In the far IOl eye, can dry eyes effect far vision but not near?????
Posted , 12 users are following.
I am really confused!!!!
.
9-10 days post cataract operation far IOL eye vision keeps fluctuating from a range of 1 to 3 meters (10 feet) to 1 to 15+ meters (50+ feet). It goes anywhere from 20/25 vision to 20/70 vision.
.
BUT the first 3 m/10 feet have always stayed sharp throughout the 10 days!
.
Just now when I was about to post, she put lubricating gel and she was again able to see far and this time 20/20! It keeps going around in circles.
.
QUESTION-1: If it is IOL movement related then how come the first 3m/10 feet always stay sharp?
Ok when IOL is near to plano then you could technically read all the way to near/ intermediate, but when it moves nearer you won't see far but continue to see near/ intermediate.
.
QUESTION 2- It does seem dryness related to some extent but why is nearer/intermediate vision not impacted? This I don't have an explanation for!!!!!
.
The two drops that she is taking against infection/inflammation are
- Dexamethasone (steroid)
- Bromfenac (Yellox)
.
Both the above drops have dry eyes as a possible side effect. Surgeon had said take only the steroid drop due to the dryness/reaction she had to the disinfectant that was used during surgery.
.
On day 4 his clinic opthomologist said we can take Bromfenac (Yellox) as it won't do any harm and because wife could handle the same combination on the previously operated left eye.
.
I am thinking of stopping Bromfenac (Yellox) temporarily as long as we are still on steroid drops (4 more days of steroid drops left). Rational being to help the dry eyes go away (if it is dry eyes related). Restart Yellox in 4 days time when 2 weeks of steroid drops time is up.
.
Any insight?
0 likes, 60 replies
Mutti3 W-H
Posted
i dont have anything to measure my vision. But my distance stays pretty much at 20/20. The intermediate to close is the problem. When i use systane drops, the intermediate vision is better. But what really does does the trick for better close and intermediate is bright lightening and moist eyes! But i " throw " on some " reader" and read. Dim light is the worse . . But driving at night is great!
Guest W-H
Posted
I think you have the answer to your question - it helps with the gel, so yes, the problem is dry eyes 😃
I don´t really know about the details, but dry eye can really make a mess. When I was at my second day check with iol number two, I was ordered to use some type of artificial tears each hour the next 3 days because my eye seemed very dry to them.
And they said, it was not possible to use to many artificial tears.
I think I still have dry eyes some days here and there, my vision and side effects changes from day to day, but even the worst days are so much better than previous 45 years, so I don´t really care 😃
I have no doubt your wife´s eyes will turn out really well, she is a very good healthy candidate, with no other eye issues, she will end up with great vision, when the eyes have healed, and it all have settled.
W-H
Posted
Online surgeon on another forum responded to me
Cut and paste if in future someone else stumbles on the info-
.
Sue.An2 W-H
Posted
interesting comment. So IOL move very little and it is the incisions to cornea that account for visual changes.
W-H Sue.An2
Posted
My surgeon said that even 0.1mm movement of IOL can be noticed by patients. Maybe it was a typo and he meant 1mm?
.
Either way my surgeon said be patient. 10 days gone and wife will be going to work tomorrow. Near and intermediate vision is top notch though.
.
This morning after all the lubrication drops the best she could do was 20/40 vision.
.
Can be both I guess. In my wife's case I don't think it is the movement of the IOL. I think it is cornea surface and cornea post OP healing related. Or could be combination of all of them. I really don't know 😦
soks W-H
Posted
following.
Deb03 W-H
Posted
Does she have astigmatism in that eye? When will she the doctor and have vision tested again? It is still early. I know it's hard, but try not to worry...Coming from someone who is a huge worrier herself!
W-H Deb03
Posted
Hi Deb, I assume astigamtism is not an issue.
.
In her RE pre OP it was -.29 Cylindrical
.
1 day after OP -1.25 Cylindrical, Spherical +0.25
4 days after OP -0.75 Cylindrical, Spherical -0.25
.
In comparison the LE pre OP was -0.58 Cylindrical
5 weeks post OP it went down to -0.25 Cylindrical
RE was tested 1 and 4 days after the OP. First time surgeon checked it and the second time the surgeon's clinic's ophthalmologist checked it. Both times everything was healthy and normal apart from some dryness. Lens was centered, capsule fully clear. Retina ok too.
.
Ophthalmologist said come back in a month to see if we need fine tunning with glasses, if at all.
.
We can go back anytime we want though. Also we have option of our own private very nice female ophthalmologist.
.
I wanted to go to local eye glasses shop today to get the numbers checked but wife did not see the point as eye is in transition state so kind of meaningless. I still wanted to know though.
.
We went for a walk and she did see far again, car number plates around 10m/32feet away.
.
With her far eye she can read from 60cm/22inches. She can read that close now (10days later) and also on the day the Autorefractor said -0.25 (4 days after OP).
.
We will just wait and be patient! None of the eyes could just have been straight forward for us!!!!!!
soks W-H
Posted
Isn't it great that she can see clearly from far to 22 inches with a monofocal lens? Or is she seeing better at 22 inches because the far is not very clear?
Meuwth W-H
Posted
W-H,
Can you elaborate on the far eye that can read near vision at 22 inches? Exactly what font text is she reading? If you could give me some specific numbers, I would appreciate it.
Kind of outrageous for me to think about bc that kind defeats the purpose of the multifocals? Like what.
Meuwth
Posted
Edit: I can't tell if Im getting the benefits of the multifocal or not or am I just being scammed by the industry...
W-H Meuwth
Posted
Last night she banged out 20/25 and then 20/20 too. This morning she woke up and could bang out 20/25 without applying any lubrication drops.
.
So positive signs. I hope it stays. Have had enough of roller coaster for last 4 months!!!!!!
.
Last few days the vision swing was between 20/70 and 20/25....then between 20/50 and 20/25...then 20/40 and 20/25. So it does seem to be improving.
.
She continues to be able to read J1 with her far eye at 55cm/21.6 inches.
.
She is back to her office job.
Yes sure...
.
Her far eye is still healing but yes it can read J1 text held at 55cm/21.6 inches.
At last eye measurement that she had, her far eye was at -0.25 (which was the target). No idea if it is still there or -0.5 or -0.75 or even over in the plus direction. My guess would be between -0.25 and -0.75.
.
Jager eye test chart is what she used to check near vision on her far eye. J1 is VERY small text.
.
I don't know if you can call it a scam but there is a huge marketing element involved and obviously big money. Everyone has to make their own decision about what constitutes a marketing scam.
W-H soks
Posted
The million $ question lol 😃 Check my latest reply before this one (to Meuwth).
.
The latest signs point to from near 21.6 inches to far 20/25....sometimes touching 20/20 vision. Next few days and weeks will clarify that. Stay tuned.
Guest Meuwth
Posted
Edit: I can't tell if Im getting the benefits of the multifocal or not or am I just being scammed by the industry...>
Premium lenses are not a scam, the science behind them are quite clear.
Most people that gets monofocals get good far and intermediate vision, and need glasses for near. Some have better results than that with monofocals, but only the lucky few.
With a trifocal you get all distances on both eyes, getting full vision and the binocular bonus of seeing the same thing equally good with both eyes.
But there are big money involved in premium lenses as well, whether they are worth the money and the side effects is a personal choice.
soks W-H
Posted
thats the eye lottery then! celebrations are in order.
Sue.An2 W-H
Posted
A multifocal usually provides better reading than at 21.6 inches (that is on far edge of what I would call near vision. (How did you get 21.6 - with s measuring tape?)
When I was tested for reading at 24 hours post op the test was at 14 inches which is where reading is tested. I guess if one has long arms 21.6" could be considered reading distance.
Meuwrh - not a scam but there are those whose eyes are such they can see a better range than others with a monofocal lens. If you are in that category just thank your lucky stars! Someone posted in a mew discussion yesterday she adked for near vision with monofocals and surgeon targeted for distance ignoring her request. She is very disappointed as even mid range is blurry. So great all range vision with monofocals is NOT a guarantee or everyone's outcome. Their is science and testing with multifocsls /trifocals and EDOF lenses that show the range you can expect and even thise will vary depending on each person's unique set of eyes. The trade-off is more glare and halos with night vision.
I wish there was a more perfect lens but we all need to be grateful that it is 2019 and not like when our grandparents had cataracts having their natural lens removed and handed a thick pair of glasses.
Vision is better for us all compared to having cataracts. Some opt for this surgery with just beginning of a cataract (eyes can be corrected with glasses or contacts) or even more tragic - clear lens exchange. Now that is riskier than I would have it but to each their own decision.
soks Sue.An2
Posted
gratitude helps you be happy, accept reality and make peace. but i think it is ok to complain or vent out frustration. otherwise there would be no progress. our grandparents would have said thankful for thick glasses because their grandparents went blind with cataracts. but someone complained about thick glasses and now we got iols.
soks Meuwth
Posted
Meuwth i am sorry u r having to deal with this at 24. one surgeon told me the other day that your combination of symfony and pan optix gives the best results in his practice. i want to think that drop in vision quality at 24 would be large from natural eye to iol and really hope you get good vision.
Deb03 Meuwth
Posted
Have you received your prescription/refraction numbers yet?
Sue.An2 soks
Posted
True - agree sometimes it pushes forward invention so that status quo is challenged. Guess we need a bit of both things for a balanced life.
W-H Sue.An2
Posted
.
The point is not that someone will read at 21.6 inches with arms in super extension 😃 The point is that the monofocal IOL eye set for far is able to read J1 at 21.6 inches in my wife's case while still managing 20/25 for far. Frankly that is more than what I was expecting.
.
The near IOL eye has near vision already very well covered, so the question of extending the arm is not even relevant 😃
.
Steel measuring tape 😃
Deb03 W-H
Posted
"The point is not that someone will read at 21.6 inches with arms in super extension 😃"
I do it all the time! 😃 😃 😃
W-H Deb03
Posted
We have a winner 😃
Sue.An2 W-H
Posted
Those are very good results - but was only pointing out to Meuwth who posted "Kind of outrageous for me to think about bc that kind defeats the purpose of the multifocals? " Monofocals don't defeat purpose of premium lenses in that you don't have to give up binocular vision targeting one for near and one eye for distance. And even if both targeted for distance not everyone would see from 21.6 inches to distance that well like your wife. Some see distance with no intermediate vision. it is a gamble as surgeons can't predict who will see better than others But yes to gain better range of vision with premium you have to accept more glare and halos at night. It really is an individual preference.
soks W-H
Posted
i will do 22 inches in both eyes with monofocal if there was a way to know that is what i would get! i would then wear the most expensive readers in the world with a smile on my face!
Sue.An2 W-H
Posted
lol Deb I am not a very big person! Barely 5 foot 2. I doubt my arms would extend that far which is not exactly near vision to me. I actually read an article about height and how it affects ones vision after cataract surgery. Guessing tall people always have an advantage.
soks Sue.An2
Posted
thats true sue an, about who will get large range with monofocals is difficult to predict. i think u wud be that person. w-h's wife has short eye and mebbe that has something to do with it.and if its really your brain doing the vision adjustment it would be interesting to see what it does with monofocal. in the interest of progressing cataract research may i suggest a lens exchange 😃
Deb03 Sue.An2
Posted
it's not near vision but it lets me get by with my monofocals when I need to without putting on readers! I'm 5'8" and can definitely stretch my arms out. 😃
Sue.An2 soks
Posted
Well there is a limit soks to what I would do to advance science. But my curiosity factor vs my risk adverse nature struggles with doing a lens exchange. Brain vs eye structure who knows but would be sooooo tempting to find out.
soks Sue.An2
Posted
lol
Hudsongrl W-H
Posted
With all due respect, I think you are way over testing eyes. normal eyes fluctuate throughout the day due to lighting, eye strain, dryness. Try to be patient and let her eyes heal. Constantly straining to read eye charts is too stressful for both of you. If her vision is less than perfect after a couple months correct with glasses or contacts.