How long to get used to new IOL?

Posted , 10 users are following.

Hello, I just had my first eye surgery on Jan 9th. The other eye has a cataract and surgery is scheduled in 2 months. I an high myopic and using a contact lens in my undone eye.

I am feeling two eyes are not working well after first surgery despite using a contact lens. my surgical eye can see well by itself but with two eyes.

I felt disorienting and nauseated at times, my brain seems to twist and stress a lot. My depth perception is a bit off when looking down. anyone has that problem? Do you know why? Do I need sometimes to adjust to new vision?

0 likes, 126 replies

126 Replies

  • Edited

    Since you are doing the other eye, I presume you went for a full correction in the operated eye? With a contact lens in the unoperated eye, there is an image size difference now, between the two. While it is not nearly as pronounced as it would be with glasses, it is still there. The image, in terms of lighting, looks a bit different as well, because the artificial lens is letting more light in.

    You likely will adjust in time to the difference(s) as your brain works towards reconciliation of it, but once you get the other eye done, they will be more nearly matched, with regards to that. We all can be a bit unique, so I don't believe a specific time that is tailored to you, can be furnished, on when you will eventually neuroadapt / adjust / reconcile.

    • Posted

      My operated eye's image does look a touch bigger than the contact lens eye. is that why i feel the operated eye is somewhar magnifying?

      Initially i thought the refraction was wrong. The operated eye supposed to target -0.6 but ended up at -1.75. So i asked my optometrist to let me try a contact lens that is -0.5 lower than my power. However i dont feel much difference dropping from -1.75 difference between eyes to -1.25.

      Do you know the nauseating and disorientating are from the image and light difference? or the refraction?

    • Posted

      Consider going the other way, and try a contact that gives you -0.25D

      If light adjusting lens is feasible for you, consider that . Think about it... they missed the target on the first eye by 1.15D.

      Also, you did not mention cyl.

    • Edited

      The disorientation / nauseating effects are more likely from the Aniseikonia, as also relayed by the other posters.

      If you did not find some relief from manipulating the refraction, such so, in an attempt to more match the size differential, you may need to just ride it out, as the surgery for your other eye is not too far off.

      I can tell you from personal experience, even though my particular situation differs from yours, any potential ill effects from a new prescription (and resulting image(s) display), especially one that has not really been encountered before, takes some time to flesh out.

    • Posted

      Missing the target by 1.15D is not considered a fail in high myopia. It is a common occurrence. That is why it is good practice to aim for a refractive target of one to two diopters of myopia, so a patient doesn't end up with a disastrous hyperopic overshoot. -1.75D is a huge improvement from the presurgical refraction and should enable clear near vision without glasses.

    • Posted

      Did you also have that nauseating feeling after your first cataract surgery?

      Will the second surgery balance my eyes out? i am beginning to worry that the second surgery wont solve my ill feeling!

    • Posted

      I can see phone if hold out to about 18". However i find it hard to ficus on my laptop that is about 22" away! does that mean i will need a reader for laptop?

    • Edited

      Missing the target by 1.15D is not considered a fail in high myopia. It is a common occurrence. That is why it is good practice to aim for a refractive target of one to two diopters of myopia, so a patient doesn't end up with a disastrous hyperopic overshoot. -1.75D is a huge improvement from the presurgical refraction and should enable clear near vision without glasses.


      Sounds like that could be a good reason for a high-myope to try to get the LAL, if the predicted residual astigmatism is not too high.

    • Posted

      It sounds like you may need glasses but I don't think they would be called "readers" because "readers" are usually the +D glasses that are sold in drugstores. You would need corrective lenses like you've always worn to see the computer, but in a much lower Rx, for example -0.5D.

      You could also try changing font sizes and/or moving your monitor, using a laptop instead, whatever accommodations you need to see clearly without eye strain.

      Good luck!

    • Edited

      I was implanted with a power that gets closer to my unoperated eye, uncorrected, for balance. I did not feel vertigo / dizziness from this. I did go ahead and boost the refraction in the operated eye w./ a contact lens, to a point I've never really had it, before, to try and get some more depth and usability out of it. From this I did experience some, at times, for some time. I have nearly adjusted and do not really feel ill effects of this sort any longer.

      I believe after the second eye is done, where it is more closer to the other eye, this 'should' near-alleviate for you. By then though, you may have adjusted.

    • Posted

      So even with a contact lens in the unoperated eye, the difference between eyes is still large enough to feel nauseated?

      operate on one eye and use a contact lens in the other was one of the choices my surgeon gave me! The imbalance was a shock to me!

    • Edited

      In my specific case, my ill feeling was due to having a level of increased negative power in an eye that has never been taken that far, prior and the illusion of more depth (one that I've never really had / experienced, prior.).

      Without contacts in both eyes, my operated eye is closer to my unoperated eye so I don't really experience aniseikonia. It trails it a bit (I've been operating with this eye trailing the good eye by a decent amount for quite a long time). There's a scleral buckle there adding to the myopia so that adds another variable in to the final target achieved. Currently, I use the same negative power in both eyes (I will likely increase / decrease a little bit on next renewal time in the operated eye, depending on how the next months go in my observation, adjustment, etc.).

    • Posted

      If you think the IOL and contact lens combination is bad, try taking the prescription lens out of your operated eye in your pre cataract surgery glasses and try using one eye corrected with an eyeglass lens and the other with an IOL. That makes the effect much worse.

    • Edited

      Just musing.... I wonder if it would be practical to have a compound lens in an eyeglass frame that would adjust the observed sizes of things.

      This could be potentially a special frame that holds two or three test lenses into a position. That would be clunky for normal wear, but it would seem useful to test drive lenses to check out prospective degrees of monovision.

      The math to predict the proper lenses and placement would be complex, but the implementation, once you have the results of the math, would not be all that complex. Test lens sets are relatively inexpensive. But normal test frames are not able to hold multiple lenses at specific spacing. Maybe the subframe holding the lenses could be 3-D printed, and that assembly would be put on a standard test lens frame.

      The special compound lens combo could be designed to be worn over the operated eye or designed to be worn over the other eye.

    • Edited

      Patients start to feel the effects of aniseikonia when the difference in image size is greater than 3%. This forum doesn't like me to post links, but if you search "aniseikonia" and "iseikonic lenses" you may find some information explaining why you feel badly. It is a big adjustment for your brain!


    • Posted

      Image size differences are a bit beyond my knowledge of optics, but I think it is a side effect of the distance between the correction lens and the lens in the eye. Not sure how you could adjust it other than with the amount of correction applied.

    • Posted

      Telescope makes image larger.

      Look backwards thru a telescope, and the image is reduced.

      I am suggesting that two lenses or 3 could get the expansion/contraction ratio to whatever you wanted.

      Yes, that would be hairy math and physics.

    • Posted

      The bottom line is that you need the power of the lens that you need. You cannot change it arbitrarily. However the closer the correction lens is to the lens in the eye, the less impact it has on image size compared to the other eye which has no correction.

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