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!
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.
I went from myopia to distant, crystal clear. First, right eye 15 months ago, then left eye 5 months ago. Had troubles galore in right eye, ending in Vitrectomy last week.
I find that both eyes have gone from distant, to a best-focus of about 1-2m away now. Not sure why, perhaps change in the shape of my eyes. The surgeon is going to investigate when my right eye settles down.
I was myopic I chose distance but the one eye ended up with the wrong prescription lense and i can see close up and the other I can see to drive without glasses. Both eyes blend together and you'd never know. I also had lasik done in 1998 and one was better at distance than the other and the other I could see close up. To me thats the best of both worlds. If you pick close up your may not be able to see 5 ft in front of you , don't think they can regulate slightly myopic., by the sounds of these horror stories. To me that would be scary not to see in front of you, I think one person commented on that that she wanted to see close up and now can't see in front of her. You should try contacts on one for distance and one for up close and see how it feels before you make a decision
You suggest you aren't sure about the idea of monovision, one eye focused at distance and the other at near, due to concerns over dizziness. Most people can tolerate a small difference, its usually only a larger difference that is a risk. I don't know how bad your cataracts are, if they aren't degrading your vision too much then you might see if a contact lens trial of monovision would be possible to see if you might be able to tolerate your eyes being focused at different distances. Even if you don't like contact lenses in general, the idea is just to try it temporarily to set your eyes to focus like they would after surgery. If you haven't tried contact lenses in the last decade or so, they have improved a lot (even more compared to 20 years ago). If your cataracts are causing too many problems that may not be a good test though.
The way to set your eyes partly depends on when you'd prefer to not need glasses, but if you can tolerate a little difference between the eyes you get more flexibility. For instance if you have one eye set for about -0.5D, 2 meters (=6.6 feet), and one eye for -1.5D, 66.7 centimeters (=26.2 inches), that 1 diopter difference is usually tolerated well by most people and that is the range for most social distance, computer distance, and walking around the house. It may not be enough for much reading though. You might set one eye for computer distance, and one eye for reading distance. If your eye is set to focus at -X diopters, then the distance in centimeters it sees best at is (100 / X). How much nearer you see well depends on the person and the lens you get, and unfortuantely also how much farther you see. Even if you have an eye set for computer distance, you might still see fairly well at social distance with that eye.
Unfortunately your range of vision, how much farther in you see from the best focus point, varies with the person depending on their eye's natural "depth of focus". A tiny minority of patients even with monofocals set for distance can still read a bit, but that isn't something to count on.
re: "Since I'm not interested in "multi-focasl" (apparently not as crisp vision as "standard" lenses),"
There are other types of premium lenses (if money isn't the issue), depending on what country you are in (since the FDA in the US tends to be slow about approving new lens options and keeps us a few year behind the rest of the world). This is a global site, I see many posters from the UK as well as the US. In case you are outside the US (most people don't travel for surgery I realize), I travelled to Europe from the US a bit over a year ago to get the new Symfony lens which is a new category of lens called "extended depth of focus" which provides a bit more near vision without some of the drawbacks of multifocals, and studies show comparable distance vision to a good monofocal. I was highly myopic (before my cataract hit and made it worse, I was around -6 and -9 or so). Within a week of surgery I had close to 20/15 vision at distance (and subjectively I'm guessing I'm at 20/15 now, I need to get tested soon), and I can't recall having distance vision this crisp even with contact lenses or glasses. One of the things the Symfony does is correct for chromatic aberration which allows it to get decent distance vision while also then providing a larger range of focus. Also within a week of surgery I was 20/25 at my comfortable near distance, and can read my smartphone (if I'd gone for a slight bit of monovision I'd likely have at least 20/20 at near&far, I may get a laser tweak). It seems to have comparable contrast sensitivity and risk of visual side effects to a good monofocal based on studies so far.
If you are in the US, there is the Crystalens which is a single focus lens which may provide some accommodation (a small minority of patients just wind up with it being no different than a monofocal, which is part of why i didn't consider it) to be able to get good intermediate and some near (though still likely a need for reading glasses), or if its set for computer distance or social distance you'd have more chance of reading without glasses than you would with a monofocal.
Overall the newest model multifocals tend to have decent distance vision (e.g. the new low add Tecnis multifocals approved last year in the US, or the trifocals available overseas), I'm not sure if the difference is enough to worry about, it depends on your visual needs. The usual concern is more the potential risk of things like halo & glare, which are also lower in the newest lenses (some surgeons got turned off by older models and aren't as familiar with the latest).
I have been near sighted since I was seven and struggled to decide whether to correct for near or far. I finally decided to correct for near, because I use my smart phone a lot and love to read. I do not like the magnifying effect of bifocals and couldn't give up perfect near vision.I have been so happy with the decision
As I wait for my next surgery I have learned that full monovision is probably not right for me, although I am going to spend a few weeks giving it my best effort. I expect I will go for a mini mono so that I will have near and computer without glasses and for everything more distant I will wear glasses.
Clarity of vision is my most important criteria, so I did not consider a mult-focal lens. My cataract became advanced very quickly so I could not wait for surgery until a more perfect multifocal lens is approved.
Correcting for near was totally the right thing for me.
Hi..I'm a little confused...you are opting for a premium lens, and you suffer from astigmatism yet you didn't mention getting a toric lens. Unless you get either a toric lens or appropriate surgery, you will be needing glasses for something due to the astigmatism....Now the good news:
I suffer from astigmatism in both eyes..one substantially worse than the other and I had both lens replaced with torics within the past month with cateract surgery. Prior to surgery, I wore progressive glasses. They provided satisfortory vision for distance and close up work up to several inches. Following the replacement of the first lens in my dominant eye, my vision was corrected to 20/20. I expected both lens to be set for distance viewing and that I would need reading glasses as well. Just prior to surgery and replacement of my lens in my second eye, Doc said that since my first eye was so successful, he could set the second eye to a half unit nearsighted. He said the outcome would be almost as good vision for distance and less dependence on reading glasses. Following the surgery, it's been 3 weeks since the second eye was done, this is where I am: with both eyes open, my distance is still 20/20, somewhat less with my right eye closed (Doc's response to that was that eyes are meant to work together). My left eye is allowing me to not even need reading glasses for occasional close work like reading mail, writing a check, reading a newspaper or doing computer work. I did buy a pair of reading glasses for more extended reading, but I can function without them. I suggest you discuss this with your doc.
Well I had a monofocal IOL in my right eye only. The problem I've noticed is I can't focus And when I asked my dr. He said no I'll never focus again. The lens is focused at one point. So focusing is gone forever. So I now have no focal glasses to read at 12". And computer glasses at 24" and 12" I think it's a pain. So I'm waiting the longest Possible time to have the other eye done.
The things they don't say before surgery
And I have a friend she decided to do contacts one with reading and one long distance for 6 months before surgery
She has now put off cataract surgery for as long as she can. And keeps wearing the contacts one close and one far away. And she wears glasses to correct the contacts
This is a fascinating discussion.
I do hope you get a good result from your cataract surgery and look forward to hearing the outcome
As a cataract surgeon in UK my experience has been to consider monovision or low myopia post-operative target for NHS cataract patients of presbyopic age group with pre-existing myopia and who have needed spectacles or contacts for myopia since youth.
Such folk will be happy being less spectacle dependent than pre-operatively and will have much thinner distance spectacle lenses postoperatively.
Emmetropia for distance viewing is good for folk who were used to wearing reading glasses without problems after they developed prebysopia
Yes there are evolving alternatives with use of multifocal or 'premium' intraocular lens implants in the private/self-pay sector but these are not without issues
A key factor in selection of the post-operative refractive target following cataract surgery is for the ophthalmic surgeon to understand the patients visual needs, visual goals and past optical history and have a good discussion on all these matters in advance of surgery. By doing such talking beforehand shared decisions and realistic expectations can be arrived at by patient and surgeon. It is wise to set some time aside to do this talking in advance of planned cataract surgery and not just do it on the day of surgery. All too often these matters are rushed as the doctors often lack the time to undertake the discussions to arrive at bespoke decisions
I might also add that the guy who fitted me for my eyeglasses post-op asked me why, with the problems I've ALWAYS had focusing on my computer screen (I've never been able to read it clearly with OR without my glasses), I'd never been fitted with eyeglasses JUST for computer distance. I'd never heard of that & didn't know it was a possibility. So I had him do me a pair of "computer glasses", which he said he felt would benefit me a great deal. Boy, do they EVER! For the first time, I can clearly see my computer screen! I have complained repeatedly through the decades about the HORRIBLE headaches I suffer due to eye strain from not being able to focus on the computer screen (my job involved extensive computer work, plus the time I spend on my computer at home), so WHY has nobody ever mentioned doing a pair of eyeglasses just for "computer distance" to me before??? They were only about $100 & well worth it! I got them (& my "regular" eyeglasses too) from ReplaceALens in Denver, CO. Ordering was very easy (online or over the phone) & turn-around time very fast (mailed to my door). I will definitely use them from now on & wish I'd found them sooner. If anybody else out there has problems focusing on their computer screen, I most definitely recommend trying a pair of eyeglasses set for computer distance!!!
I am way past ready for cataract surgery. As someone who has worn glasses for distance since 4th grade and (until cataracts got worse) never before had to use glasses to read. I know you had complications after your procedure, but I need to understand just what lenses they put in your eyes, near or far or whatever near near is. Can you read without glasses as you hoped.
Greta, I've also been in glasses since 3rd or 4th grade, so I understand what your fears & questions mean! I had both eyes set for near (so, "near-near", so as to approximate what I've been accustomed to pretty much my entire life. I was afraid (so was my doc) that it would be really hard for me to adjust to suddenly being farsighted, which is how most people end up after surgery, since I've been SO nearsighted SO long. The brand of my IOL's is AcrySof, & I have no issue with the brand at all. They're the "regular", NOT multi-focal. What I have issue with is that the doc "accidentally" left me just as nearsighted as I was prior to surgery ("calculation error", which was quite a lot, so the lenses of my eyeglasses after surgery are just as thick/heavy as they were prior to surgery & I still have to wear glasses all the time to see, just like I did prior to surgery. The goal was to leave me only BARELY nearsighted, so my lenses would be a lot thinner/lighter, but that didn't happen because he didn't double-check his calculation of my lens strength. Yes, since I am still nearsighted to a significant degree, I can still see AT A CERTAIN CLOSE-UP DISTANCE without my glasses...so I can see to put makeup on, fix my hair, etc...I just have to have my face that certain distance from the mirror to do those things. Once you have IOL's implanted, they don't "flex" like your normal lens does, so the certain "sweet spot" distance where us significantly nearsighted folks can see clearly without glasses is fairly narrow...but it's still there. I hope that makes sense. But as we age, our natural lens loses its ability to flex (presbyopia), so you may have already experienced that aspect with your natural lens & not even notice a difference in that after surgery. I can read a book without my glasses, but it has to be held at that certain distance. If you read my last post (prior to your post), you will see what I said about having a pair of computer-distance eyeglasses done. These have been extremely helpful to me for computer work! I just told them (ReplaceALens in Denver, CO is where I ordered them from; they made them & mailed them to me) about how far my computer screen is from my face when I'm sitting at my computer desk & they figured it all out. That set of eyeglasses is only good at that particular distance (things closer in or farther out are blurry), so they only work for my computer work (or anything else at that particular distance)...but that's what I needed them for, as I've NEVER been able to see my computer screen clearly with or without glasses & experienced BAD headaches when sitting at my computer...until now, so I love them! The hassle is that I use a laptop downstairs & have my PC upstairs, so I have to remember to carry them upstairs/downstairs with me! The only thing I really WISH had happened is for my doc to have double-checked the calculation of my IOL strength, so I would have ended up BARELY nearsighted, as opposed to REALLY nearsighted. I hope this helps you!
I have had corrected monovision for 40 years, originally with a contact lens in my dominant right eye working with my uncorrected, myopic right eye. Worked great. In 2011 my O.D. sent me for cataract surgery in my right eye. The Opthamologist implanted a monofocal lens with LRI, continuing the monovision. 5 years later, June 2016, I was referred to the same surgeon for cataracts in the left eye. My O.D. and I agreed that monovision had worked for me historically, so I anticipated that the surgeon would implant a monofocal IOL. The day before surgery I paid the bill, which included $300 for an upgraded lens. I was more interested in why Medicare wouldn’t pay, than what was the upgrade. At no point did anyone describe the lens to me, and I assumed “same surgeon, same problem, same procedure”, no problem.
The day after surgery I met the Surgeon and received a card identifying the lens he had implanted. (I couldn’t read it, print too small). The Doctor suggested that I might need reading glasses, but that didn’t compute….why would I need readers if I only had cataract removal? In the next few days I realized my arms weren’t long enough to focus on iPhone text, so I got my magnifier and read the lens identifier card….Technis1 multi focal, +2.75D astigmatism, ZKB00. I googled that and soon understood why I couldn’t read small print (20” theoretical reading distance), and the meaning of the Surgeons suggestion that I might need readers. I dug through all my junk drawers and found a pair of Thrifty Drug store readers that I briefly used when I had contacts in both eyes 40 years ago.
Google research, including this site, informed me that I could demand the surgeon remove and replace, but that worries me. My O.D. suggested that time may fix the problem. THEN I received a bill for another $450, which the billing dept (in a different state or country) described as the difference in the uncovered cost of a Toric IOL and a Technis IOL upgrade. My choices now seem to be:
1. Borrow $450 and wait for nature to help my vision.
2. Live with readers, that was the reason I went to monovision years ago (and purchase a second pair of readers to “see” to tighten the screws on my old readers using a 00 screwdriver.
3. Make an appointment with a “competing” surgeon, for a monofocal IOL with astigmatism correction and/or LR, or
4. Return to the original surgeon for redress.
Gosh...I can't believe I have found this site with your query which is exactly my own situation right now. I am very worried about seeing into the distance permanently and not being able to focus sharply for near (say when applying make-up....I am a singer). What did you opt for in the end? I was thinking of telling my surgeon I want a lens that leaves me a bit more myopic than 20/20...I assume by doing this my clarity at near distance would be something just shorter than arm's length. Would this do? I will need both eyes doing eventually......Because of this dilemma, I have put surgery off twice now and thinking of trying Can-C eyedrops....does anyone have any experience of these?
I am post cataract surgery on my left eye one week. I had Lasik in 2000 and only have worn glasses for driving until the last year. My vision has been 20/30 I'm my left eye and 20/28 in my right. For the last year I have been wearing glasses most of the time except for reading and computer work due to my cataract. I'm a software developer, so am on the computer at least 8 hours per day. My doctor talked me into near near. I asked her if my vision would still be around 20/20 to 20/30. She said that is what she would go far. I visited the doctors PA today. She told me that my vision is at 20/80 in my left eye. I am very unhappy. The PA says that is what should be expected for near vision. My right eye is scheduled for next Tuesday. I told her that I need to talk to the doctor. She is saying that the reason the doctor recommendations near near is due to my age, so I could put makeup on. I am 58. I want to get this lens replaced. 20/80 is not slightly myopic to me.
My story is so similar to yours : Myopic at 9, hard contacts at 17 until 1988, soft toric contacts that usually rotated etc. ! I also live in CO, having recently moved from the Chicago area. and am trying to get used to the medical availability issues here. After analyzing and re-analyzing the options, I finally decided to make my priority near vision . Like you, I cannot imagine not being able to see near (reading, computer, art etc.) I was told that the best option for consistent near vision w/o corrective lenses would be a multifocal lens, and that even using the monovision lens, one for each distance, I would most likely need some sort of additional glasses. My astigmatism will also be corrected with laser adjustments (instead of going the toric IOL route).
I am still extremely anxious, as I am such a visual person, but my vision is not going to improve at this point without clearing up the cataracts.
Tomorrow, my right eye is scheduled , and I will let you know what happens.
As a young boy , I could see both far and near. Then at around age 16, my eyesight started to lessen. Far objects started to be slightly blurry. By 18, I could not see any far objects. Close objects no problems occurred. Then in 2014, at age 63, my vision became blurry to the point that far and close images were out of focus. Newspapers were completely gray, so I could not read any printed material especially is large or small print. I couldn't even see my face so I could shave my face if I missed a spot. I couldn't even find an eye lash that was irritating my eye. I finally saw an eye doctor in the US in January 2015. I was told I had a severe and dense cataracts. It took 7 months to see an eye surgeon due to my insurance company not contacted me sooner. I told the doctor I preferred to get my close vision back but my far vision was ok too. After cataract surgery, I now can see close and far vision with or without eye glaases. I don't use any reading glasses that you can find in any store. Most days I don't use my prescription eye glasses at all unless I want to see further away like for 2 city blocks. For close vision, I only use my glaases when my double vision pops up, but otherwise I can see every spot on my face that I miss while I am shaving my face. According to my doctor's card, she used ACR Sof IQQ lenses, my right eye had the power of 19.5 D and my left eye was power 19.zero D. The company listed on my Patient lens implant ID card listed Alcoa Laboratories. The 2 cards list the Model number, power, length, serial number when the surgery occurred, me the patient's name, and my doctor's name. It is very helpful to have two cards listing that information.
I hope my information helps you in your surgery. Good luck