Major Trouble with Progressive Lenses Glasses after Cataract Surgery
Posted , 10 users are following.
I would like to get some advice on my trouble with progressive lenses glasses after cataract surgery. I am so frustrated because I got my new glasses (progressive lenses) about 10 days ago expecting that I could wear the glasses all day long for all distances, but it did not work at all. I did a cataract surgery implanting mono-focal long distance and astigmatism correction lenses about 2 months ago. Before the surgery, I have worn progressive lenses glasses, so I thought my eye can quickly adjust with new glasses. It did not work from day one. The optician said it may take a week or so, so I patiently worn the glasses expecting that it becomes better. However, so far, I did not make positive progress. Interestingly, I can see well for long distance without glasses. However, when I wear the glasses, I feel some dizziness for long distance. Intermediate vision is just okay, and short distance is good.
Here is one side note. I initially got a prescription from my surgeon's office. It showed Sphere(Plano), Cyl(Sph), ADD (+2.5) for both eyes. Very simple prescription. However, I felt noticeable vision difference for intermediate distance between two eyes. So one week after when I went to my OD's office to order glasses, I had another eye exam and got the quite different prescription. It showed SPHERE (+0.25(R), +0.75(L)), Cyl (-0.5 for left eye), Axis(040 for left eye), and ADD +2.25 for both eyes. Since I felt some vision differences and the new prescription from OD seemed to confirm the differences, I ordered glasses using the OD's prescription. However it does not work now.
My question is why I have a trouble with long distance when I wear a glasses and why my reading glasses (+1.5 power) works better when I do a computer work. I start thinking whether the original prescription that has only ADD value was the right one. If you have any problems with glasses after the surgery, please share your experience and suggestions.
0 likes, 14 replies
RonAKA gabe03481
Posted
A few thoughts.
How did your surgeon determine your prescription? Was it the full test with the eye chart and you are asked which is better? A or B? Or, was it the machine with the hot air balloon or barn on the horizon that does it automatically. I trust the eye chart method much more. And how long was this test after surgery? It takes 6 weeks before you can be reasonably confident that the eye is healed and stable.
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My experience with the surgeon vs the optometrist is that the surgeon is just doing a rough check, and they will not even issue a Rx for glasses. I trust the optometrist more than the surgeon in any case. And, to be a bit cynical the Rx that your surgeon gave you indicates he did a 100% perfect job of your IOLs! To be that exact especially with a toric lens has to be pretty rare. And, with toric lenses they can rotate out of position so that could be responsible for some of the change especially if the eye was not fully healed before you got your prescriptions.
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I have progressives that I got a couple of weeks ago. To be honest since I have mini-monovision I have only worn them once. What I did find is that on the computer the band that brings the monitor in perfect focus is fairly narrow, so one does have to keep moving your head up and down to see the whole screen. With +1.5 readers you would not have to do that as the full lens is giving the same correction.
gabe03481 RonAKA
Posted
Thanks, Ron for sharing your thought and experience. Surgeon's office used digital eye chart for the exam, while OD used hot air balloon. I had the eye exam 6 weeks (6 and1/2wks for left eye, 4 and 1/2 wks for right eye) after from the surgeon's office while 7 weeks after from the OD's office. My most curiosity is why I cannot see clearly for a long distance when I wear progressive lens glasses. If I ask to remove the power for a long distance part of the lens (currently the upper part of lens has some power. I guess +0.25(R) and +0.75 (L) ), then do you think the problem can be resolved?
RonAKA gabe03481
Posted
Not sure. One further check you can have done is to get the optometrist technician to check the progressive lenses you got to see what power they actually are. It is possible the lenses are not what they were prescribed to be.
Myope_PSC RonAKA
Posted
That's the first step for sure. About 5 years ago I got the call to come pick up a new pair of progressives. I immediately knew that they were wrong when I tried them and told them. That person said try them as it takes time to get used to them and I explained that they were very wrong. Then a second person got involved and repeated it takes time to get used to them. I wouldn't leave with them so they checked the lenses and discovered that they had accidentally switched right and left lenses when installing them!
Myope_PSC gabe03481
Edited
My Rx is similar to yours Gabe. You probably have very good outdoor distance vision. I have not had my progressive glasses prescription filled because I'm certain it will leave me noticeably nearsighted and also that the Add is too much for 95% or more of my needs. I've trialed a variety of powers in contact lenses and determined that one eye needs zero net Spherical Equivalent (SE) correction. The other eye gets a tiny bit better with a +0.25D contact lens and with any more it gets worse. The improvement from the +0.25D contact lens is not worth the minimal effort it takes to put the lens in in my opinion but I'd want the improvement it gives if ordering glasses.
The above is for daytime outdoors. I have almost no need for daytime outdoors correction due to the combination of the properties of the Eyhance monofocals I have along with smaller pupil size in daylight. I can read my watch and messages on my phone for example. I'm slowly figuring out what the most seamless indoor and low light solution is for me.
@jimluck metioned reducing the Add power in progressives recently so I did some reading up on that. The theory is that lower the add, the wider is the corridor of usable reading correction will be. My prescribed add is +2.5 but, from testing, +1.5 from plano will cover 95% of my needs. I'll probably go with an add of +1.75 (from plano). I use +1.00 readers for computer viewing so your add need might be more than mine.
The reason you can end up nearsighted after your phoropter exam is the built-in error caused by testing to only 20 feet or 6 meters instead of optical infinity. (1 meter divided by exam lane length in meters)
Corrections from a 20 ft exam lane result can leave you 0.16D myopic.
Corrections from a 6 meter exam lane result can leave you 0.17D myopic.
Corrections from a 10 ft or 3 meter exam lane result can leave you 0.33D myopic.
Some optometrist's compensate for that in the Rx and some don't. My assumption is that most think that the 20' or 6 meter distance correction is good enough. If you're a golfer or sailor or someone who just likes seeing very distant things as clearly as possible then it's probably not good enough.
Optometrists should have a device called a Trial Frame which can be filled with up to a combo of 4 lenses for each eye. It should be used after the phoropter to fine tune the Rx. You need to look at distant objects outdoors with the Trial Frame device on to get the distance Rx you actually prefer. Check to see if your OD has one. You might find out that you only need 0(sph) R & +0.5(sph) -0.5(cyl) L with an add of +2.00 for example.
I'll just add here that +1.5 monovision with a contact lens would be a good indoor solution for me except that it's inconvenient for temporary and on the go needs. I occasionally do +1.25 with a contact lens now and need just a bit more for some things. I prefer full binocular vision outdoors though. I've taken a chance and ordered monovision glasses that should put me at 0sph/0cyl one eye and -1.5sph/0cyl other eye to see if that works indoors at home and as a grocery/hardware store "reader" for example. The cost online was around $25 so worth trying for me. If the monovision glasses don't work out then I'll get some progressives after testing with a Trial Frame device.
gabe03481
Edited
I made an appointment with a different OD next week to have an eye exam. Then, I guess I have some ideas on what the correct prescription (at least average of three Rx) looks like. Thanks for trying a Trial Frame, which is a great idea. I don't know whether they have it , but at least I will ask and try it.
Myope_PSC gabe03481
Edited
Both the possibility of the final prescription needing to be adjusted by -0.25DS and the need to use the Trial Frame to fine tune the Rx after the phoropter better/worse routine are well explained in Essilor's Practical Refraction manual (page 34) if anyone wants to read about it.
RonAKA gabe03481
Edited
My brother is into the cataract process and I have been exchanging information with him and helping him with his test results. Here is an example of how his actual eyeglass powers compare to the prescribed values. These are a pair of progressives from Zenni and do not speak well to the quality of Zenni glasses.
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Prescribed Powers:
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Eye Sphere Cyl AxisNear Add
OD: -1.75 -0.25 177 +2.5 No Prism
OS: -3.00 -1.5085 +2.5 No Prism
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Lensmeter Rx Measured values:
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Eye Sphere Cyl Axis Near AddPrism Base Prism Base
OD: -2.00 -0.50 6 +1.25 .75 Out .25 Down
OS: -3.75 -1.00 69 +1.00 1.5 Out 1.25 Up
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This shows it is certainly worthwhile to have the lenses in progressive glasses measure to see if you actually got compared to what was prescribed. It also shows that Zenni is not the place to get accurate prescription eyeglasses.
Guest gabe03481
Edited
A few quick points…
jimhermann gabe03481
Edited
Gabe,
i am having similar problems with Progressive Lens after Cataract Surgery. The reading magnification area is too small and I have to tilt my head back to read, which is very uncomfortable. The middle magnification is not strong enough, so I can't view computer screens without tilting my head back to look through the bottom of the lens. The distance viewing was better with no glasses, so the Optometrist removed the astigmatism correction for a second pair of glasses and that helped. Note that I never had astigmatism correction before surgery.
The problem with the Progressive Lenses is crazy because both of my old Progressive Glasses worked fine for months after surgery, except for distance. I need the manufacturer to manufacture the new lenses to match the old lenses, but with new distance correction. They do not operate that way.
i tried wearing the second new pair for four days continuously and my eyes did not adjust. I am going back to complain again.
Any suggestions?
Jim
RonAKA jimhermann
Posted
Some resort to getting special glasses made for computer viewing.
Guest RonAKA
Edited
Yah I think progressives are for day to day living out and about… they're not great for computer use. The sweet spot for that distance is always going to be too small unless you get progressives that are specifically optimized for computer. It's much much cheaper and better to just get some single vision glasses for computer. It's very safe to buy single vision glasses online (they are very hard to screw up) so it's a small investment. I paid $30 for mine on Zenni and they're fantastic.
RonAKA Guest
Posted
Prior to cataracts I had worn progressives only for 25-30 years, including for heavy computer use. I got used to them. One of the secrets is to set the computer monitor as low as possible, much below eye level. There are differences in quality levels of progressives. I mainly used Essilor Varilux or Accolade Freedom as Costco calls them.
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This said now that I have mini-monovision I never wear my up to date progressives. I have been spoiled by being able to see the whole screen without tilting my head up and around to get the best vision.
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Jim,
Did you change the brand or model of your progressives?
aspen88 gabe03481
Posted
hi Gabe...what was the solution to your issue with the progressives?