Posted , 12 users are following.
hello. who had monofocal toric or even reg mo offical IOL and was able to see intermediate vision... 2 feet and further...? I understand you must need close up near like your cellphone etc..but a little further? can the long distance monofocal(toric in this case) let you see intermediate decently? like cooking..talking to someone 2 ft away..etc..
thanks!
1 like, 25 replies
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RonAKA ayeaye
Edited
This is a subject of interest to me as I plan for a monofocal lens in my first eye, and am considering an under corrected monofocal in the second eye. In any case here is one graph that shows the estimated vision of one eye fully corrected for distance. The visual acuity is highlighted in yellow. The distance is in meters and you would have to translate what you consider as intermediate vision to meters to see what you could expect.
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And here is a second graph showing the estimated binocular vision when one eye is corrected for distance and the second eye under corrected by varying amounts. There have been some older studies which have suggested that the best compromise for under correction is -1.5. I have highlighted that combination in the graph.
The current thinking is to go for less monovision especially in older (>65 years) patients. It seems a smaller pupil size (which decreases with age) allows more depth of focus and lower amounts of under correction. If one is younger then -1.5 may be a better tradeoff.
ayeaye RonAKA
Posted
you are brilliant and soooo informing with such great research! Thank you soooooooooooooo much!!
DonDiopter RonAKA
Posted
Hi Ron,
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Could you advise the source link of those interesting graphs?
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Thanks.
RonAKA DonDiopter
Posted
I found that you can't post links here, but if you Google for the following, you should find the report.
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Optimal Amount of Anisometropia for Pseudophakic Monovision Ken Hayashi, MD; Motoaki Yoshida, MD; Shin-ichi Manabe, MD; Hideyuki Hayashi, MD
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And here is another one that is similar and interesting. It also covers the more conventional monovision in the -2.0 range.
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Monovision Strategies: Our Experience and Approach on Pseudophakic Monovision Misae Ito CO* and Kimiya Shimizu
Mutti3 ayeaye
Edited
I have intermediate distance in my left eye. computer distance, 2 feet out no problem. my right eye is set for distance. Able to drive without use of glasses. I use cheap readers for close vision. if i am in bright light or sunshine, i can see close with no visual aides. I am over 65, but was told my pupils are not small. At two feet everything is very clear. i have like a mini mono.
i am very pleases with my results. I worn glasses since i was a child, it is great to be almost glasses free!
marc14910 Mutti3
Posted
What is the LE rx? I like having good distance and wearing readers is fine, so I'm thinking of -.50 in my non dominant eye. That way maybe I can read text messages and emails on my cell phone, even if it isn't that sharp. I keep cheap readers in my car and my rooms in my house where I would want them.
ara21947 ayeaye
Edited
Hello,
I can but I am not sure if you mean monofocal set to near or to far? Mine were both set to near. Both toric. My intermediate vision is 2 ft -- I just measured, give or take an inch . Everything is crystal clear. I use glasses for distance but the toric implant makes it clearer but I dont get detail. Computer and phone no problem. Reading books no problem. Reading very small print? I need good light.
I was told if my near vision was made closer than it currently is, I would lose more intermediate. Outdoor bright light is rough even with transitional coating on lens. Im going to have to buy prescription sunglasses.
ayeaye ara21947
Posted
hello Ara..dr set mine both for distance. I have all around poor eyesight and astigmatidm.. He wanted me to go for pan optix but I said no, after researching trifocals or multifocal cause more nighttime disturbances.. surgery for first eye in 9 days..With natural lens I'm very near sighted which allows me to read super fine print..plus to txt on phone! Now I will lose that...😪
ara21947 ayeaye
Edited
ayeaye, have you had this done yet? It will flip your visual world if so. The first surgeon told me also that I would lose near vision and "just use reading glasses" But when your whole life is the opposite its something to think about. I went to someone else who recommended I stay near sighted. Thats why you were probably researching here. I too was very near sighted, which I loved, seeing every tiny thing in detail up close. With the IOL implant your cornea loses that flexibility but you can still keep your near vision. You can tell him that is what you want and use glasses for distance since you've been a spectacle user for years anyway?
Ive lost the super power of superfine print reading with naked eye-- I think only those of us who had this know what we miss , but at least I take my glasses off to read or eat or do any of those things us near sighted people do. Mine were set to -1.5. It works. (My distant vision is clearer too since I dont have as much astigmatism anymore) My cataracts were so bad driving was scary.
I review books also and at one point told an author her typeset/font was too light (Ahggg, it was my failing eyesight) so now I'm good enough. Get what YOU want and YOU need.Let them give opinions. If you want your near vision preserved with a monofocal, tell them. I wish you luck and feel your distress.
scott10751 ara21947
Edited
Superpower is right. -15 and -13.5, I can take off my glasses and hold my hand up to my eye and see what looks like the individual cells. It's like looking through a microscope. I see perfectly clear up to about 2 inches out. 😃
I can remember as a child duplicating the small pictures that came with Legos in the 70's, of the "other things" you could build with the same pieces that came with the sets but came with no instructions and the pictures were tiny, because I could take off my glasses and see them well enough to reverse engineer them. I did the same thing with lite brite, didn't pay for the templates but used blanks to make the same pictures because I could count the holes in the tiny pictures. I'll miss the built in microscope, not that I use it often.
I've been thinking -1.5, -.5 myself although there is no guarantee they can hit that, as when I look around the room there is far more intermediate to far then near to intermediate, and I wouldn't mind glasses for close up if I can read things at arms length. Reading your post does make me think about more near though. My vitrectomy is Wed, fighting off a little bit of a cold, hoping I'm ok by Tuesday so I don't need to reschedule, then I will probably have 6 months before I have the cataract to make that decision. The surgeon did tell me she had one form in only 4 weeks once, but felt confident I would have it within 6 months because I do have a small cataract now and the vitrectomy will accelerate the process.
How far can you see with both set to -1.5? What activities require glasses? Can you watch a large screen tv from 10 feet away or drive comfortably? With -.5 in one eye and -1.5 in the other, I'm hoping I'd get a little more range between the 2, or -1 and -2. It really would depend where the first eye lands.
Mutti3 scott10751
Posted
just an fyi, i have -1.50 set in my left eye for intermediate. i see range iof 20/30. my right eye is 20/20.
Use reader for reading distance.But to get that super close vision, i would get stronger readers, The benefit if seeing clear out weights the inconvenience of readers!
ara21947 scott10751
Posted
I also loved going to miniature art shows -- where an entire painting is the size of a postage stamp. Those artists must have near vision. Seeing every vein in a leaf or seed in a flower. Its a different world. I definitely see a 55 inch tv from 10 feet away tho I see it slightly better with glasses. Im thinking of getting a 65 inch and then wont need glasses.
I use glasses for driving, shopping, seeing the back of classrooms, that sort of thing.
RonAKA scott10751
Posted
If you look at this chart vision with a -1.5 drops to about 20/50 at 3 meters. That is the legal limit for driving in many areas. My thoughts would be that driving would require eyeglasses or contacts for sure. The prime distance for a 1.5 is going to be from about 0.5 to 1 meter. Too close even for watching TV, unless you watch on a laptop or computer.
ara21947 RonAKA
Posted
Despite the chart each of us comes out slightly differently, otherwise this site would be moot. One thing to think about is if your focus is on near vision, both eyes will read better together than 1 eye. My right eye near (done first) was 20/25 close up. I wanted it closer but surgeon was afraid I wouldnt have intermediate. The left eye came out 20/20. At my final exam both eyes tested to 20/20 close tho I feel the left eye has better close vision than the right. My distant vision tested better than pre cataract due to much of astigmatism being corrected. Distance I went from something like 20/100 or more to 20/40 and 20/60. Its personal and a bit of chance thrown in. Every surgeon will tell you it isnt an exact science targeting what we hope for.
ayeaye ara21947
Posted
hi.. so you chose near..and correcting your astigmatism even made your far better than it was pre surgery?. did you have monofocal toric?
ara21947 ayeaye
Posted
yes because it removed the astigmatism which was rather severe. It improved my distant vision and weakened somewhat my near vision.
Both eyes monofocal toric.