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Is Targeting the Dominant Eye for Distance Necessary for a MonoVision Strategy?

Posted , 12 users are following.

indygeo
indygeo

Hi Everyone, 

Most, if not all, articles I've read on the subject of mono-vision say that the dominant eye is the one that should be targeted for distance and the non-dominant eye for reading.   I've been informed by my consultant/surgeon that my cataract affected eye, which is also my non-dominant eye, is being targeted for distance whilst my near sighted non-cataract affected eye will stay natural.  So I'm wondering... How necessary is it that the dominant eye be given the implant for distance in a mono-vision scenario?    I'm scheduled to have the surgery in the next 10 days or so, so I'm trying to finalize all this knowledge.  Thanks. 

Regards, 

G

 

0 likes, 21 replies

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  • SilverGirl
    SilverGirl indygeo

    Edited

    Hi, G!

    Without reading others' replies, I am advocating for mono-vision. 

    My left eye is dominant and also the weakest vis-a-vis distance vision. 

    My surgeon corrected the left eye for mono near vision, and the right for mono distance. 

    My vision is perfect! I can read perfectly, drive perfectly. No night halos (which are a possibility w/Symfony and other multifocal lenses). 

    It's fabulous! 

    I had a great surgeon, but this was also only the second surgery I had ever had (first one at age 4), so I was extremely nervous. 

    Now I am delighted every day to wake up and look out at the world with beautiful, clear vision. Small miracles of life.

    Best of luck with this!

     

    • betsy83524
      betsy83524 SilverGirl

      Posted

      I had surgery three weeks ago on my left eye and had a toric monofical lens implanted.  I am quite surprised with my loss of near vision which has caused me to postpone surgery for my right eye.  My left eye was worse and with my glasses I can function ok with the distance correction in left eye.  I was advised about the monovision option but felt did not want this since for several years I had worn monovision contacts and don’t like the idea of this being “permanent”.    Since your surgery is very successful, can you still wear Rx glasses which would make both eyes function the same, something I had not thought of.  I am considering a Symfony Lens in my right eye but still not sure.
    • indygeo
      indygeo SilverGirl

      Posted

      HI Silvergirl...Wow! You've had amazing good fortune.   That's what I'm hoping for.  It's so good to hear such a great success story with mono vision.   Do you know what the diopter difference is between your two eyes?  I've heard the sweet spot is about 1.50D but I've read about success with variations from that.   My surgeon had also recommended Symfony lenses in both eyes but I'm reluctant to pursue that route due to a) my right eye doesn't have cataract at the moment, and b) I'm hoping to avoid any halo effects.   So happy to know that you had a great outcome from your treatment and are so happy.   This will be only my second surgery as well. I'm in my early 50's.

      Cheers, 

      G

  • AnneLan
    AnneLan indygeo

    Posted

    is it important to have your dominant eye set as distance for a mini mono?

    • RonAKA
      RonAKA AnneLan

      Posted

      My surgeon says that it is not necessary to set the dominant eye for distance, but it is best to simulate monovision using contacts to see how much you like and whether or not you will adapt to it. The situation I am in is that I have had cataract surgery in my right non-dominant eye. The lens selected was targeted for distance and I my eyeglass correction for it is now 0.0 D spherical. My left eye is not bad enough yet to justify surgery. I am now simulating mini-monovision with a contact lens in my left eye. This eye needs about -2.0 D eyeglass correction. I am using a -0.75 D contact to leave me -1.25 D under corrected. I also tried a -0.50 D contact to give me -1.5 D under corrected. It was OK, but I prefer the -1.25 under correction.

      .

      When you set the non-dominate eye for distance it is called crossed monovision. It is not the preferred way to go, but most adapt to it. I would say that I am adapting to it pretty well. The only issue that I notice and possibly attribute to the crossed monovision is at a distance of 50 feet or so. In the distance I see fine, and up close I can easily read a computer screen, but at this long intermediate distance I can have some issues when I am in a store and am trying to read signs that are about 50 feet away or so. I think that at that distance my brain is debating between which image to use. If I concentrate I can read the signs, but it is not totally perfect. But in the scheme of things I am at least 95% free of wearing glasses. I very occassionally wear some readers for very fine print but that is about it. I do have progressives that correct both eyes, but I much prefer the monovision without glasses. The image is sharper with the progressives, but everything seems more natural without them.

      .

      I found one study that compared conventional to crossed monovision. "Anisometropia is the uncorrected difference between the two eyes. A quote:

      .

      "

      Crossed versus conventional pseudophakic monovision: Patient satisfaction, visual function, and spectacle independence

      .

      Results: The review comprised 7311 patient records. Forty-four crossed monovision patients were identified, and 30 of them were enrolled. Thirty matched pairs were surveyed. The mean anisometropia was 1.19 diopters (D) in the conventional and 1.12 D in the crossed monovision groups. No significant difference was identified for eye-hand coordination, eye-foot coordination, or sport-related depth perception, but satisfaction was slightly better in the crossed monovision group (P = .028). No significant difference was identified for 6 of 8 spectacle independence measures, but nighttime driving was a little easier for the crossed monovision group (P = .025). Seventy-seven percent of crossed and 50% of conventional monovision patients did not use glasses for intermediate distance activities (P = .037).

      .

      Conclusion: Crossed pseudophakic monovision appears to work as well as conventional pseudophakic monovision in terms of patient satisfaction and spectacle independence in patients with a mild degree of anisometropic pseudophakia."

      .

      Hope that helps some

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