Multifocal/ Symfony - Delay when changing focus between near and far?

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Hello, I had a Restor 2.5D implanted in my right eye 4 weeks ago. The cataract in my left eye is not yet affecting my vision and I have a multifocal contact in that eye. Overall the results are decent, but I do have one issue and I wanted to see if it was common for others with multifocal IOL's and also Symfony (as I am considering mixing Symfony with Restor once I reach the point where my other eye needs surgery).

In my operated eye, both my far and near focus points work, so I know that the lens is OK. What I've noticed is that when I'm working on my computer, reading, or using my phone/tablet for an extended period of time, it takes a long time to regain my distance vision and the longer I've been performing the near task the longer it takes (and the worse the distance vision gets). For example, when I sit down at my desk around 8:30 AM, I can read 20/20 comfortably on my vision chart. By lunch, I'm more like 20/40 and by 5PM or 6PM, I'm probably 20/100. It takes 2-3 hours (at least) to get back to 20/40 and i will not get 20/20 until the next morning. My left eye (which has a multifocal contact) instantly adjusts to any distance.

I'm wondering if others have experienced anything similar and if it improved over time? I do already try to look out the window every hour or two for a few minutes to use the more distant focus but it doesn't seem to help. Thanks.  

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  • Posted

    i've experienced something similar where my right eye with a Tecnis toric monofocal IOL starts out early in the morning with excellent distance vision 20/20 or better most days.  Later in the morning it may drop to 20/25 and in the later afternoon and evening 20/30 to 20/40 sometimes.

    I'm on the computer for several hours for work morning thru early afternoon usually.  I try to use a timer set  to look away at a distance and focus every 10min or so.  Long time at the computer can also make dry eye worse, so eye lube drops and blinking may help too.

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  • Posted

    This issue was also much worse for me for the first 6 weeks or so after my right eye cataract surgery - you are still in that period I see.  After I could stop having to take the steroid drops after 4 weeks, I think the amount of variation in my right eye's vision reduced. In the first month I too noticed somedays my right eye would get worse than 20/40 blurry.  Since the initial 6 week period, I don't think its gotten worse than 20/40, usually 20/25 or better, best vision in good lighting and during the morning.

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  • Posted

    That sounds very frustrating.  I haven’t come across anything on this.  Have you asked the surgeon if others have complained of similar issue.  With Symfony I haven’t found any delay in adjusting to varying distances. All was pretty seemless from early days till now.

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  • Posted

    Thanks. Glad to see it's not unique. I stop two of the three drops tomorrow. I'm hoping it's somewhat related to that. If it continues, I'm interested to see if it's something that only happens with multifocals but not an EDOF.

    It's a bit frustrating, but because my left eye is so good right now with the multifocal contact, I only really notice it when I close the left eye. Even 20/50 (but clear) is way better than prior to surgery. 

     

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    • Posted

      In ypur case it might be a case of the brain getting used to viewing thru a multifocal lens, since that lens is producing 2 images at different focus points, one near and one far.

      Maybe once you are using the near focus for hours, your brain has a hard time selecting the distance view?

      Over time will probably help as the brain has to get accustomed to that lens.

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    • Posted

      I'm hoping that it's just some type of brain-training as well. It's just so fast and effortless with the mutifocal contact in my other eye though.That one is also a center-distance design like the Restor 2.5 IOL. I'm 51, so thinking that maybe there is just a little accommodation left in eye with the contact and that's what's making it work so much more quickly. There doesn't seem to be much information in terms of suggestions or exercises to speed adaption. The fact that I CAN see quite well at both distance and near point at least tells me that the IOL is working and close to the target.   

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    • Posted

      Hi Derek - been looking online for some info.  Seems it can take 6 months to completely settle.

      Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.

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  • Posted

    Night-Hawk is correct. It took me over a year for my brain to adjust. As with yourself, my distance vision was great in the morning then got worse as the day went on. I would even start to have bouts of days at a time where it was great all day then for some reason it would return to only being good in the morning. These bouts then turned to bouts of months but now, two years in, it seems to have permanently settled. Hope yours settles too, I'm sure it will. Good luck.

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  • Posted

    Wow, up to a year to settle? I am just so glad I cancelled the surgery on my second eye. Hopefully I will be able to go another year or two before needing to have surgery in the other eye (and this one will then be stable). I own a business and if would be very tough to function with both eyes doing this at the same time.

    With one eye stable, I rarely even notice the focusing issues unless I'm opening and closing my eyes to check. It seems that most doctors want to do both eyes within a short time frame and I understand some of the reasons for this, but I think that younger patients, especially if they are working full time and not in jobs where an extended absence is possible, maybe should space out their surgeries. Maybe wait at least until the first eye is past the eye drop phase.

    It probably depends on the situation and condition of both eyes pre-surgery.

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    • Posted

      Yes I do agree for patients that work do need to space out their surgeries.  Was fortyto take a week off after surgery but worked another 5 weeks before having 2nd one done.

      Tried to send you a link.  Moderator still reviewing.  Link is on the all about vision - my cataract journey.  Aptly names as this is a journey.  Some interesting tips for focusing near intermediate and far to get your brain to adjust.  Hopefully moderator will release it.

      The other big difference I have seen is in the expectations of doctors who sY to resume normal activities in 48 hours.  Those would be quite different for an 80 year old than a 50 year old and I would suspect they see far more if the former than latter!  

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  • Posted

    Just in case anyone stumbles on this thread in the future. My focusing issues seem to have mostly resolved after I passed the 4 week mark and went down from three different eyedrop prescriptions to one. It only seems to happen now if I'm really working intently on the computer for an extended period of time and my blinking is reduced. Even in this scenario, my distance vision seems to now return within 5-10 minutes so that's much better than before. Lubricating drops also seem to help. My eyes don't feel dry so I didn't bother to use them but I started to do so just to see if it would help and it does seem to improve overall vision a bit.  

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