Mini-monovision
Posted , 8 users are following.
Has anyone been disappointed with the results of near-intermediate mini-monovision? Are there risks?
I asked my cataract surgeon if he would consider near-intermediate mini-monovision rather than two IOLs of the same power. He did not agree without a contact lens trial and my optomotrist will not agree because of the condition of my cataracts.
I'm concerned that 2 near IOLs might be too limiting and 2 intermediate IOLs might require both readers and distance glasses. I understand that some members of the group have had success with 2 near or 2 intermediate, but everyone is different and I might not be so lucky.
Multifocals with associated halos and distance lenses with associated readers don't appeal to me. Is my only option to change surgeons or is there another way?
Many thanks for your consideration!
0 likes, 36 replies
trilemma judith93585
Edited
Change optometrists? You told the optometrist that this was just a diagnostic procedure, and that you would not wear the contacts for a long period? Maybe that was the problem-- no recurring revenue.
How about getting your dominant eye fixed for distance. Then worry about what the second eye is to be set for, or who your new providers will be.
Also, what are your prescription numbers for your non-dominant eye now?
judith93585 trilemma
Posted
Thanks trilemma!
Lynda111 judith93585
Edited
Ron can better advise you about mini- monovision than me, but for near\ intermediate mini- monovision I don't see why u need to trial with contacts first. That is a mild mimi-monovision. Your cataract surgeon should follow your wishes unless he has good reason not to. Insist on what you want or find someone else. That said, both my eyes were targeted for intermediate vision and I see fine.
judith93585 Lynda111
Posted
Thanks Lynda! Yes, I do feel like I'm back at square one. The concern is that I might not like it and redo would be necessary. According to my reading, this does happen even with mini-monovision. The more I know about cataract surgery, the more I realize there are risks for every decision!
Lynda111 judith93585
Edited
Judith,
There is no need to be back at "square one." You can move ahead with your decision. If by a "redo" you mean a new IOL because you didn't like or adjust to mini-monovision, cataract surgeons don't do "redos" or explantations for that. They just fit you with eyeglasses. I am going to send you a Message.
RonAKA judith93585
Edited
The way I look at it, there is not a large risk in going with mini-monovision, even without a trial. Consider your alternatives. If you go with matched eyes both for near, or matched for intermediate, you are going to require progressive glasses for a full range of vision, or multiple pairs of single vision glasses for the various distances. With mini-monovision you have an opportunity to see both near and far with no glasses. And, in the fairly unlikely chance you do not like it, you are no worse off than you would be with matched eyes for near or intermediate. You can still use progressive glasses to get a full range of vision or multiple single vision pairs.
judith93585 RonAKA
Posted
Thanks Ron! I was able to converse with the surgeon directly and happily he would be fine with mini-monovision!
RonAKA judith93585
Posted
That is good. Will he give the go ahead to simulate it with contacts? Not essential but is a good idea unless your vision with cataracts is very bad.
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The other important step would be to agree with the surgeon prior to surgery on the targets for mini-monovision. For the best chance of a full range of vision I would suggest -0.25 D in the dominant eye, and -1.50 D in the non dominant eye.
jo61855 judith93585
Edited
Mini-monovision means the two monofocal lenses have different powers. Depending on the power difference and how your eyes focus, it may or not work for you. Personally, I would not try field testing contacts lens with cataracts needing surgery in your eyes. If you tried monovision when younger and your eyes were in good condition, you might have a clue.
judith93585 jo61855
Posted
Thanks Jo, It's interesting to know that how the eyes focus can affect the success of mini-monovision. Somehow I thought it was a matter of pushing through the discomfort if any until the eyes adjust. This sounds like more than mind over matter.
Dapperdan7 jo61855
Edited
it also depend how bad your cataracts are when testing mini mono w contacts. mine are not too bad and i can experience mini mono knowing its likely to be even a better choice when the cataracts are gone ie: if you can tolerate the contact lens trial with mild cataracts (as i guess i have) it will probably be an improvement after its done
RonAKA Dapperdan7
Edited
I agree. The raised risk of falling is bogus. Monovision reduces the risk of falling even when simulated with contacts. The reason is simple. You can see your feet and the stairs.
trilemma judith93585
Edited
Focus is an ambiguous word. After you get an IOL, there is no actual focus in the verb sense. Focus still applies as a noun after IOL surgery. Yet I still feel like I focus (verb) when I stare at an eye chart etc for a bit. I think that my vision has some higher order aberration that will remain, and as my eyes move a bit, the brain accumulates info that appears as a sharper focus maybe 1/2 second later.
Judith, what is the latest prescription for your second eye? Prescription/refraction consists of three number for each eye (sph, cyl, axis), although for the purpose of this question, axis can be ignored.
So one reason I ask about this is if your prescription is already around -2 or so, and the target on your far eye will be -1/2 D, you would in effect be trying -1.5 monovision anyway, by waiting for surgery between eyes.
See https://patient.info/forums/discuss/monovision-training-and-testing-803295
That page has a link with two videos. Your providers may not have the testing capabilty described in the first video, titled "how to test for monovision". Mine neither.
I like Ron's take on this.
judith93585 Dapperdan7
Posted
Thanks Dapperdan!
judith93585 trilemma
Posted
Thanks trilemma! Very clever! Once I find my most recent prescription I'll plug in the numbers. It did also occur to me that living with one worse cataract might count as mini-monovision!
jo61855 RonAKA
Posted
Cataracts increase the risk of falling. I know from personal experience. Biden either has cataracts or a problem with IOLs. Monovision increases problems of depth perception, It's not just a matter of seeing the stairs or your feet. Mini-monovision likely has less loss of depth perception. The problem is one of constrast sensitivity not visual acuity.
RonAKA jo61855
Posted
Did you read the study I posted the information on in the other thread? It found that monovision reduced the risk of falling compared to having cataracts, and also to having cataract surgery with a target for distance.
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Review of Optometry Published August 25, 2021 Pseudophakic Monovision Patients Have Relatively Low Fall Risk
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Mini-Monovision INCREASES depth perception compared to distance set monofocal IOLs. Contrast sensitivity is a very minor factor compared to visual acuity.
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Biden is another subject. I worry about him falling every time I see him walk. However, I think it is just age. He seems to be in better condition than Mitch McConnell though...