Interested in your feedback on questions for opthamologist

Thanks Victoria. There so many things I do close range that I am thinking I would prefer to keep that. I guess if I choose for distance I gain something I haven't had since a child but I'd lose what I have had - my near vision. Might be best to go with what I know.

You are a wealth of information and I wish I'd have been so well informed prior to my surgery! I have a question for you.

August of 2016: cataracts removed and the basic lens ( only lens covered by insurance) was implanted.

Insurance only covered the traditional surgery--scalpel, no laser. I have basically no near vision any more, and have floaters as big as horseflies. Also have something I can only describe as a curtain that remains over my eyes after blinking. Sometimes it will go away after a couple of blinks. Other times it lingers for 5-10 minutes.

The eye doc tells me that he "slightly" reduced my near vision so as to facilitate better vision distance. So far, I've washed my hair with dog shampoo (after our dog had his bath, I left the bottle by the people shampoo and my near vision is so bad that I couldn't tell what I was grabbing). I also used baby butt cream as toothpaste!

I can't figure out how any tweaking was accomplished without some kind of laser. Is it possible to do it with a scalpel?

Any ideas? Thank you so much.

1. They used to use a "scalpel" to correct vision, but most of the opthamologists began to use laser for the vision correction about 30 years back. The best way to know what he did is to ask him that question again and make sure that he gives you a direct answer.

2. Sorry to learn that you have been having quite a few vision issues. Again, the best thing to do is to address them one by one. Starting with the floaters and the curtain effect in the eye, check with your surgeon or another opthamologist: for an explanation. Hopefully, the problems will get better soon on their own, but it is nice to know the reason for the problems and to know if anything needs to be done at this time. He should do your eye examination, as needed, to confirm his diagnosis.

3. Regarding the poor near vision, I assume that you are wearing glasses most of the time. What is the prescription for those glasses: for distance and for reading? How well can you see with those glasses at distance (20/20?) and at reading distance. If you can share that information, I may be able to give you a more specific suggestion.

I just saw your reply. Sorry about that. I haven't been able to get a pair of prescription glasses because my eyes have't reached the end goal. The surgeon had told me that he would be able to fix my near vision and when I repeated that the cost of lasik was not in my budget then and still wasn't, he said "It can be worked out".

That's what I thought I thought all the contact trials were working towards. Rather than $3600, he was allowing me $200 off per eye.

Even if you to have to spend about $100 to get an inexpensive pair of prescription glasses to see well, which may become obsolete in couple of months ( if you have LASIK for eye correction), they are worth the cost. Also, you will know how well you can hope to see after LASIK or if you have some other vision issues. Also, that will remove the urgency of your having to make a decision about LASIK.

Just for reference, after my cataract surgery in early December 2016, I had the prescription for my glasses to get the best distance vision about 2 weeks after the surgery, even though I was scheduled to have LASIK enhancement to correct the astigmatism in another 4 weeks. I used the glasses to see well at night for only 3 weeks, but the $80 spent by me were  still worth to me.

I never even thought about buying an inexpensive pair of glasses! Absolutely it would be worth it! The only talk about glasses was that I'd be waiting until vision was more stabilized. Thank you SO MUCH!

I was reading a bit about my surgeon today, only to find out he is one of the Rising Stars in his field in Minnesota! He invented a gadget that aids in a part of the laser procedure. Of course, he is beyond reproach!!

I think the cloudiness (curtains) is worsening. Although the retinologist advised to proceed with the refraction work prior to cleaning up the back of my eye, I'm not really able to make.an informed decision about setting the vision because of the increased haze I'm looking through. Jeez Louise!! Always something!

Thanks again!!

I have never tried multifocal contacts or any sort of monovision (too late to try that due to cataracts).

Thanks for your help. Surgery for 1st eye is July 10

I think that besides making the Symfony versus monofocal lens choice, the first decison which you need to make is whether you are willing to use a small amount of monovision in order to not have to wear any glasses even for reading. If you don't use even a small amount of monovision, then you will be needing glasses for reading. Nothing wrong with making that choice, but you just need to be aware of that.

Whether you have the Symfony lens installed first or second will probably not make much difference. Having 2 Symfony lenses instead of having the combination of a Symfony lens and a monofocal lens does not really offer significant advantage regarding the day vision, but has the potential of increasing night vision issues.

My suggestion will be to stay with no 2 option. It provides you with a good chance of not having any night vision issue as well as not needing any glasses. Most people adjust fine to a small amount of monovision. If by any chance, you find that you just can't adjust to it, you will still have the choice of using LASIK fo change the best focus of the Symfony lens from 32 inches to the far distance.

1. One can get most of the day-vision benefits of using two Symfony lenses by using a combination of a Symfony lens and a monofocal lens, with the combination potentially resulting in less night vision issues if done right.

2. One has the best choice of avoiding the night vision issues by using the monofocal lens in the dominant eye and setting it for the best focus at far distance (equivalent distance prescription of zero).

3. It is better to have the Symfony lens in the non-dominant eye. Setting it for the best focus at far distance will result in the maximum chance of requiring glasses for reading. Setting the Symfony lens for best focus at about 32 inches (corresponding to -1.25D prescription) will probably mean not requiring any reading glasses. However, one can choose to aim for the effective prescription of any value between -1.25D and 0D: the more negative this value corresponds to less chance of requiring reading glasses, but a larger (even though still small) difficulty in adjusting to the difference in the prescriptions for the 2 eyes.

Thanks for your input - first eye I am being operated on is my right eye which I think is my non dominant eye. Still thinking I will stick with Symfony lens. Although I don't mind glasses thinking that this will give me best range of vision. If I need readers for fine print and extended reading that won't bother me. Really hoping I can adjust to halos over time. Do you know if the Symfony lenses are pupil dependent? From my reading seems the MF lenses that are pupil dependent cause more halos. My optometrist cautioned me about MF lenses as my pupils are large. So thinking they play a role in this. My understanding is younger people's eyes do dialate more anyways and as we age they construct more so perhaps another reason for visual night time issues.

I also read on this his forum some are experiencing halos with inside lights. Haven't read that anywhere in studies so wondering if those are separate issues to the lenses themselves.

If all goes well will likely do both eyes with Symfony as my surgeon said they work

Better together. However if I am not comfortable with that after first eye will see about left eye - consider monofocal.

Appreciate your feedback.

However, even if the halos in that case are acceptable, my suggestion will be to leave well enough alone and have the monofocal lens in the dominant eye (left eye). All you will be doing at that stage by choosing Symfony lens in the left eye will be paying a lot more money for minimal additional benefits and taking unnecessary risk of having halos.

Sue.An

I'm guessing that you mean nighttime halos, right? Maybe there are other kinds I don't know about. I've learned more about cataracts from people on this site than I was ever told by my doc.

Anyhoo..my biggest trouble with driving at night is headlights that are no longer defined, they are starbursts. Best of luck to you!

As I have said ealier, the best solution is to not limit yourself to either Symfony lenses or the monofocal lenses. Combining a Symfony lens in the non-dominant eye with a monofocal lens in the dominant eye gives one the best chance of achieving a better good vision range (compared with 2 monofocal) while providing a better chance of avoiding the potential night vision issues with using 2 Symfony lenses.

With that combination do you end up with monovision? Do you wear a contact lens then in one eye (obviously glasses wouldn't work) for eye with monofocal.

The decision about whether to have monovision (and how much of that) is independent of that (one can achieve that with 2 Symfony lenses, with 2 monofocal lenses, or with a combination with 1 of each).

Been having a lot of anxiety over this. Realize it's partly just my personality of wanting to know the outcome. Strong

Pull right now to call

My surgeon's office this week to say I have changed my mind and going with mi officials. Feel that's the safer route - but that's because wearing glasses is all I have known. Whatever isn't corrected with a monofocal I can get glasses for. 85% of multifocal lenses are happy - but if I wind up the unhappy statistic I will be sorry I did t choose a monofocal.

I know you're helping a lot of us on these forums with these decisions and outcomes. Have you encountered many happy patients?

Probably not as I'd never heard of them until joining this site.