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need feedback re: cataract surgery & correcting for near vs far vision

I'm facing cataract surgery & am wondering if anybody can help, particularly if you were myopic (nearsighted) prior to surgery & chose to remain slightly myopic afterwards? I am approx -4 in both eyes with approx. +1 astigmatism in both. I've worn glasses since early childhood, so I'm used to seeing things clearly without glasses (being able to read, remove a foreign object from my eye, apply mascara, etc) , as long as those things are within about 1-foot of my eyes. It seems that the majority of cataract patients get corrected for far vision, in which case they no longer see things that are up close clearly without glasses (the exact opposite of what I am used to). Since I'm not interested in "multi-focasl" (apparently not as crisp vision as "standard" lenses), & also probably not interested in setting 1 eye for distance & 1 for near (I'd probably stay dizzy all the time), I'm wondering how those in my situation have delt with suddenly not having clear close vision (such as if you needed to remove a foreign object from your eye) if both eyes are set for distance vision? Also, I've read reports of people who have gone that route saying they end up having to get reading glasses in several different strengths, since different "near" tasks are performed at different distances...for instance 1 pair/strength for reading a book, a different pair/strength for knitting, ditto for working at the computer, & so on. Although being able to drive without glasses is very appealing, I'm not sure I want to deal with all of the issues that it sounds like I would be faced with by having both eyes set for distance. Can anybody who has gone from being nearsighted to being corrected in both eyes for distance comment on the issues I've raised (particularly if your nearsightedness was around -4 or worse)? Are these valid concerns? SO, due to those concerns, I'm currently considering staying slightly myopic (nearsighted) in both eyes...anybody out there have this esperience??? My concerns about this choice include not knowing at what distance from my face I would be able to see clearly without glasses...will I be able to see my computer screen clearly enough to not get horrible headaches due to the "fuzziness"? Will I only be able to see about 1-ft from my face clearly (like now)? I spend a LOT of time reading books & also on my computer (so it terrifies me to think of losing my near vision if both eyes are set for distance!)...it would be REALLY nice to be able to see well enough to perform tasks from the distance of my computer screen in...is this even possible??? Right now, the WORST distance for me is the computer screen...it's not clear AT ALL without my glasses or with them (I have progressive bifocals & can't find ANY spot where the computer screen is in good focus).  I really hope somebody out there has been in the same boat as me & can provide some insight! I am particularly interested in hearing from anybody who was in my situation & chose to stay slightly myopic, but any comments/points are welcome! Thanks in advance!    smile

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  • xyzxyzxyz

    I had cataract surgery this past summer, and my vision was corrected for myopia - 9.5 in the right eye and 10 in the left.  So I was very nearsighted.  I had some similar concerns to those you express, as I always liked having a kind of built in "magnifying glass" of sorts when I removed my glasses. And that is gone now ... but overall I'm very happy with my corrected vision.  My distance vision is a little short of 20/20, so I do have glasses to sharpen things up (reading an eyechart, for example). They're bifocals, so I can also wear them for reading fine print.  But day in day out I almost never wear the glasses. I can read from about a foot and a half away (clearest at about 2 or even 3 feet), and can see very clearly for driving and such. I'm typing here at the computer without glasses, seeing the screen easily.

    So it works for me. I think it tends to be a bit of a crapshoot, how the surgery finally works out, it's partly science but also partly an art, from what I can see. I do know that If my regular vision were as sharp now as it is with my glasses on, it would be annoying and uncomfortable. No way can I read through the distance lenses on my glasses.  Don't know if this helps, but this is my experience, anywyay.

    • Macjazz

      Thanks for replying! So, did they do both of your eyes with the "standard" lens? Both set for distance, or did they do 1 for distance & 1 for intermediate? How do you think you'd handle it if you needed to remove a foreign object from your eye, or if you needed to apply mascara? 

    • xyzxyzxyz

      Both my eyes were done with the standard, single focus lens, and both were set for distance. That distance vision wound up being a bit less than 20/20 in each eye, but still very useable for driving etc.  I'm also able to read without glasses, and usually do. If I need to see close up into one eye or the other, which is not a common occurrence, I hold reading glasses over one eye and look through that at the other eye. This works ok, though it is less good than my old near vision used to be. A very fair trade-off, for me. 

      I'll take this result any time ... I'm actually very happy to be where I'm at, as for several months after the surgery I had a flashing in my left eye, which appears to have been related to movement in the fluid in the eye, and movement in the retina.  This finally resolved itself after about six months, which has been an enormous relief.  Cataract surgery is fairly routine nowadays, but as we see in these forums, there definitely can be complications and inaccuracies.

    • Macjazz

      Only a very tiny minority of patients can read with monofocals set for distance, that is rare, you are lucky. The amount of near vision people get depends on their eye's natural depth of focus, most people's vision starts getting blurry at 6 feet our or so is the general description I've heard for monofocals set for distance. No one should expect that sort of result,  they should plan their surgery expecting more typical results, and of course hope they will be pleasantly surprised with even better results like Macjazz received.

      Most patients do have good results with catarct surgery, it is only a small minority that have probelms, but of course they are the ones that will post. 

    • Macjazz

      Great to hear a positive experience. I am due to get my cataract surgery for 22 June and have opted for toric lens, to correct distance (am nearsighted, but not terribly so. The main problem is the cataract.) My opthamologist relative told me going for distance correction was better in my case, so I decided to do it. Hope it works out. Am nervous, of course...but will grit my teeth and bear it!!! 

    • softwaredev

      I'm writing this for anyone who may be reading it at some point in the future as a response to what softwaredev said about most people's vision starting to get blurry at 6 feet and closer with standard non-toric monofocal IOLs set for distance and also what he said about only a tiny minority can read without glasses with standard non-toric monofocal IOLs set for distance. Well he is totally incorrect about this. I for one can see fine without glasses at all distances with standard non-toric monofocal IOLs set for distance (and my insurance company covered the entire cost for them - the ones I have were made by Bausch & Lomb, but they're all basically the same no matter who the manufacturer is). The only time I need glasses is for the teeny tiny print on the side of a prescription bottle (not the front of the bottle, that I can read fine without any glasses at all). I don't need glasses for any other reason, including driving or seeing my car's speedometer which I see perfectly without glasses. I also found 3 studies done by Abbott (the maker of the Symfony lens) that state that 95% of people can see fine without glasses at intermediate distances of 2 to 5 feet with standard non-toric monofocal IOLs set for distance and the amount of people who can also read without glasses with standard non-toric monofocal IOLs set for distance was pretty high as well (and there's no guarantee the Symfony lens will allow anyone to read without glasses, plus they cost thousands of dollars extra in the United States).

    • Update: I just tried reading the extremely tiny print on the side of a pill bottle (also known as J1 print on a Jaeger reading eye chart). After having cataract surgery in August 2017 and September 2017 (this is now November 2017) with standard non-toric monofocal IOLs set for distance, I can now read that tiny print without reading glasses. Also, I had my eyes checked today and my distance vision is 20/25 (6/7.5). I have some PCO in both eyes though, so if I have that treated with YAG laser eventually, I would think my distance vision will then be at least 20/20 (6/6).

    • lin59

      I am happy for you.

      I cannot do that. However, I do have an astig in one eye, so made that is why (i.e. both eyes are not seeing the same; so they are not working well enough together to help with close up).

    • lin59

      I mentioned your case to my clinical consultant and she replied that she would need clinical evidence to support your statements.  As I am getting very close to scheduling my cataract surgery, would it be possible for you to share your age (younger eyes tend to have more natural accommodation) and the distances (in inches) that you can see objects clearly at intermediate (computer) and near (book or newspaper), and the tiny print on the pill bottle? Your comments

      are throwing more thoughts into my plan to go with Tecnis monofocals (at least one Toric for LE)

      both set for distance and have the non-dominant tweaked at -1,0D to boost intermediate vision for computer work.

    • Polyphemos

      I'm 58. I also had LASIK 15 years ago and that supposedly makes it harder to do the power calculations for cataract surgery. There's no point in giving you exact measurements of how far I can see since I can see at all distances clearly without glasses (and my intermediate vision was clear by the day after cataract surgery done on my first eye - I drove to the eye doctor that day and could see my car's speedometer perfectly - my other eye took a little longer to get clear for close vision). The only exception would be if I were to read an entire book I would probably want to wear reading glasses to avoid eye strain (my reading vision is good to read quick things and since I don't read books much, I haven't tested that out yet). I will PM you links to the studies I found.

    • lin59

      Thank you.  Would the LASIK procedure (combined with your cataract surgery) help to optimize the visual results that you have shared?  In other words are your amazing results perhaps skewed in your favour because of the LASIK procedure?

    • Polyphemos

      No, to the contrary - probably more people who had LASIK before cataract surgery have bad outcomes after cataract surgery than people who didn't have LASIK before. I sent you a private message. If you're on a phone, I'm not sure if you can see it or not.

    • Macjazz

      HI,your post is a real ecouragment to me as I am considering monofocal set to +0.5D and hopefully I can still read the computer screen. One reservation I have is my vision at night. How is your near vision (computer) at night time? Can you still see with the same clarity as in the day time?

      Thanks

    • lin59

      HI,your post is a real ecouragment to me as I am considering monofocal set to +0.5D and hopefully I can still read the computer screen. One reservation I have is my vision at night. How is your near vision (computer) at night time? Can you still see with the same clarity as in the day time?

    • al26912

      Night time vision is still pretty good, no problem reading the computer screen right now, at night.  I'm fortunate that the doctor hit a very good balance between near and far vision in my case - I know a couple people who have blurrier near vision but better far vision ... but my far vision is perfectly adequate for driving and such, no issues.  No problems with the eye exam for my driver's license, either, with no glasses.  So this can happen, though not everyone has identical results. 

    • Macjazz

      light is very important.Computer screens are brightly lit so focus excellent.Contrast rather than blurriness happens as light dims.I have symfony lenses and have full range of vision in daylight.In car  can read maps etc.indoors need to walk over to window to read small newsprint.I got to love 20/20 vision with need to make a few concessions here and there.

      i did learn corneas matter.Dry eye is a big topic with drs so i use tears as a precaution as i get older.Seems the cornea is a vital part of getting good results..

      i bough5 some reading glasses but find i used them once or twice..also eyes took awhile to work together as with cataracts one can favor the better eye..

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