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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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  • Macjazz Macjazz 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.

    • xyzxyzxyz xyzxyzxyz 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? 

    • Macjazz Macjazz 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.

    • softwaredev softwaredev 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. 

    • vegmama7 vegmama7 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!!! 

    • nina234 nina234 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).

    • nina234 nina234

      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).

    • mark65089 mark65089 nina234

      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).

    • Polyphemos Polyphemos nina234

      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.

    • nina234 nina234 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.

    • Polyphemos Polyphemos nina234

      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?

    • nina234 nina234 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.

  • donelson donelson xyzxyzxyz

    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.

     

  • diane97793 diane97793 xyzxyzxyz

    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

    • donelson donelson diane97793

      I also thought about doing this, but decided to have both lenses be the same, both set for distance. That has not worked out as I expected .... so far!

      We will see what the surgeon says after a few weeks or months.

    • xyzxyzxyz xyzxyzxyz diane97793

      From what I understand, if you opt for slightly myopic, they'd just put you in glasses to correct for the intermediate & far vision = basically what I have now except my lenses would be a lot thinner since the myopia wouldn't be nearly as bad as it is now. Is that not correct? If it is correct, I'd wear glasses the vast majority of the time, like I do now, & I'd continue to remove my glasses when doing "close" things such as reading, knitting, removing a splinter, etc. In your case, with 1 eye set for far & 1 set for near vision, does it not put a lot of strain on your eyes since basically only 1 eye at a time is seeing clearly? It seems to me it would, & I think I would have a lot of headaches due to the eye strain. I guess you were already used to it since your eyes were pretty much that way after your lasik procedure in 1998...but at THAT time, did it take some getting used to? Do you feel as if you have good vision at ALL distances now, with both eyes, or does it always appear as if you are "seeing" better on the L or R?

    • xyzxyzxyz xyzxyzxyz donelson

      It certainly seems as if your eyes should have stabilized before now, doesn't it? 15 months & 5 months post-op & you're still having problems! I hate to think about that happening, as I've already not been able to drive for over a year & it has GREATLY impacted my life (& I'm not quite 57 y/o). I live 20+ miles from the nearest small town, so it has been horrible.

    • diane97793 diane97793 xyzxyzxyz

      The one thing i would want to ask is how myopic would you be and i wonder if they could even tell you that,  You wouldn't want your distance vision to be worse than it is now.   See i went for distance in both eyes but one ended up not good distance about 20 40 but I could see up close with that eye.   The other one is good distance 20 20.  I never chose close up vision it just happened that way . Before I had cataract surgery I ended up with a cataract on one eye, could only see close up well and not good in distance., so i went about 4 years with one eye for distance.   It felt fine could never tell that I was seeing with one eye for distance , it all blended together. I think I'd be worried how far in the distance i would be able to see if I chose close up   You should see if they'll give you an answer to that or maybe they won't know till it's done.  Nothing seems to come out as planned

    • alexandra47598 alexandra47598 diane97793

      Please DO that I ended up not being able to get near vision on my other eye with contacts apparently a surprise to my surgeon as I had a lazy eye as a child and even though I had early surgery in childhood it ambliopized 

      is a horrible feeling not to be able to see up close 

      my surgeon tried to convince me to monoficals both for distance but the idea at 48 not to see my child if I could not find my glasses and not be able to read a word is truly horrible

      just got an exchange to symphony Tori and unfortunately blurred with and without glasses now

      not sure what my options are scared to get surgery in my other eye now 

      Any thoughts anyone ????

  • donelson donelson xyzxyzxyz

    I also thought about doing this, but decided to have both lenses be the same, both set for distance. That has not worked out as I expected .... so far!

    We will see what the surgeon says after a few weeks or months.

  • softwaredev softwaredev xyzxyzxyz

    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). 

     

    • softwaredev softwaredev

      I should add that I said -1.5D is around computer distance, but that varies, in my case I'm using a desktop computer with large monitors, more common I guess for software developers these days than the general public. Many  people may use laptops and read them closer in, so it might be more like -2D or higher. If you measure the distance to your computer from your eyes then -(100/ distance-in-centimeters) would be the diopters that your eye would be set at to focus at that distance. 

    • xyzxyzxyz xyzxyzxyz softwaredev

      Thanks for your reply! I'm in the US, a fairly remote area of CO. Moved here from AR after retirement. I was a pharmacist & was "in the know" with the medical community where I lived/practiced all those years, so moving to a different state means I'm no longer "in the know" & that causes some apprehension. If I still lived in AR I would know immediately who to go to for this surgery & would know how much I could trust their recommendations. Here, not so much.

      I've read a bit about the Symfony & it sounds as if it would be a better fit for me than what is currently available, but I don't know if I can wait that long for the FDA to approve it. I know it's expected to gain approval within the next year, but as a pharmacist, I know how the FDA can be about dragging their feet too! I'm not able to travel abroad, as I'm caring for a parent who has advanced Alzheimer's & have no other family to take up the slack, so I'm stuck here. I'm to the point of having constant headaches from eye strain & don't that I can continue like this until the FDA finally grants approval for the Symfony, so I will most likely need to go ahead with surgery.

      I saw the ophthalmologist/cataract surgeon for my initial eval this past week. He travels here a couple of days/month for consults & to perform surgery. My first eye is scheduled to be done on 4/26, so I have a bit of time to make decisions. This doc uses the AcrySof brand of lenses. Have you heard anything about that brand that I should be aware of?

      The doc mentioned the toric lens (AcrySof IQ Toric). From what I've read, most docs don't consider implanting a toric unless the degree of astigmatism is >1.0 (I'm approx 1.0, both eyes). Apparently  the margin of error in correcting astigmatism with a toric is great enough that there's a pretty good chance I'd still need correction with eyeglasses, so I think I'd do just as well to save the extra cost of the toric & do all of the correction in the glasses. Especially since the toric is a monofocal lens & he said I'll most likely still have to wear glasses the vast majority of the time anyway. Did you have astigmatism? If so, what are your thoughts?

      Regarding the multifocal lenses (AcrySof IQ ReSTOR), I've read that people who desire the most crisp vision usually don't get that with a multifocal. The doc said I'd probably be more satisfied overall with a monofocal, since I told him I DO want good, crisp vision. He said halos & glare are more common with multifocals too (which I also read) & I've had issues with halos & glare, even when my eyes were young, so I sure don't want to continue having those issues if I can help it. So those are the main reasons why I don't think I want multifocals. There is another ophthalmologist/cataract surgeon who travels to a small hospital about 1.5-hours from me, so maybe I should check to see if he uses the Tecnis, which you mentioned, if you think it is a lot more advanced than the AcrySof IQ ReSTOR. Do you think it's worth pursuing? The problem with these docs who travel to this area is that it takes MONTHS to get an appointment (I waited about 6-months for the appt I had this past week...but no ophthalmologists anywhere near this area, so you do what you have to do).

      You mentioned the Crystalens. A couple of things concern me about it. The muscles in an aging eye (& I'll be 57 next week) work less & less to allow "accommodation", so I'm not sure that lens would be much of an advantage in the long run. Also, since I could easily live another 3 decades, I have to wonder about "wear & tear" on a lens that "flexes" back & forth all the time. Don't have to worry about that with these other lenses. 

      The Tecnis I haven't heard of. Perhaps I need to check it out.

      You mentioned a trial of monovision contact lenses. Perhaps that is something I should check out. I started wearing glasses when I was about 9, then switched to "hard" contacts at age 16 (mid-1970's) & LOVED them. I've never had vision with glasses like I had with those hard contacts! I wore them approx 20-years, until my eyes dried out too much, then tried toric soft contacts (this was when they first came out, so the technology wasn't that great). They rolled around & around & wouldn't stay put to correct my astigmatism, so they didn't work for me. So I've been back in glasses approx 20-years & in bifocals approx 15-years. The reason I question monovision making me dizzy all the time is due to how my eyes are now. The cataract in my non-dominant eye is worse than that in my dominant eye, so I sort of feel like I'm living with monovision already & it bothers me quite a bit. I know it's probably not a fair comparison to true monovision, so perhaps I really should check on a trial of contact lenses, as you suggest. But since I'll apparently have to wear glasses the majority of the time, no matter which route I choose, would I accomplish much if I chose monovision? What do you think?

      That brings us to setting for distance versus near:

      Apparently the vast majority of myopes are set for distance in both eyes, BUT... I don't remember not being myopic, so suddenly becoming essentially the opposite REALLY concerns me! I've always been able to remove my glasses & see very well to read, knit, paint, apply makeup, remove a splinter, remove a foreign object from my eye...things that are done within about a foot of my face. I've tried, but really can't imagine not being able to do that! What if I'm set for distance, then for whatever reason the doc is unable to correct me well for near (is that even a possibility)??? WHAT would I do??? This terrifies me! You were more myopic than I am, so I'm sure you know what I mean. Did you have both eyes set for distance? If so, what was it like to adjust to the change? What about all of the things I just mentioned (reading, removing a foreign object from your eye, etc)- if both of your eyes are set for distance, do you have trouble doing those things? 

      Another issue I've thought about regarding setting both eyes for distance is having to lug around a bunch of reading glasses. I've read a lot of complaints about that very thing. People saying they end up needing quite a few different strengths, depending on what task they're performing since different tasks are performed at different distances. So a pair/strength for reading, different pair/strength for knitting, yet another for computer work, & so on. That would drive me CRAZY! 

       

      I've read a couple of opinions of ophthalmologists/cataract surgeons who ended up having the surgery themselves & commenting on what they'd do differently. They were both myopes prior to surgery & had worn glasses for years. Both said they'd go with monofocals. One said he'd have both eyes set for near & wear glasses the vast majority of the time to correct everything else, since it was basically what he was used to. The other said he'd set 1 eye for near & the other "a bit farther out". I guess that would mean "intermediate" (not sure exactly how far out that would be)? What they both said, combined with the fact that I'm obviously concerned about losing near vision, really gave me pause about correcting for far. Am I being unreasonable, or missing an important point? I keep thinking in the back of my mind...there MUST be a reason the vast majority are corrected for far vision in both eyes, but WHAT is that reason??? Thoughts?

      I have to admit the 1 guy who said he'd do near & intermediate made me wonder... What would be the advantage of doing near & intermediate? What would be the advantage of doing far & intermediate? Would either or both of those choices be much different than doing monovision? Would they be easier to adjust to than monovision & also preserve depth perception? Do you have thoughts on any of that?

      I know I've asked a LOT of questions, but these are my EYES & I want to make an informed choice! Again, thanks so much for taking the time to help me achieve that goal.  smile

       

    • Carolyn7171 Carolyn7171 xyzxyzxyz

      [u]I compliment you on asking these questions BEFORE your cataract surgery [/u]so you will know the right questions to ask and decisions to make. Wish I had! (you've probably read my post by now advising I got what I feel was the wrong lens (set for distance) in my right eye. I'm now no longer able to read without glasses and my temp glasses are not doing the job. I'm looking for a different doc now as my cataract surgeon was dismissive about my concerns. So applause to you. I think your explorations are helping  many people.

    • softwaredev softwaredev xyzxyzxyz

      I'd say most people get corrected for distance since that gives them useful driving vision, and lets them pick the right readers for whatever near vision they need. I think most people who have poor vision when younger also just get used to having their vision corrected for distance so that is the default they stick with. Most people don't bother thinking through the option of setting their eyes for different distances.

      btw, monovision merely means each eye set for different distances, which could be near&far or intermediate&near, etc. Setting intermediate&near (or two different parts of the intermediate range) could let you function around the house without glasses for most things with just glasses for driving, and for perhaps any rare need for really close near. The level of depth perception you retain just depends on how many diopters different your eyes are. The more you use 2 eyes for a distance, the more 3D things will seem, though most people likely don't really notice the difference since they get used to it. I didn't notice that monovision had cut down on 3D perception until I switched to multifocal contacts and realized things seemed oddly more 3D than they had before that.

      re: "What if I'm set for distance, then for whatever reason the doc is unable to correct me well for near (is that even a possibility)???  "

      Don't worry about that, that is never an issue. If you have good vision at any distance, then glasses/contacts can always be used to give you good near vision. In terms of lugging around lots of different reading glasses, it seems like one option is progressive glasses where the "distance" focus is set at intermediate and the near focus is near (or bifocals with the same arrangement).  It does sound like you might be more comfortable with your eye's set for some intermediate range, and then you'd have distance correction for driving and then reading (/progressive) glasses if you needed more near. If you have a smartphone, there are magnifier apps for them these days (though I haven't found a need for one yet). At a Barnes&Noble I've seen foldup reading glasses that will fit in a pocket, but I hadn't felt a need.

      re: "a fairly remote area of CO"

      I'm in Boulder, near Denver. I take it you are too far from the Front Range to get to a doctor in a city? Unfortunately FDA approval timing is unpredictable, and the Symfony is in a new class of "extended depth of focus" lenses so it isn't clear if that will lead the process to take longer since its the first one in that category. Even if you got the Symfony you could still target your vision at intermediate if you wanted even better near, the wider range of focus is useful regardless of what distance you target your eyes at.  The new low add bifocals tend to have lower risk of halos than the older bifocals that turned some surgeons off to them, but they still have a greater risk of halos than a monofocal so it sounds like they aren't a good option for you. If I were getting surgery in the US now I'd likely have gone for the Tecnis +2.75D bifocal.

      I would suggest trying monovision if you can,  but it sounds like your cataract may interfere with that. It   does sound like your issue now isn't really with monovision but with reduced vision due to the cataract clouding things and making them blurry. I suspect there are contact lenses these days that are better for dry eye issues than what was available before.

      Overall I've heard better things about the Tecnis lenses than the Acrysof lenses. I found the data they submitted to the FDA before, and although they may have asked questions differently so the data may not be exactly comparable, it looked like even the monofocal Acrysof lens had a higher risk of halos than the Tecnis low add multifocals, with the Tecnis monofocal having the lowest risk. Also the Tecnis lens material has  a higher Abbe number which corrects for chromatic aberration, and the Acrysof lenses have a higher risk of "glistenings" (though there is debate over whether that has much if any visual significance or its not really noticeable). The Acrysof lenses are "blue blocking" lenses, which many surgeons think is marketing hype and since we can always wear sunglasses, I'm not sure that its a noticeable difference since it mostly blocks UV rather than visible blue light.

      I was fortunate that although I was highly myopic, I didn't have enough astigmatism to worry about. Postop I have 0 astgimatism in one eye, -0.5D astigmaitsm in the other which still left me with at least 20/20 distance vision in that eye. Surgeons can often correct astigmatism with an incision as part of their surgery, e.g. an LRI (limbal relaxing incision) which causes the eye to reshape as it heals. It tends to be less predictable than toric IOLs, but some surgeons prefer it for low astigmatism, you don't mention how much yours is. (though some use laser incisions for even a few diopters of astigmatism). I have the impression that toric lenses or incisions do a fairly good job so you likely wouldn't need glasses. Unfortunately I don't know that they have approved any toric multifocals in the US, though they have approved a toric version of the Crystalens, the Trulign.

       

      In term of the Crystalens, they've used it in older patients with good results. Presbyopia isn't a problem with the muscles that accommodate, they suspect its more to do with the natural lens itself.  It is true that the issue of movement led me to prefer a lens which doesn't depend on moving, but personally I'd likely have risked that over a monofocal, but I hadn't researched it enough to be sure.

      In my case I was so myopic that I always wore correction, especially since I greatly preferred contact lens correction so I rarely wore glasses. I wore contacts every waking hour (and for some periods of time I wore extended wear lenses 24/7). Even when I wore glasses during periods where allergies caused problems with contacts, I didn't find it useful to take my glasses off to do things since the focal point was just too near, about 6.6 inches for my better eye and closer for the other. So for me I compare the results of surgery to what vision was like wearing correction. To me its like early presbyopia, I don't usually need to hold things at a different distance to read them,  but with say the small print on an eye drop bottle I do need to hunt for the right "sweet spot" to see it. Both my eyes are targeted for distance, though unfortunately in a high myope sometimes their formulas are off so my more myopic eye wound up postop slightly farsighted,    +0.5D which reduces near a bit, so I might consider a laser tweak to -0.5D for micro-monovision.

    • xyzxyzxyz xyzxyzxyz Carolyn7171

      So sorry about your problems! I'm becoming frustrated in my quest, especially when I try to get answers to questions from the doc's office. Seems as if you get a different person each time you call & get a completely different answer each time too. I'm almost to the point of giving up...

    • xyzxyzxyz xyzxyzxyz softwaredev

      Hello again!

      My astigmatism is approx. 1.0, each eye. Not sure if that is a huge amount or not. I've read that the incision made during cataract surgery can correct a bit of astigmatism (a bit of reshaping as it heals). Not sure if that is true or not, as I don't see how such a tiny incision could have much impact. Since placement of toric IOL's apparently requires a lot more precision than non-torics, my current thought is that I may want to stay away from the toric (to avoid more variables than absolutely necessary) & do any astigmatism correction through eyeglass lenses, especially since  the doc indicated I will most likely have to wear glasses after cataract surgery anyway. Plus the fact that torics are just monofocals to begin with (might as well just go with a standard monofocal?).

      I called the doc's office in Pueblo (he travels here to Alamosa from there, so the Pueblo office is his "main" office & is much larger than the Alamosa office) today to inquire about a trial of contact lenses to simulate some degree of monovision. Took them all day to get back with me. Don't know if I ended up speaking with the village idiot or what, but I am very frustrated after speaking with her. For starters, she acted as if it was the craziest inquiry she'd ever heard. She told me "All cataract patients are only corrected for far vision. That's how it works". I told her Dr Murphy had specifically mentioned correcting for far-far, near-near, or far-near last week. She said I must be confused. I told her I am CERTAIN there are options other than "just far-far". I again asked what I need to do to have a trial of monovision with contacts. She said I should probably call the OD in Alamosa & see if he can evaluate me & prescribe a set of contacts. So, I basically got nowhere today with my contact trial inquiry. I may stop by the OD's office on my next trip to town & see if anybody there seems to know what I'm talking about, but it doesn't sound promising. She also told me I need to hurry up & decide what I'm going to do, or cancel my surgery so somebody else can have that spot. Like I said...village idiot? Ding-a-ling? What?

      Anyway, I've become really frustrated over this whole thing today.  

      Since "far" seems to be what is being pushed: Do you think there would be any advantage to setting 1 eye for far & the other for a bit "in" from that? Or if I need to just go with "far-far" & hope for the best with correcting everything else with eyeglasses?

       

       

    • Carolyn7171 Carolyn7171 softwaredev

      I have been finding your comments and unbelievably wide scope of knowledge really helpful.  Thank you. I have replied to MarioD as to my own situation as it may be helpful.  I have appts with 2 cataract surgeons for 2nd opinions in the coming month.

    • softwaredev softwaredev xyzxyzxyz

      re: "Not sure if that is true or not, as I don't see how such a tiny incision could have much impact."

      Actually your astigmatism is in the range where I think most surgeons would choose to use incisions rather than a toric lens, though some would still prefer a toric lens. Astigmatism is merely the eye being a tiny bit shaped like a football (American) instead of a sphere. Actually in the old days cataract surgery used to require much larger incisions just to do the lens replacement than it does with modern surgery and as a side effect it could potentially create more astigmatism than you have, Surgically Induced Astigmatism. These days they use such tiny incisions that there is little astigmatism induced so its not a concern,  but they try to  plan the incisions to counter a tiny bit of existing astigmatism. Adding additional incisions can counter small amounts of astigmatism. 

      One thing you might need to be aware of is that the astigmatism you have now may not be what is relevant when determining whether you need a toric lens, since the astigmatism may be slightly higher or lower than the measurement from your prescription. Sometimes people have astigmatism in one direction on the cornea, which is countered by astigmatism in part by slight astigmatism of the lens in the other direction (or added to by astigmatism of the lens in the same direction). Since they are removing the lens, the only thing relevant is corneal astigmatism.

      They need to measure that with special instruments. Older equipment  only meaured the surface of the eye, the anterior corneal astigmatism. Ideally you should make sure your doctor has up to date equipment that also measures posterior corneal astigmatism (the back of the cornea) to come up with total corneal astigmatism. Until a few years ago surgeons didn't realize that posterior corneal astigmatism was large enough to make a difference, but based on surgical results it does. Not all surgeons keep up to date. Unfortunately it sounds like your doctor options may be limited.

      re: "stop by the OD's office"

      At least around here I'd guess almost all  ODs are used to the issue of monovision contacts for presbyopia, and the majority are likely also used to prescribing  multifocal contacts by now (though it sounds like that is less of interest).  For just trying monovision, high volume ODs are more likely to have more trial lenses in stock, like the ODs at Walmart. You don't need an MD just to try contacts. 

      If an MD insists you must be corrected for far vision, I'd avoid them if at all possible and find a better one. I would suspect most competent doctors  these days would at minimum raise the issue of at least some monovision, one eye far and the other eye a little bit in.  That suggests either their thinking isn't very flexible if they are experienced (perhaps stuck in their ways and they don't keep up to date) or that they aren't that experienced if they haven't considered the option. Either way I'd personally prefer to risk my eyes to a surgeon who is knowledgeable, experienced, and with flexible thinking skills. Its a routine safe operation, but in rare cases issues can arise so using a good doctor makes sense.  

      Unfortunately it sounds like you have limited options, you are "remote" as you say out in Alamosa.  I'm not sure what to suggest,  since you mentioned you are a caregiver for a parent  and can't travel (the Symfony is available in Canada fyi).   I'm guessing even travel driving a bit further to Pueblo or  Colorado Springs or something might be an issue (though you will need someone to drive you home after surgery btw, at least most places sedate you and don't consider it safe to drive afterwards, in addition to usually having a patch over the operated eye the first night usually). 

      There is a  toric version of the Crystalens approved in the US, the Trulign. Outside the US most multifocals and the Symfony have toric versions, though I don't think the US has approved any toric multifocals yet and I don't know if the Symfony toric is up for approval.

      re: "really frustrated"

      I'd guess that however you get your eyes set, the odds are  the improvement in vision from getting rid of the cataract will leave you happy with the results. If you are used to dealing with wearing correction at times, at most a change in what you need might be inconvenient but will be something you get used to easily. I'd suggest thinking about the issue as just hoping you can plan things so they are more convenient rather than a bit less. 

      In my case after needing to wear correction all waking hours for so many years I guess the quest to perhaps not need glasses much or at all the rest of my life was worth some effort. (oddly since I have a high deductible it turned out to even be cheaper to have traveled to get my surgery than it would have to get it here since I went to a low cost country but still used one of the best docs in Europe in the Czech Republic and still came in under my deductible. Initially I was just trying to find the best lens and it wasn't available yet in Canada or Mexico, I hadn't counted on it being lower cost as well, though I did get a special introductory price so it may not be quite as much a bargain now). 

    • alexandra47598 alexandra47598 softwaredev

      is early for me ; 10 days after lens exchange from simple Tori for distance which I hated ; I could not tolerate the contact for near vision ( seems my left eye can't get to see near )

      i now got symphony on my on my right eye and everything at any distance is blurred and fuzzy 

      laser tweak ?

      it ended up that my cataract is incipient and maybe I did not need cataract surgery at all but have really bad astigmatism 

      i am very confused ,went to a reputable second opinion but surgeons don't seem to like the extended visits with questions and concerns 

      I am a pediatrician and my experience has been somewhat shocking 

      Thought I must get educated first before getting a now third opinion 

      I wonder if at least for distance I will need something done to my left eye soon ( LASIK ? ) as I have  too much astigmatism un corrected now on that eye 

  • barbara96330 barbara96330 xyzxyzxyz

    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.

    • xyzxyzxyz xyzxyzxyz barbara96330

      Barbara,

      Thanks for your reply! It is interesting that I just got off the phone with the doc's office- I called to ask about correcting for near/near or near/intermediate (I suppose that would be the "micro-mini" with bias toward "near"wink. The person I spoke with told me that with cataract surgery "you're ALWAYS corrected for far vision". Huh? Always? (obviously not, since I just read your reply, which clearly states you were corrected for near!) I kept asking her why that is the case & if there is a reason to never correct for near, what that reason is; also what people do if they get something in their eye, if they need to apply mascara, etc, if they no longer have even remotely decent near vision. She replied that those are things they just have to get used to not being able to do anymore. I'm REALLY becoming frustrated with this whole cataract surgery thing, because it seems that no matter who you talk to, you get totally differenet (& sometimes totally crazy) answers! I told her I really expected, after my eval appt last week, the doc to tell me, "Based on your situation, X is going to be the best choice for you", rather than telling me to do some reading & internet searching & let them know which way I want to go. I am REALLY frustrated! Barbara, how soon is your 2nd surgery scheduled? I will be very interested to know exactly what you end up doing with the 2nd eye & what you think afterwards. 

    • diane97793 diane97793 xyzxyzxyz

      If you get something in your eye put refresh eye drops in to get it out.  I don't think I have ever known anyone asking for   close up vision.  but some have ended up with it. When you  have distance sometimes you get close up also in one or both eyes or you need reading glasses. If the distance doesn't come out that good you end up seeing close up.   Its just a crap shoot at what you get.

    • xyzxyzxyz xyzxyzxyz barbara96330

      When is your next surgery scheduled? I'm very interested in knowing if you go for mini-mono & what you think about it afterwards!

      I am also most interested in clarity. And extremely apprehensive about giving up my near vision. I need to be able to deal with it myself if I get a foreign object in my eye, need to apply mascara, etc... I would love to be able to see my computer screen without having to "cock" my head up & down like I do now, in order to find a spot in my eyeglasses where I can only BARELY read the screen! Not to mention the horrible aching neck that results from all of that.

    • Carolyn7171 Carolyn7171 xyzxyzxyz

      Hello again.  I am commenting on your recent post following your remark after getting off the phone with your doctor's office and being told that all corrections are for long distance vision!  That sounds eerily familiar.  My doctor who did the cataract surgery I'm not happy with apparently considers the long distance single vision lens the "default" as he ignored our ore-surgery conversation in which I said 90%+ of my life is reading and computer.  Later in my post-surgical appts when I said the long distance lwna was causing a problem for me he first  dismissed my concern, then finally said he could replace it with an intermediate lens. I asked whether that was a safe procedure. A few minutes later he became agitated and upset and said "good vision is good vision, people don't seem to understand that!" He then  stormed out of the room.  So my impression was that most of his patients pretty much follow his direction and he felt I was making waves by not being happy with the outcome.  I guess I'm telling you that because that may be a prevailing opinion with surgeons. Don't know yet. I'll find out though. I have two appointments coming up for second opinions. The first is this week. These discussions have been helpful.  I'll be interested to know what happens after you tell them about your research.

    • xyzxyzxyz xyzxyzxyz Carolyn7171

      Carolyn, oh my, that would certainly be distressing! From everything I've read, apparently the majority of people DO get corrected for far vision in both eyes. I don't know if that's just a hold-over from the past, or what. Maybe before there was more technology that's just how it was done? But apparently quite a few people have 1 eye corrected for far & 1 corrected for near...a possibility that the doc I saw definitely mentioned to me. Since that sounded a bit strange, I started researching what the pros & cons might be of doing that, especially since it seemed to me that one might lose some depth perception. I also wondered about eye strain & headaches or dizziness. That's what led me to more research & even more questions. Obviously, NOT everybody is only corrected for far vision in both eyes! I'm not sure if the person who returned my call today from the doc's office just happened to also be the village idiot, or what. But I intend to find out! I spent my career in the medical field, so I'm not intimidated by doctors or anybody else. Certainly not by the village idiot who happens to return my phone call. I'd LOVE to hear what is revealed with your upcoming 2nd opinions!

    • xyzxyzxyz xyzxyzxyz diane97793

      Diane, I've read the opinions of a couple of opthalmologists who were/are also cataract surgeons & who eventually became cataract patients themselves. Both were nearsighted prior to surgery. One of them said if he had it to do over again, he'd have 1 eye set for "near" & the other set "a bit farther out", & just wear glasses to correct anything else that needed to be corrected. The other said he'd have both eyes set to "near" & wear eyeglasses to correct everything else. Those comments coming from ophthalmologists who were/are cataract surgeons AND cataract patients gave me reason to REALLY think about doing what they suggested. There are also a couple of people on this thread who have corrected for near & report that they have been pleased.

    • softwaredev softwaredev xyzxyzxyz

      re: "if they get something in their eye, if they need to apply mascara, etc"

      I'm a typical male who doesn't have need for mascara/makeup, but I'll note that the issue is the same as for people with presbyopia so they make products like magnifying mirrors that can be used for people without as good near vision. For those comfortable with technology, I imagine there are apps for tablets that will use the selfie camera to give a magnified image.  Reading glasses would get in the way, but perhaps they make reading monofocals (hadn't checked) to use one eye to look at the other. 

    • softwaredev softwaredev Carolyn7171

      It does seem like other opinions are advisable and using a difference surgeon if possibel for future work. It is almost always  possible to do a lens exchange, but the best option depends on the person. Sometimes they prefer to make small refractive tweaks using a laser (some docs say PRK is better than LASIK for post-catarat surgery tweaks). Other times adding a 2nd piggyback lens is a better option than replacing the existing lens, it depends on the patient and the doctor what the best option is (and perhaps the country, depending on what technologies are approved). 

  • LeeAs LeeAs xyzxyzxyz

    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.

    • softwaredev softwaredev LeeAs

      Monovision is definitely an option people should consider, though I am guessing that your results are above average for only having what sounds like -0.5D of monovision with a monofocal lens, since usually I hear of people getting those sorts of results with more like full monovision, -1.5D. The  level of near vision people get depends on their eye's natural "depth of focus", which can vary quite a bit. A tiny minority can read a bit even with monofocals set for distance, but that isn't something to count on. People should plan for average results  (or below average if being cautious) and then just hope they'll be pleasantly surprised with better than expected results.

      Ideally  doctors should encourage people who are presbyopic to test out possibilities before they develop cataracts (and people should encourage their friends/family to do so if doctors haven't). They should  try out   contact lenses in monovision and  try mulitofocal contacts, even if they usually don't wish to wear contacts, to have some sense of what the options will be like when they do get cataracts. Unfortuantely that isn't full test of the experience of course  if their eyes still have some accommodation left so the "depth of focus" is effectively larger, they will have more near vision than with IOLs. However it at least gives some sense of whether they can tolerate differenecs in focus between the eyes, or tolerate multifocal vision. Of course as a side effect some who don't usually wear contacts may decide they prefer them, I much preferred multifocal contact lenses to progressive glasses. 

       

    • Carolyn7171 Carolyn7171 softwaredev

      Great idea. Could not agree more with what you're saying, softwaredev. If only I had tried these options before the surgery which left me far-sighted with now more limited and risky options for redo, tweaking and corrections to surgery already completed. I hope everyone reads your wise words and tries out these options before their surgery.

    • xyzxyzxyz xyzxyzxyz LeeAs

      Nope. What I'm leaning toward is the standard lens (not the so-called "premium"wink in both eyes. And for some reason, everybody seems to be hung up on how much time they can go without glasses post-surgery. Since I have worn glasses EVERY waking hour for almost 40-years now (or rigid contacts for a FEW of those years), nobody seems to understand the fact that I DON'T CARE if I have to wear glasses post-surgery = I really don't remember what it's like to NOT wear glasses! I want the sharpest vision possible (which pretty much excludes multifocals) post-surgery, even if it means continuing to wear glasses all the time!. If I go with torics (which are monofocals), I'll have to wear glasses to correct near (or far, depending on which way I go with the correction), so why spend a lot of extra money on torics if I'll still be in glasses? Why not also use the glasses to correct the astigmatism if I have to wear glasses anyway? Since I've worn glasses most of my life, I'm not accustomed to carrying around readers...I put glasses on as soon as I get out of bed & keep them on until I go back to bed. I don't have to remember to carry glasses with me every time I leave the house...they're already on my face. I don't mind continuing to live that way another 3 decades. I'd rather do that than carry a bunch of readers around with me "just in case I need them"...I would NOT remember to grab them on my way out the door anyway. So, for me it is NOT about being independent of glasses, it's about having the sharpest vision possible, no matter how I have to achieve it. I may (MAY, mind you) consider mini-mono, depending on what the doc says after my next appt (after all the precise measurements are made), but I'm definitely NOT leaning toward full monovision, at least not at this point.

      I think softwaredev is on the right track, suggesting docs have you "test" monovision with contacts BEFORE developing cataracts, so a plan is already in place. But that doesn't seem to be the route the vast majority of docs take. It certainly was never mentioned to me & I never thought about it...& I spent a career in the healthcare industry!

      So, what I'm struggling with now is simply the decision to correct both eyes for far (& correct everything else with glasses), correct both for near (& correct everything else with glasses), do mini-mono with far bias (correcting everything else with glasses), or mini-mono with near bias (correcting everything else with glasses). The doc says no matter WHAT I choose, I'll most likely need to wear glasses most of the time (due to multiple issues), in order to get EVERYTHING corrected. And I've checked this doc out thoroughly over the past couple of weeks = highly regarded in the medical community in the field of cataracts.

      My questions STILL revolve around erring toward far vision or near with the surgery, & the pros/cons of each. I'm still particularly interested in the experiences of those who have spent the majority of their life nearsighted, especially if they erred on the side of preserving near vision with their IOL's (since there seem to be fewer of those people out there). Because things almost NEVER work in real life the way they work "in theory"! I want to know what real people think down the road & what they would have done differently.     

    • xyzxyzxyz xyzxyzxyz

      OOPS!!! I made a typo in that last post...should have said I've been in glasses every waking moment the past FIFTY years (gulp! am I that old?!) not 40!

       

    • LeeAs LeeAs xyzxyzxyz

      i won't try to talk you out of glasses then.  I can only tell you that I've worn glasses for over 50 years and hated them.  I never really saw clearly out of them (I have, or had, astigmatism and two prisms) since the slightest movement of the glasses changed my vision.  Now with torics, one at 20/20 and the other somewhat less, with both eyes open, I have 20/20 vision for distance and can read the tiny printing on medicine bottles without glasses.  I think there is an understandable reason why docs don't initially inform pts of the possibility of this outcome.  If I had been offered the option initially and the first eye had not resulted in such a good outcome, the doc would be in the uncomfortable position of needing to tell me that despite what we talked about, I would, in fact, need reading glasses.  At anyrate, I hope you're satisified with the outcome and get what you want.

    • Macjazz Macjazz xyzxyzxyz

      Yeah. Near or far (or a bit of both), it's not an easy decision. There is no right or wrong answer, it's just going to be about personal preference. I'm impressed with your intiative in seeking out answers before surgery, since doctors don't always lay everything out as thoroughly as they might. 

      I also wore glasses all the time, for over fifty years.  Like you, I virtually never forgot my glasses because they were always either on my face or on my nightstand.  And now, I do indeed often forget my reading glasses or bifocals, because I rarely need them. In fact I generally just keep the bifocals at home for fear of leaving them somewhere.  I very rarely need either readers or distance glasses - I've been fortunate that the doctor hit a very good medium in each eye, where distance is fairly sharp (but not quite 20/20), and reading is also not bad (computer distance, as right now, is just fine). 

      I do need readers for very close vision, which is ok - it's rare that I really need them, just for fine print.  I actually have to read things all day long (and am able to without glasses), so I guess that's a testiment to the possibility of having good all round vision with single focus lenses.  I feel pretty lucky. With the wider field of vision I get without glasses, and the sort of "larger" appearance of the world without wearing those lenses - which I've noticed before with contacts - though I was uncomfortable with those - my vision is now the best it's ever been.  So that can happen. 

      As we see in these forums, cataract surgery is a bit of a crapshoot, whatever one chooses.  I've ultimately had a good result, but had to go through about 6 months of very annoying "flashing" in my left eye, which finally resolved itself, thank god.  Apparently there is a somewhat higher risk for this in people who are nearsighted, so that's one more possible complication to factor in. 

      Personally, I would have been ok with still neading glasses after surgery, having been used to this for decades, but I will say that I like it better without them, my vision is better than it was with glasses, EXCEPT for that very close vision, which I do miss on occasion. It used to be nice, having a sort of built in magnifying glass.  I don't lnow if this is helpful, but it's all grist for the mill, so to speak. Best of luck!

    • alexandra47598 alexandra47598 Carolyn7171

      had I done it I would have had no surgery 

      now number 2

      Please talk to me about tweaking I am seeing b

      very blurred and not satisfactory at any distance  10 days after Symphony

      please advise

      Also I have developed opacity apparently common and will need YAG ? Can anyone comment on that will it make clinical improvement yo my vision 

      can I have tweaking and Yag?

      when I asked my surgeon who has become not nice at all what if this did not work ( Meaning Symphony ) she said you may need to have again the Tori for Lind distance and to the other eye for long distance too

      i am terrified as I hated not being an

      ble to read and it would just be worse with both eyes for distance 

      keeping positive but when I hear you say the results with symphony are almost immediate I am accepting it just did not work for me ?.

  • lindagary1960 lindagary1960 xyzxyzxyz

    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

    • Carolyn7171 Carolyn7171 lindagary1960

      LG, I'm in your boat. Can't focus near and that's 95% of my life. But I don't want to live with this, I'm seeking 2nd and 3rd opinions.  Have gotten good referrals. I'll post alittle in the item I started. Best wishes to you!

    • xyzxyzxyz xyzxyzxyz lindagary1960

      LG, the issues you speak of are exactly what my concerns are regarding setting both eyes for distance (what is done the vast majority of the time)! Being accustomed to having good near vision (since I've been nearsighted 50+ years), I'm really stressing over losing that good near vision. I remove my glasses to read, knit, etc & have no problem focusing & doing those things. Otherwise, I wear progressives to see at all other distances & ONLY remove them to do the really near things (reading, knitting, etc). I think it would be a PAIN to have to keep up with multiple sets of reading glasses! I've read several reports of people needing 3 or 4 pair (or more!), all different strengths, because particular tasks are performed at different distances...& they report that it is  HUGE issue keeping up with all of them & lugging them along. It seems that they should be able to correct you with glasses, at least pretty well, for the other distances that your monofocal doesn't work at- anything would be better than what you're dealing with right now. Have they suggested trying that for you? They would most likely be able to better fit you with glasses after both eyes are done, which my doc mentioned to me. So I'll probably have the 2nd eye done fairly soon after the 1st eye. I truly empathize with you over what you're going through, as I can't imagine not being able to focus well on my computer screen (which is how I keep up with my friends, on a daily basis) or on a book ( I'm an avid reader). Best of luck to you! Let us all know how things work out.

    • MaisonGirl MaisonGirl Carolyn7171

      Carolyn, and I am in your boat!  What did you end up doing?  If you'd be willing to post again about what your other referrals yielded, it would be hugely helpful.  I just had right eye done for distance not realizing I would be LOSING my near reading vision.  Docs assume you realize that.  It's been a shock, to say the least.   Can't read, can't see iphone or computer.  In a tizzy about what to do now. Am told by current surgeon it is not safe to replace the new lens for near vision.  Also, i'm told that having each eye set differently has a drawback re field of vision --something that matters a lot as you age.  All to say, eagerly awaiting your developments/decisions.  Thanks.

    • alexandra47598 alexandra47598 MaisonGirl

      Make sure they don't assume you will tolerate monovision I could not get my eye to see near , spent three months trying the most uncomfortable glasses even reverse vision until I gave up

      in your boat is awe full not to be able to read !!!

      i can't imagine both eyes for distance 

      try the contact lenses in the other eye 

      I got replacement 10 days ago , 4 weeks after my first surgery 

      with the same surgeon as every other told me it was too risky unfortunately symphony is not working as expected for me 

  • SimonEye SimonEye xyzxyzxyz

    Dear Mario1dog 

    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 

    • xyzxyzxyz xyzxyzxyz SimonEye

      I ended up going with the "regular" lenses, Acrysoft brand, & had the first eye done on 5/31, 2nd eye on 6/14. The goal was to leave me only slightly myopic, so my need for glasses would be less than it was before surgery (I was told I would probably be able to perform most indoor tasks without glasses post-op) & also so my glasses would be much thinner & lighter than they were pre-op (I've been significantly myopic & had thick, heavy eyeglass lenses since 3rd or 4th grade). However, a "calaculation error" (that's what they called it, in an effort to make it not sound quite so bad) was made when determining my IOL strength & my post-op prescription ended up being IDENTICAL (that's right, identical) to what it was pre-op in BOTH eyes...in other words, they screwed up big-time! So, the lenses in my glasses are just as thick & heavy as they were pre-op...& I am NOT happy about that at all! To make matters worse, I suffered Sudden Posterior Vitreal Detatchment (sudden PVD) in BOTH eyes approximately 3-weeks after the 2nd surgery. I have been dealing with complications from that for almost a month now, with large numbers of HUGE floaters & extremely blurry vision in both eyes at times. At the very least, I feel as if I am looking through a milky film almost all the time. The guy who did my surgery has a good reputation & came highly recommended, but I have been pretty disappointed in the outcome, especially the "calculation error", which has left me with thick, heavy eyeglass lenses. Oh well, nothing I can do about it now...  

    • SimonEye SimonEye xyzxyzxyz

      If you ended up with the same post-operative refractive error as you had pre-operative it sounds like a case of insertion of a wrong powered intraocular lens implant for whatever reason.

      I provided a report on such matters some years ago and which can be read open acess at http://www.nature.com/eye/journal/v25/n6/abs/eye201189a.html ;

      These 'wrong implant' episodes and not supposed to happen and are thus sometimes called 'never events' 

  • xyzxyzxyz xyzxyzxyz

    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!!!

  • GretaGarbo GretaGarbo xyzxyzxyz

    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. 

  • xyzxyzxyz xyzxyzxyz

    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"wink, 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"wink, 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!

    • GretaGarbo GretaGarbo xyzxyzxyz

      Thank you so much. I can't stand the thought of needing glasses to read my books. It's driving me crazy now since the cataracts cause me to need them for reading and the vision is not ideal.  The last doctor I visited told me there was no such thing as lenses for close up. I knew he was lying. They all tell you that you won't be satisfied with the near vision lenses. I disagree.

      There's an old Twilight Zone that always upsets me. This man's wife nags him because she hates him reading books. He works at a bank and sits in the vault to read at lunch. When he comes out, evryone is dead from a bombing. He finds the NY public library and lays out all the books he's going to read for the rest of his life. Then he bends down and his glasses fall off and break. That would be my worst nightmare. 

    • xyzxyzxyz xyzxyzxyz GretaGarbo

      Greta, what happened to that man was my worst fear & was why I stressed SO much over the option of being set "far-far" (both eyes set to see clearly at far distances). If you go that route, you WILL NOT be able to see up close (read, etc) without glasses!!! You will have to, at the very least, have reading glasses. If you are set to be BARELY nearsighted, you will still be able to read without glasses (like you've been accustomed to) & will most likely be able to perform other close-up tasks without glasses (but would need glasses to see at a distance). If I'd ended up BARELY nearsighted, I'd be tickled to death!

  • dale56266 dale56266 xyzxyzxyz

    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.

    • softwaredev softwaredev dale56266

      You quote a price in $ and reference Medicare, so I assume you are in the US (this is a global site, and there are no multifocals approved in the US that correct for astigmatism (so I'm unsure why there would be any reference to it on the lens identifier card, perhaps you read something wrong).

      You imply in "3" that you have astigmatism  , and correcting that even with the current lens might improve your visual quality potentially (though sometimes a small amount of myopic astigmatism lends a benefit without much blur, its possible yours is hyperopic and making things worse, or too large and adding blur).  I'm not sure if the "and/or LR" was a typo and it meant "and/or LRI" since an LRI (limbal relaxing incision) is one method to correct astigmatism... which can be done after cataract surgery. Some surgeons will do in their office at the slit lamp. Its a minor procedure  since it doesn't involve doing anything inside the eye like cataract  surgery does. Some surgeons prefer to do a laser incision. 

      You don't state what degree of monovision you had prior to surgery, how many diopters difference there was, how near the near eye was focused. The near add for the multifocal lens you received is +2.75 at the IOL plane, which is about +2 at the corneal plane. If you had been given monovision, its likely they wouldn't have given you a difference of more than that for your myopic eye, so it isn't clear that your near vision would have been any better with monofocals in monovision, and may likely have been worse. It may be that your natural lens gave you greater depth of focus than an IOL would and so you had better near vision than you would have even if you'd gotten monofocal IOLs in monovision. 

      Neuroadapation can improve near vision for some people with multifocals over the first few months.  It is possible to do a bit of monovision even with a multifocal if the near point isn't near enough. A laser correction could focus the near point in further than it is now, while not impairing your distance vision in that eye as much as full monovision with a monofocal would.

       

  • BW56 BW56 xyzxyzxyz

    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?

  • tanya47518 tanya47518 xyzxyzxyz

    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.

    • softwaredev softwaredev tanya47518

      If you get good distance vision with the 2nd eye, that can leave you with good distance vision overall since usually the combined image from both eyes is at least as good as the best eye (not always). One important question is what the "best corrected" vision is, can they   correct your vision using glasses or contacts, or a laser enhancement, to be 2/20. It'd be ideal to not need to wear correction, but the most important issue is whether it can be corrected.

      It sounds like the lens power they chose was off, though there is a slight chance that your vision was reduced due to the eye still healing from surgery.  

      Unfortunately there is no exact formula to determine the right lens power for an IOL, it is based on statistical analysis of eye measurements of prior patients and what power worked for them. The formulas usually tend to work well for those with low prescriptions, but there is more risk of error for those with high prescriptions (either because of less data for them, or there are some indications there may be issues with some measurements being off for those who are highly myopic). Those who have had lasik due to having a high prescription have changed their cornea, but their internal eye measurements are still like someone with a high prescription,which means there is increased risk the lens power might be off compared to someone with normal vision. 

       

      The lens can change position a bit in the first couple of months after surgery, which changes its effective power and can make your vision better or worse depending on which way it moves. They usually wait 3-4 weeks before prescribing glasses due to that, or less commonly if the vision still hasn't stabilized they'll wait   6-8 weeks or more. For most people though the change is minor, your vision a week after cataract surgery is what it will remain (aside from any healing problems like swelling).

       Any residual astigmatism also impacts quality of vision. Sometimes people don't have astigmatism before surgery because although their cornea has astigmatism, their natural lens has astigmatism in the opposite direction which balances it out. When the natural lens is removed and replaced with a spherical artifical lens, that leaves the cornea's astigmatism not balanced out anymore. 

      The doctor should be able to tell you what your refraction is, your prescription, to tell how far off the lens power is. Numbers like "20/80" merely tell the quality of vision, they don't indicate what the actual refraction is.  The number of diopters in your prescription indicates at what distance your eye has its best focus.  You have a range of vision around its best focal point that is still useful, more going inwards from that point usually than going outwards.

      The focal distance in centimeters= (100 / -diopter_refraction), so e.g. a refraction of -2 would indicate your eye focuses best at (100 / -2) = 50 centimeters.  Astigmatism complicates this a little bit, really the "spherical equivalent" would be used which factors in the astigmatism, but that is usually minor. (typically about half the astigmatism,paying attention to the sign, can be added to get the spherical equivalent, essentially the average focal distance for that eye).

    • jenny070305 jenny070305 softwaredev

      Hi there. I am 49 and high myopia since childhood - about -10 in both eyes. Wear glasses or rgp contacts cos there's a bit of astigmatism without a problem, although I don't like wearing the contacts (which are set for monovision) for night driving, supermarket shopping or computer work as they make me feel a bit queasy. But they're fine for skiing or walking or cycling.

      Now I have a bad cataract in the left eye and the start of one in the right. The NHS will operate on both eyes inserting a monofocal lense. Options are an equal -2 in each eye or - 0.5 in one and -1.5 in the other.

      I asked if I could have a plain lens inserted so that my vision would remain the same. The consultant was amazed and asked why I would want to stay with such high short sightedness. I told him cos it was part of me and I don't mind wearing glasses. By doing this would I be eliminating any chance of correction going wrong?

      What are your thoughts please?

    • softwaredev softwaredev jenny070305

      It is unusual to wish to keep high myopia, but if you decide that is what you want then they should provide it, you are the one who has to live with it. Its usually only low myopes that get practical use out of having good intermediate vision or good typical reading distance vision who wish to retain it. They are used to being able to take off glasses to be able to perform some common tasks. Usually high myopes like I was find we wear correction 100% of the time since my best focal point was closer in than convenient reading distance and so we didn't get any benefit out of being that myopic.

      If there is some activity where you like not needing to wear glasses where you focus a few inches in front of your face, then retaining high myopia might make sense (unless its not an activity you do often, in which case you could either get high + power contacts or glasses for that activity). Otherwise I guess one point is that if you merely like wearing glasses (which I'm uncertain of, given you do mention rgp contacts) then some people wear non prescription glasses for cosmetic reasons even if they have good vision. Or another option if you like the idea of being myopic would be to consider whether at least a more modereate level of myopia might be more useful, e.g. perhaps focused at reading distance, or one eye at intermediate walking-around distance and one eye at reading distance, to let you do household tasks and see the ground and walk around outside safely without correction (even if you can't see the street signs to see if you are walking  in the right direction :-) ). To me I liked the idea of not needing correction afterwards in part due to   safety considerations. While myopic I always had to worry about having an emergency pair of glasses around, and wondered how I'd function in a natural disaster or after an accident or fire if I were somehow without my glasse or contacts. Its useful to be able to have some useful level of functioning without correction, beyond merely being able to function a little in your own home to use the bathroom or get to your glasses/contacts.

      Since I'm in the US I  haven't had reason to learn  the details of what  NHS covers. I assume if you insist they will leave you highly myopic. The only reason I can imagine they might not is that in theory its possible they might require correcting vision to a level where you have some useful level of vision without correction as a safety issue, viewing it as saving them money perhaps later on since if you can't see well at the distance your feet are at then when you are elderly you might be more likely to trip and fall and break a hip and cost them money. A -2 lens is focused at 50cm=19.69 inches so its further in than your feet, but at least the blur at your feet would be less than if you were highly myopic.

      I can understand the issue about feeling your myopia is "part of you" in terms of it being part of your identity, and the fear it would seem odd not needing correction. It is a big change, though most discover it is a positive one. Even a bit over 2 years postop I still have moments where I'm amazed at how well I'm seeing the world without correction, it is definitely a shift to be someone who doesn't need correction, in my case I view it as a positive one, but someone might prefer not to tinker with what works for them I guess.

      In one sense you wouldn't eliminate the chance of the correction going wrong in terms of the lens power not being exactly what they shoot for. If they shoot to make you -10 there is a chance  chance they might instead make you -9.5, -9, -10.5,-11, etc.  However  the issue is that unlike those who are looking for perfect distance vision without correction, where a difference of 1 diopter might be a problem, if your eyes are off by that much you may not in practical terms tell much off a difference.   A -10 eye has a  best focus at about 10cm= 3.94 inches, while a -9 eye has a best focus of  11.11 cm=4.38 inches and a -11 eye has a best focus of  9.1 cm  = 3.58 inches.  So if the correction doesn't hit your exact current level of myopia, its not clear if you'd in a practical sense notice.

    • jenny070305 jenny070305 softwaredev

      Thanks for this. Your last comment is spot on. I think once you get over -4 or so everything is a blur anyway!

      My thinking was as it's much more difficult to obtain the refraction aimed for in high myopes there is more chance of something going wrong. I'm really concerned to read some of the stories on here. It seems there's an element of luck involved!

      The NHS service in the UK is amazing but they only offer a monofocal lense. If I go private and pay around £5000 I could have a Symfony multifocal lens in each eye which the consultant said would (could) give me excellent vision at all distances. However I believe the chance of haloes and glare especially in night driving increases with this lense which is a concern.

      I used to wear same prescription contacts all day but they got changed to monovision lenses when I was about 45 to cater for the presbyopia. I don't like them much though and would prefer them to be the same prescription again and just wear readers on top for close work. So I feel I definitely want my eyes about the same with a difference of no more than .5.

      Remind me please of the surgery you opted for and the specific lends inserted?

    • softwaredev softwaredev jenny070305

      The  major issue with high myopes vs. others is the lens power selection, and they've gotten better at that over time so for most people the result is still very good (and if it isn't, then laser correction is an option,and laser fine tuning afterwards is sometimes bundled with a deal for a premium IOL).  High myopes have larger eyes so there may be some more risk of a toric lens rotating since its looser in the capsule (since IOLs are physically all the same size for every power), though it sounds like the risk may not be that much different. Other risks like retinal detachment  (usually at some point postop, perhaps a few years later even, not during the surgery itself) are very rare with modern surgical techniques, even if slightly increased.  I had a rare issue I'll get to below.

      The most likely flawed result after cataract surgery  with a high myope is merely a slight  increased risk of needing to wear correction afterwards due to the lens power being off, or at least until a laser touchup if they go for one (and that the small laser tweaks required after surgery are safer than the larer corrections most people get with laser surgery, and that is also far better than it used to be).

      I opted for the Symfony lens, implanted in both eyes early December 2014. The Symfony was the best choice for my needs, for those who want more near a trifocal may be a better bet (at the cost of not quite as good intermediate, and slightly higher  risk of halos&glare and reduced dim light vision since it splits the light more).  At my last eye check a couple of weeks ago I had 20/15 vision at distance (and it was easy to read the line, they didn't have a line below that, so it might be slightly better), at intermediate computer distance, 80cm, it was 20/20 (plus a bit). At near I've consistently tested 20/25 at my best near distance, where they give you a chart to hold where its easies to read. In this case they tested it at a fixed 40 centimeters, and they didn't have a 20/25 line, so I tested 20/30, but read some on the 20/20 line so it likely matches my prior tests of   20/25.

      That  result is despite a slight glitch in the lens power on my left eye which wound up +0.5, slightly farsighted, which does reduce its near but my left makes up for it (so I hadn't bothered with a laser tweak).  My left has a trivial myopia, -0.25  sphere with -0.25 cylinder. I am one of the rare people that sees halos with the Symfony, but they are so mild/translucent that I see through/past them and haven't considered them a problem since my night vision is overall better than I can remember it being. I think that is partly since I actually notice less glare issues, bright headlights are less distracting so having halos around them that I see through is a tradeoff I don't mind. 

      The nice thing about the Symfony is that due to its extended range of focus, even if the lens power were off and correction were worn, its likely that single vision glasses or contacts (rather than varifocal/progressive glasses or bifocals or multifocal contacts) would suffice.

      Unfortunately there is no perfect IOL yet, there are always tradeoffs. Some people even have problematic halo or glare issues with a monofocal lens. Studies put the risk of problematic halo&glare issues with the Symfony as being comparable to monofocals, though not as low as the best monofocal. Unfortunately some rare people wind up being the "statistic" with halos they consider problematic, but the same is true of a monofocal, and a lens exchange is usually an option. I figured better vision for a few decades was worth the slight risk of needing a  lens exchange. Contrast sensitivty is comparable to a monofocal in most studies, though some suggest there might be a slight reduction. So vision in dim light, like reading a menu in a dimly lit restaurant,  might be slightly reduced from a monofocal, though in my case its definitely better than it was with multifocal contacts before I had my cataract.  Oddly someone here with the Crystalens seems to have noticeably worse dim light vision (we compared it in a well lighted room where we met and he held something to cast a shadow over the near reading chart, and it cut his vison by some lines, but not mine). That was  despite being about the same age and despite the Crystalens being a single focus lens, albeit one that may accommodate a bit.

       I  actually traveled to Europe to get the Symfony, and you could   get it far cheaper outside the UK.  The lens actually wasn't approved in the US at the time, our government is slower about approving things and so they stil haven't approved trifocals here. The only multifocal IOLs here were high add bifocals, and since intermediate distance is more important to me, and I may live with the results a few decades, I decided it was worth traveling. 

      I considered going to the UK and checked on other countries, but I'd heard that those in the UK sometimes use the Czech Republic for medical tourism. I decided that as long as I was traveling, I could use a top surgeon there and still get it cheaper than the UK. Last I checked for someone a few months ago, depending on options like laser cataract surgery and lens choice, at various clinics in Prague now you can   get the treatment for $1200-$2000 per eye total paid out of pocket from a reputable surgeon (I'll let you do the currency conversion). Fortunately I had little astgimatism so I didn't need a toric lens. 

      Did you ever try multifocal contacts? I liked them, which is part of why when my cataract appeared my initial assumption was that I'd go for a premium IOL. Unfortunately after people get cataracts it is hard to give multifocal contacts fair test if the cataract is interfering with vision. Their optics are a little different from premium IOLs, but at least it would give some sense of having vision corrected for multiple distances at once.  I discovered I liked multifocal contacts better than  monovision in part because I noticed that the world seemed more subtly more 3D since I was using both eyes. I hadn't noticed the reduction in stereovision with monovision while I had it, I think since the difference between the eyes only gradually increased each year (and I only extremely rarely wore glasses for a few minutes at home). 

      The thing to remember is that there are > 20 million cataract surgeries worldwide each year, and the vast majority have great results. Unfortunately even if only a tiny percentage of those have problems, obviously *someone* winds up being the statistic and can give others a skewed perspective on the risks. Those who post are usually those who have problems (or occassionally some who researched things beforehand online and feel it appropriate to return the favor by posting information afterwards, who know it can be difficult sorting out options, especially for those of us a few decades younger than the typical  cataract patient since we expect to live with the result much longer and on average are more active). There are far fewer who get premium lenses, but they are often those more likely to have gotten them because they did net research and since they use the net they may be more likely to post.

      For full disclosure, in terms of the existene of risks for high myopes, I had a very rare issue due to my high myopia (unrelated to the choice of IOL). Its extremely rare even for   high myopes,. Its   likely one out of tens of thousands or perhaps  rarer, surgeons didn't hazard a guess at how rare, most don't surgeons don't see it so I kept checking around trying to find an explanation for the symptom of flickering light when reading close up. Iridodonesis, the iris jiggling, can happen  after surgery to  some high myopes since an IOL is smaller than the natural lens, and the iris loses support and when the eye moves it can jiggle a bit, e.g. when the eyes are moving back and forth to read (not something that anyone looking at you would notice, it took getting a video of my eye while reading to discover it). That  is usually innocuous and doesn't cause issues. In rare cases, in those with light colored eyes, the stray light passing through the iris can be an issue if as in my case there are black striations in the iris mixed in with the blue, so as the iris moves the stray light varies. Its like a rotating fan blade blocking light part of the time causing a flickering effect. In my case it was only an issue with reading, and over time my brain has been learning to tune it out. (and its always been worse with close up reading than computer distance, and fortunately these days almost everything can be read online).  My risk may have been higher due to having  been younger than the typical cataract patient, so my retina is more sensitive to light  (including stray light) than someone of more typical cataract age.

    • jenny070305 jenny070305 softwaredev

      It was when i visited the optician last July to enquire about bifocal contact lenses (cos I keep having to move my glasses down my nose to read) that a) she told me I wasn' suitable because they are soft lenses and I need RGP for astigmatism and b) she found the deterioration in the vision in my left eye and altho' she could see the beginnings of a cataract she didnt think that was enough to cause such a drop, so she referred me to an NHS consultant.  However, the wait was 5 months and thats when I decided to pay and get a private consultation as I wanted to be sure there was nothing else 'going on'.

      So the private consultant said he could fix my eyes so I didn't need glasses at all but he didn't actually say which lens he would use, how my eyes would be set, what the risks of haloes would be (they weren't mentioned at all) and the rough cost he gave me turns out to be for a standard lense only so now the cost is £600 more per eye.  

      I have an appt in 10 days with the NHS consultant who obviously has nothing to 'sell' and I want to know what he thinks he could achieve with a monofocal lens which is all that will be available to him on the NHS. The private guy actually said I shouldn't bother to see the NHS guy and should cancel my appt which I thought wasn't right - I am entitled to have a consultation with the consultant in charge of my NHS surgery, should I go down that route.

      I like what I know ... i have an old phone and an old car, both of which work perfectly well.  I don't like change and it would be a disaster not to be able to work (computer) or drive (live in a village).  At the mo I can type this, look at the TV or check my phone all with the same pair of specs.  If I go for a plain lense I will be retaining the status quo of 45 years and if they get it wrong by an optre or half it won't matter since like you say -9 or -11 is no different to -10 for me!

      Saying that, there is a suggestion of going for -2 in each eye, meaning I can see a lot more without my specs (I had never thought about the safety aspect before you mentioned it) and will still need specs (but thinner and cheaper) and can still wear contact lenses perhaps with glasses over the top for close work.  Your thoughts please?  (PS  It's not the thought of having to pay for an op that I could have for free, it's the thought that I just want the cataract sorted but never wanted to have my vision interfered with!

    • softwaredev softwaredev jenny070305

      Is your vision degraded enough due to the cataract that the NHS will cover it now? In most places government or insurance only covers it when it degrades vision to 20/40 best corrected, though some are starting to consider other issue like degraded night vision and be more flexible about covering surgery.

      re: "At the mo I can type this, look at the TV or check my phone all with the same pair of specs.  If I go for a plain lense I will be retaining the status quo of 45 years and"

      The problem is that it won't be the status quo, it is like the level of presbyopia an elderly patient has in terms  of the range of vision out of each eye.Usually people have decades to adapt to a slow degradation in the amount of near vision they have, higher adds gradually over time in their glasses.  The range of vision people get with a monofocal varies greatly, but the typical thing I've read from doctors is that with a monofocal set for distance (or single vision glasses correcting a monofocal to distance)  that things will get blurry from 6 feet inwards. I saw a recent post from someone with a monofocal where it was 10 feet where things got blurry, though some tiny minority of lucky  people get good intermediate vision with a monofocal, it isn't to be expected. The lower range of vision means some people find their distance glasses won't work to see intermediate at computer distance, and that their intermediate distance computer glasses don't work for near reading distance. 

      So most people with a monofocal  even for driving might want bifocal/trifocal glasses or varifocals/progressives in order to be able to see distance and maps/phone/stereo. Unfortunately varifocals/progressives tend to not be as easy to adapt to with the high adds required since  there is a larger range of focal points covered over the same space on the glasses so a small eye movement changes focus to a greater degree.

       I tend to describe the Symfony as like early presbyopia, where most of the time I don't need correction to see near, but I'm aware that my very near is blurry (as yours would be now when wearing distance correction). So it is like rolling back a little bit of time for someone your age, vs. skipping ahead many years with a monofocal IOl to final state presbyopia.

      I rarely wore glassses rather than contacts, and even with the level of presbyopia at 49 when I tried varifocals/progressives (fyi, I keep using both terms since the UK and US use diferent terms and not everyone is aware of that) I didn't like them, I much preferred contacts. Of course its also possible to do multifocal contacts with a monofocal IOL, though the  multifocal vision may not be the same quality as using a multifocal IOL (or extended depth of focus as with the Symfony, which is different, even if similar). 

      I didn't like the idea of having such a small range of focus, which is why I figured I'd go for a trifocal, and then decided on the Symfony after that came out.  I had figured if they didn't get the lens power right that I'd get a laser tweak, but that in the meantime even if needed to wear correction that the Symfony would be more useful than a monofocal since I could wear single vision correction most likely, or that if I needed them that varifocals/progressives would work  better since they'd need a lower add. 

      Yup, the glasses with a low prescription are much cheaper/thinner, these days you can get dirt cheap ones online from places like SelectSpecs and ZenniOptical if you can use a cheaper lens material.  I don't need prescription glasses for distance obviously, my distance vision is better than I ever experienced with glasses or contacts as far as I can remember,  but   I wanted new sunglasses with a lighter tint and discovered  I could get dirt cheap prescription ones made with whatever light transmission I want so  I'm waiting on some now since I'm curious if I'll notice the difference.

      re: "have an old phone and an old car"

      That is understandable, if something works then many people see no reason to tinker with it. I do that in some parts of life, though in others I'm more a typical technophile early adopter, often working at the bleeding edge of computer technology.

      re: "didn't think that was enough to cause such a drop"

      Oddly I had a similar experience at the same age, it may be partly at age 49 they assume it isn't a cataract issue. I never had enough astigmatism to worry about toric contacts in the past.  I was trying a new model of contacts and when I came back for a followup since they weren't working well, the optometrist saw the problem was  my astigmatism had increased, and she was puzzled about the problem, since she didn't think the slight changes in the lens were enough to even label a cataract. She described it as "trace nuclear sclerotic changes"  in a referal to an ophthalmologist who diagnosed the problem as a cataract, which eventually the optometrist was able to see as it got worse. In the course of 3.5 months my astigmatism in the one problem eye had gone  from -0.75 to -4, and best corrected vision dropped from 20/25 to 20/60 and the optometrist  was stumped and finally gave up and referred me to an MD to diagnose it. Usually cataracts don't appear and worsen that quickly (at least nuclear ones that don't seem to be related to any trauma or medication side effect) or impact refraction that much. (that eye later saw astigmatism subside, but  increased from -9.5D sphere to -19 before surgery).

      Actually there are toric  multifocal contacts that correcet for astigmatism in both soft and RGP models.

    • SimonEye SimonEye jenny070305

      dear Jenny 

      It would be most unusual to aim for a post-operative target of high myopia and as which you have! 

      the options the NHS surgeon has suggested to you ie  equal -2 in each eye or - 0.5 in one and -1.5 in the other seem spot on to me, and especially as you say you do not minf wearing spectacles or indeed contacts 

      COI: I am an NHS cataract surgeon and with a professional interest on the insertion of 'wrong IOLs' 

      I no longer implant multifical IOLs as too many patients report haloes etc whereas such matters are almost unknown with correctly implanted monofocal IOLs 

    • jenny070305 jenny070305 SimonEye

      Hi Simon,  I had noted that you were part of this forum and wondered if you were watching my notes to softwaredev.  Needless to say your last comment caught my eye ...  Can I ask which part of the UK you are in?  I am in the South West/Midlands.

      I am seeing the NHS consultant that I am 'under' the week after next - I have specifically asked to meet him before the op in early April to be very clear about the surgery. 

      i have made some decisions already:

      not to go for a multifocal.

      i want my eyes to be set the same (cos I don't get on with my monofocal contacts).

      The third decision is to see if i can just have the worst eye operated on and manage with a contact lense in the other eye for as long as possible - that would be better than rushing to get the 2nd eye done within a few months as has been suggested in the pre-op assessment, when the cataract really isn't that bad yet. (thus lowering the risk of a retinal detachment in BOTH eyes)

      Once the operated on eye has settled surely i can get a new lense in my existing glasses for that eye (to accommodate the -2) and a new contact lense?  

      Or would I need readers / bifocals for close work?!

       

    • jenny070305 jenny070305 SimonEye

      PS  It had occurred to me that multifocal IOL's were only approved in the UK in 2014 and so there is no long-term data yet on their use, whereas monofocal lenses have been used for decades by the NHS.  Sometimes it's better to stick with the tried and tested ... 

    • SimonEye SimonEye jenny070305

      dear Jenny 

      i agree that not having cataract surgery soon on the fellow eye is a good plan.

      you can continue to wear the contact lense in the good eye only and then just get a low spectacle correction to wear over both eyes  and which may be circa -1.5 for distance in the eye with new IOL

      The reason why the surgeon may be scheduling you for both eyes in quick succession is that few patients will do the above and most patients cannot tolerate a significant imbalance in spectacle lens powers between their two eyes (known as anisometropia) biggrin

       

    • jenny070305 jenny070305 SimonEye

      So, to be clear, my glasses would cater for -2 in one eye and -10 (ish) in the other (as now), is that right?  And is that do-able?  Or will one lense be massively thicker than the other (I pay top dollar for Zeiss lenses to be as thin as possible and luckily have a small face/glasses frame) - so will there be a noticeable difference in the glasses lenses?

      Secondly, existing contact on right eye, new contact to combat -2 in the left eye, yes?  Will I need second pair of reading glasses to put on over th contacts?

       

    • SimonEye SimonEye jenny070305

      it is extremely unlightly any patient could wear spectacles with 8 diopters of difference between the two eyes.

      What i was alluding to  was you could perhaps wear spectacles of circa minus 1.5 in both eyes and that such spectacles be worn over the contact lens in the non operated eye

      You need to speak to the surgeon and also perhaps disregard a lot of the comments on this website !

    • jenny070305 jenny070305 SimonEye

      I misunderstood your last message, Simon - should have read it twice before replying!  You mean to wear the contact lense in the good eye plus glasses for a low prescription over the top - wearing them all the time to correct the -2 in the bad eye (as it doesn't work having 2 very different glasses lense prescriptions, as you said)  Would it be a plain lense in the right eye then? (as the contact has already corrected the vision)

       

    • jenny070305 jenny070305 SimonEye

      Got it now!  One more thiing - if I wanted to wear just my contacts sometime, e.e. to go skiing (!), would i have one to correct the -2 vision in the left eye?

      I am much clearer now on what's what and how this could work and feel much happier and more prepared for my chat with the NHS chap in 10 days time.  Really appreciate your advice, Simon.

    • SimonEye SimonEye jenny070305

      yes for sking you would wear -2diopter contact lens in the eye which has had IOL implant and you existing contact lens in the fellow eye. You could also cobsider carrying a pair of off the shelf 'ready readers' (circa plus 2.5 diopters)  to read maps etc while sking or for reading the menu in the ski resort 

      I expect you will wish to request lens exchange (aka cataract) surgery in the fellow right eye in due course and once you experience the massive benifit you willl have had from the cataract removal in left eye

    • softwaredev softwaredev jenny070305

      Yup, it was the Symfony that was just approved in the UK (and Europe) in 2014, and the US in 2016. Multifocals have been used for quite a while, however they have been improved quite a bit over the years in terms of a reduction in risk of halos&glare. Unfortunately some surgeons used the early generation multifocals and encountered too many problem patients, and then haven't given newer multifocal IOLs a chance since their interest is in what is easiest for them, rather than what is best for the patient. (though admittedly on the flip side there is some incentive for some docs to get people to pay more for a premium IOL).

       Monofocal patients might not have as much useful visual range as they might have with a premium lens, but they don't have anything to compare it to so they don't complain so the doctor doesn't need to deal with it like they neeed to with a patient who has problem halos with a multifocal.  

      To me the certainty that a monofocal would make functioning more difficult for any remaining decades of life  due to a lower range of vision outweighted a slight risk of problems with a premium len. 

      In terms of "long term data", in most of the ways that would matter over the "long term" the multifocal  lenses (and the new category of extended depth of focus lenses) are the same as monofocal lenses. For instance the Tecnis multifocals and the Tecnis Symfony are made from the same material as the Tecnis monofocal and have the exact same overall size and shape, it is merely the optics that are different.  By analogy to eyeglasses, its like having the same eyeglass frame and using the same material for the lens that goes in them, but merely griding the lens differently. Any medical issues related to the material and its biocompatibility or issues of PCO or edge relfections or  the physical stability and placement of the lens would be exactly the same. 

      The major issue is the difference in optics, where neuroadaptation means the results get better over time, so long term data isn't really a concern. e.g. the incidence of halos will go down over time. So long term results would be better.

      The only issue regarding long term use that is imporant to consider would be the interaction of a premium lens with other eye problems that might arise over time. That   is a risk some people might not think of. Some people who have other eye problems, in addition to a cataract, aren't considered candidates for multifocals due to those other issues not playing well with multifocals. However its always possible that you might develop that eye problem in the future after you've had a multifocal implanted.

      In my case I knew that was a possibility, but that the risk was low. If I ever developed some other eye problem that didn't play well with a premium IOL then I could get a lens exchange to a monofocal. The high probability of having more useful vision for a few decades was worth the slight risk of needing an exchange. Also fortunately the Symfony seems to be more tolerant of other eye problems than multifocals, though that is an area where there isn't much data yet because doctors are cautious about implanting a non-monofocal in someone with other eye issues. Each person needs to make their own risk assessment though.

      Ideally decisions should be based on knowing what the data shows. Unfortunately many doctors base their decisions based on their personal anecdotal experience with patients, rather than what larger studies say which may be more statistically representative of likely outcomes.  

    • softwaredev softwaredev SimonEye

      re: "You need to speak to the surgeon and also perhaps disregard a lot of the comments on this website !"

      Unfortunately there are some problematic comments on this site from patients who haven't educated themselves on issues, so its worth suggesting people exercise appropriate caution. However I'd also suggest that the most productive response to such comments from someone knowledgeable is to post specific critiques of flawed comments. Especially since in the real world busy  doctor's don't always educate themselves about a particular topic if they don't need to. e.g. many surgeons are focused on medicine rather than optics and don't spend time reading through the data from various IOL studies (whereas others do, I corresponded with a surgeon prior to getting the Symfony who was researching it at the same time  and who passed along what might be the patent for the tecnhology that went into the detailed physics and math behind its diffractive optics).

       

    • softwaredev softwaredev SimonEye

      re: "I no longer implant multifical IOLs as too many patients report haloes etc whereas such matters are almost unknown with correctly implanted monofocal IOLs"

      The idea they are "almost unknown" is questionable, even if the risk is lower than with multifocals. There is no lens yet that doesn't give someone halos.  Studies for approval of multifocals by the US FDA compare them to a monofcal control lens. In this case the April 2015 approval of the Alcon Restor +2.5 lens includes a comparision with an Alcon monofocal (one of the most widely used monofocal lenses, and possibly the most widely used though I don't have statistic). Since this site moderates links, google this:

      "ACRYSOF IQ RESTOR +2.5 D MULTIFOCAL INTRAOCULAR LENS" 15M-1325

      The page that shows up has a link for the summary of safety and effectiveness data. In table 12, the monofocal result shows mild halos: 26.9%, moderate 7.5% and severe 3.8%

      Unfortunately I haven't seen a head to head comparision between the Symfony and an Alcon monofocal, and I'm not sure without looking further if those were directed or non-directed responses to know what data to compare it to. Comparing data from different studies is somewhat problematic since they can ask questions differently or have different patient demographics, so you just get some general sense of the general magnitude of results.  Googling "High rates of spectacle independence, patient satisfaction seen with Symfony IOL" shows a summary of multiple studies of the Symfony showing low rates of dysphotopsias that appear to be in the same general range as monofocals, if perhaps a bit higher than some, not by much.  The studies show it not doing as well as the Tecnis monofocal control, so its not the same as the best monofocals perhaps but comparable to others, so I'd be curious how it would do in a direct head to head comparision with an Alcon monofocal.

    • softwaredev softwaredev SimonEye

      re: "I no longer implant multifical IOLs "

      I should note that I hope this merely means you educate patients on the pros and cons in as unbiased a manner as possible, and then refer those patients who wish a multifocal to other surgeons. Some patients when presented with the pros and cons will chose to use multifocals, just as some surgeons consider them to be the best choice for many patients. If no patient opts to leave and get a multifocal elsewhere, that would suggest a biased presentation of the pros and cons . It is rational if some surgeons choose not to risk needing to deal with patient problems to make their jobs easier, and refer patients elsewhere to surgeons who have more patience for giving patients what they want even if it means dealing with some problems.

      Unfortunately I get the impression most surgeons wish to keep their patients and instead would be more apt to push monofocals and not let their patients get a fair hearing of the pros and cons of multifocals, rather than merely their personal biases. Some patients aren't going to carefully weigh the options and go with what their surgeon recommends. Some patients unfortunately won't do a good job of evaluating the pros and cons, but many  are a better judge of their personal needs and risk tolerance than the surgeon could be. 

  • mary96078 mary96078 xyzxyzxyz

    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.eek

  • john75639 john75639 xyzxyzxyz

    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

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