of the light to near or far like a human lens it just spreads the light out giving some to near, intermediate and far. That's why the image quality and contrast suffers, because nothing you're looking at is ever using 100% of the incoming light and because everything you look at is both in focus and out of focus at the same time! Your brain just processes out the out of focus parts.

"I have always been cursed with myopia. I guess even with age I dont know if I would have noticed presbyopia"

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Being myopic all my life I certainly noticed when presbyopia developed. When my eyes still had accommodation I could wear my myopic correcting (-4.0 in my younger years) glasses and still see close up with the glasses on. When presbyopia developed I started to lose that close vision with my glasses on. However, it was easy to remove the glasses when I needed to see close up. But, out of convenience, I got progressive glasses with a +2.5 add. But the real eye opener came when wearing contacts. Taking contacts out when you are in a store trying to read fine print is not nearly as easy as taking your glasses off. Readers became essential to read fine print. That is when I pretty much stopped wearing contacts and went to progressives full time. I really disliked having to carry around readers everywhere.

when i watch tv my eyes transition from intermediate to far without any refocus with eyhance is that what accomodation does in real time?

you get it we can see real close up but with contacts need glasses eople think with contacts you can see close up too Ron had second eyhance done different experience. first off thanks Lucy for the encouragement the versed was almost pleasant this time although i heard voices did not see anything heard dr say mary stop talking. total blur night of surgery when i took patch off for drops heart attack time total huge spiderwebs from lights other light halos. eyes did not match up a little pain this time. first eyhance perfect vision hours after surgery no pain. day after check up after praying all night went for post op Dr was pretty cool he didnt perform surgery. Based on yall i went in armed with misalignment pco astigmatism etc. i said please dont tell me its normal and go rest in a nice way. turns out he did a total thorough exam cause he said you know more than me thanks forum buddies i saw cool iphone pic of implant perfect position my retina pic vitreous pic etc all perfect He did see some pco and told me i had three cataracts heads up my second eye was better over weeks it got so bad Dr Magic warned me pre op about pco post doc said he probably saw something Total respect for Dr Magic and Dr Cool. I said just yag me and he started laughing i guess forum knows why. He said eye must heal first and gave me post op glasses or contact appt and we will know from there. I went store got readers and was nervous that readers had no effect on new eyhance blur eye. Within hours I started seeing clear and although my just operated eye does not have same sharpness as first eyhance i couldnt be happier. both eyes are working together and the readers i got now take away blur on just operated eye which is a good thing maybe with pco readers would not take away blur? Spiderwebs gone halos gone thank you that was so halloween like no joke. Im sitting typing now with no readers just left store and my vision is great at both eyes -1 eyhance maybe the tiny blur is pco maybe the tiny blur will go away maybe i will get contacts in any case both -1 works great and if i had to without any correction i could see as in now and be totally satisfied. I really think eyhance is better than basic monofocal i see all distances without having to refocus my eyes just transition smoothly. Big question is it possible to have all three types of cataracts on one eye at same time? and does that happen really quickly? Million thanks buddies i would have gone into this whole cataract stuff clueless .

I did a bit of research and yes, it does appear there are three basic types of cataracts at least according to one article I found. If you do a google search for this phrase you should find it:

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"Understanding the 3 Different Types of Cataracts September 10, 2019"

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They are:

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1. Nuclear Sclerotic Cataracts - These start in the centre of the lens and progress outward to the surface of the lens. Said to be the most common type, and progress slowly.
2. Cortical Cataracts - These are the opposite, and start at the surface of the lens and progress to the core. Said to be more common in diabetics.
3. Posterior Subcapsular Cataracts - These form at the posterior or back of the lens. Again said to be more common in diabetics and they can progress rapidly.

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   Something to keep in mind is that it is kind of irrelevant what type of cataract you HAD, as they are gone after cataract surgery.

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   Keep in mind that if your lens implants actually left you short sighted at -1.0 D myopia, you will not have sharp vision at distance. I would expect you could not read the 20/20 line on an eye chart but possibly the next biggest one. And if both eyes are at -1.0 D both eyes will left the same and the 20/20 line will be a bit of a blur. If only one eye (micro-monovision) is at -1.0 D and the other eye is at 0.0 D, the 0.0 D eye should see the 20/20 line perfectly, and if your brain has this choice when you have both eyes open, it will ignore the -1.0 D eye, and just give you the sharp image from the 0.0 D eye.

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   Also keep in mind that the YAG laser is done as a last resort. The lens is inside a capsule in your eye. The YAG laser essentially burns a hole in the capsule, and cannot be reversed. This complicates any further surgery on your eye.

thanks Ron is it possible to have different types of cataracts at same time in each eye instead of just one of the three? and Dr Cool said he did see something behind eye i assumed he meant pco but all blur gone now if it was pco could Dr see it could one develop it day after cataract surgery? and can pco be corrected with glasses or contacts or unlike myopia or far sightness which can correct pco is type of blur that cant?

My understanding is that a cataract can't come back after the lens is removed. PCO can develop but that is usually not for some time. PCO is a physical build up of material in the eye, and cannot be corrected with glasses or contacts. If it really is PCO then YAG is the only treatment I am aware of.

when i watch tv my eyes transition from intermediate to far without any refocus with eyhance is that what accomodation does in real time?

No. The natural eye physically shifts 100% of the light from near to far. IOLs simply spread the light out over a wider range of distance.

hi Ron, how myopic are you in the non operative eye? i have cataract in L eye but R eye is good. I am high myopic -11 and -12. Would i anle yo do surgety on cataract eye and not have to mess with the good eye?

Sam,

My eyes prior to cataract surgery were mid to mild myopic at about -2.0 to -2.5 D. I went about 18 months with one eye done for distance and not the other. After surgery I got progressive prescription glasses that corrected both eyes for distance and near with a progressive add of +2.5 D. However, I wanted to test drive mini-monovision and got fitted with a contact lens in my non operated eye that left me about -1.5 D. It was better than the progressive glasses solution and I pretty much used the contact solution full time.

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Being in the -11 to -12 D range is much more significant. My guess is that you could not tolerate having one eye fully corrected with an IOL and the other eye corrected with an eyeglass lens. The problem seems to be that the eyeglass lens is located at a different distance than the IOL lens and this results in each eye sending an image that is in focus but a different image size to the brain, and the brain does not like that much. I noticed it with my more minimum correction but I suspect you would really notice it to the point of it not being tolerable.

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I think you have two possible solutions. One would be to go to virtual full time contact use in the non operated eye after your first surgery. If you can find contacts that are ok to wear that much, that may be the best solution. The other option is to get both eyes done with an IOL even though one eye does not need it.

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Let me know if you need help with contacts. I tested quite a few different ones and I can let you know what was best for me.