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

please update ...how are you feeling

On medical leave for another Month

I am too new to this and could not remember my password either

Hope that way is more useful for everyone

i clicked on your name you never started an initial discussion thats all about you   but you can now.  dont worry about password you're able to get in here to post. so all good.  tell the folks what you're going thru and they will try to help you.  just go to top of this page where there is a red box and a green box.  hit the green box and a page will open for you to fill in.  it's easy 

yes sir, it is.  say you were in an accident, you'd want the docs to know about your i

Hi there.  My surgery was scheduled for April, but I postponed it until I felt I really needed it.  I now have cataracts in both eyes and surgery on the first (worst) eye is scheduled for early July.  I then anticipate having the second eye done within a couple of months, as the surgeon says it will be very difficult for me to tolerate -2 in the good eye and -12 in the other.

i am now under a different consultant on the NHS who I haven't met or spoken to. I hope to be able to speak to him before the surgery but am not hopeful really.  I am therefore planning to have -2 in both eyes. I will be able to see at 50cm without glasses so make-up and showering will be ok.  I should also be able to have varifocal soft contact lenses as the astigmatism should be corrected with the surgery, and new glasses of course, which should be cheaper and lighter etc.

I was scared off multifocals by the chance of haloes and glare at night, and because the optician said it is more difficult to get to a zero than a -2, and I might end up long sighted which I would find very strange as I've always been very short sighted but I can see up close.

Personally I don't like monovision; my contacts are mono and I feel queasy when looking at, e.g. supermarket shelves.  

I don't mind wearing glasses/contacts so to me the risk of paying £6,000 for multifocals wasn't worth it, but that's just me.  I am not a risk taker.

If I didn't have a cataract in the good eye I wouldn't have it done until I absolutely had to, but it is likely I'll need it doing anyway in the next year as my vision deteriorates so now I am going for the double.  Very nervous of course but I am getting to the stage that I don't have a choice - the text on the computer screen at work is getting more blurry!

Apologies if you got a partial response. Good luck with Phase 1. Odds overwhelming that'll it'll be so smooth as to senna miracle.

I kind of like having a distance eye and 3 options for the untreated eye--2 diff contacts or no contact at all. But I suspect I should make a decision whil still fully healthy.

Thanks Barbara. More good information. I'm curious about making another run at glasses to balance out my vision (now farsighted, need +2 readers in repaired eye) and forever -7 in uncorrected right eye.  Wearing glasses isn't a problem and having transitions & progressive lenses in one pair means no need for cheaters or sunglasses. Would love to hear from any others who've gone that route.

Hi Mark: This is all above my pay grade as they say. It seems we all want perfection--the ability to see clearly at all distances at all times--and that doesn't seem possible yet. I'm still with left eye fixed 20/20 for distance and using various 'solutions' in right eye. With no contact in right eye, with medium contact am comfortable walking around and driving, with strong contact (20/20) correction, a pair of cheaters (+2.00) works for reading and computer work.

Already determined nothing is perfect. But trying to pick what is 'best' is much more difficult that I would have thought.

I keep going back to "if I had lasik years ago, then I would have already been at 20/20 when I needed reading glasses, and would have been used to it". (of course was never a candidate being -12D)

So that is why I am leaning towards distance.

Plus I like see the clear distance while driving.

I just also do no like having to on glasses when I want see my phone.

All about picking a good balance.

And I think I'd rather be able to get cheap cheaters for whatever thing I am doing, then having to get real glasses for everyday.

My understanding with monofocal lenses set for distance I will lose both near and intermediate distance. As I am not retired and likely have 10 plus years of working ahead of me thinking intermediate distance is very important for work (do 80% of my job in front of a computer.). I have worn glasses since a young teen for distance and only just started needing progressive glasses in last year (and now have cataracts to muddy the waters). I still have pretty good near and intermediate vision and not sure I want to lose that.

Good luck to you in figuring out your best option.

The docs generally recommend the distance correction for all those reasons plus one more: It generally comes closest to an ideal result.

Another question for those "in this boat."

Has anyone done the distance correction for both eyes, then opted for progressive lenses (basically blank for distance) but then able to work for computer, reading, and smartphone distances? Oh yes, and added the transitions/photogray option tobworj as sunglasses?

Hi Mark.  I am not sure how much of my background you have read on this forum, but in a nutshell I have always been very short sighted and now I have cataracts in both eyes I am at -12 and -12.5 so am eligible for NHS cataract surgery; the first eye is scheduled for early July.  The NHS jnr dr gave me 2 choices: 20/20 vision or -2.  She said a lot of people with high myopia go for -2 in both eyes because they are used to wearing glasses/contacts all the time and its a big bonus for them to have much better eyesight without anything.  People who go for 20/20 vision would still need to put glasses on for close work and apparently this can be quite irritating, always looking for your glasses, on/off, on/off, for a quick look at your phone/paper/ipad whatever.  Also if they go for -2 there is room for manouvre, as -1.5 or -2.5 won't make a lot of difference, whereas if they go for 20/20 and end up getting +1 that wouldnt be good, as being long-sighted is different to anything I've ever know in my 49 years. 

I have put the surgery off as long as possible but both eyes have deteriorated by -1 since January so I have to go for it now, bearing in mind the second eye won't be done for at least 6 weeks after the first.  I am hoping I can manage in the intermin with a contact in the unoperated eye, like Barbara did.

Having tried monovision contact lenses and not liking it at all, I count myself lucky that I have had that experience so I know that I want both eyes the same if possible.

Mark, I would go for a lense swap in the left eye to make it 0, to match the right.  But then you would need to pop specs on for close work (I think?)  

Barbara - that is very interesting to hear that you could get glasses for a big dioptre difference.  The consultant told me that would be impossible ....

Not sure setting for distance is an ideal. Spoke to someone just yesterday that never knew there were options and surgeon never mentioned different lenses. She got monofocal lenses for distance and mourns total loss of near vision (which was perfect before cataract surgery. She does were glasses for that but simply tasks like putting on makeup is impossible now. Hard to apply eye make-up when you're wearing glasses.

Hi Sue.  Our situations seem very similar.  There is a lot of info on here but I remember one person saying they wished they hadn't gone for distance, although that is generally recommended by cataract surgery, as they couldn't see close and near, as you say, meaning they couldn't put their make up on or see the bottles in the shower.  Like you I have always worn specs or contacts and I am ok with it.  I saw a private consultant to compare the options and for around £6k he would give me multifocals and said I would never have to wear glasses again, but from looking into this further I think I might need glasses for close work ... and may suffer from haloes/glare although apparently this affects people with larger pupils the most and mine are only medium sized.

Hi Jenny yes does sound like our situations are similar. I live in Canada so fortunately healthcare covers cataract surgery 100% (provided cataracts are bad enough to fail the driving test). They will cover monofocal lenses too but not a premium lens. I am still seriously contemplating a multifocal (actually the extended focus Symfony lens). I have another appointment with the surgeon in June and I have been compiling a list of questions (many of which come from discussions on these forums - a big help). I am not sure if my pupils are large or not but will definitely be asking that question as I am not wanting to have bothersome halos and glare (but will have to accept some as I do t see anyone posting they don't see any of those with a multifocal lens - no matter the brand).

I too will have the surgery in July.

The comments by contributor 'Simoneye' in respect of the use of multifocals are very interesting.  They let more light into the eye which is how they can give you great vision for almost all situations but the trade-off could be the haloes/glare at night.  

As in Canada the NHS here in the UK only provides monofocal lenses. Initially I was going to go for the multifocals but having looked into it a lot more I have decided against it, because of the increased risk of hales/glare and also because they are more tricky to get just right and there is less room for error.

The contributior 'softwaredev' seems very knowledgeable about multifocals; I believe they are improving all the time and if my cataracts weren't so urgent I would leave it in the hope that even better ones will be developed.  

I keep telling myself it is a routine operation and thousands of people (inc. my elderly mum) have it done but I know on the day I will be very frightened of what the outcome is going to be.

As an NHS surgeon I have done the above many times and with excellent results

Further this is exactly what I would advise to family and friends and self

Simon Kelly

Yes can so relate - I am absolutely dressing this operation.

Just out of curiosity will UK NHS let you pay for your premium lenses or do you have to go private (£6k sounds like a lot). In Canada I just have to pay the difference between a monofocal lens (which is $300 per eye vs multifocal $1,200 per eye). Net difference $900 per eye. Sounds like in U.K. to get a premium lens you have to pay privately for surgery and premium lens)

If you opt for monofocal will you have them set for near and opt for bifocal glasses for intermediate and distance?

Few if any NHS hospitals provide multifocal IOLs (outside clinical trials)

Do look at ' draft NICE guidance on cataract surgery' via google to better understand why

Post operative refractive outcome aka IOL choice is a mater between doctor and patient or should be

Thank - will look that up. Was thinking it had more to do with cost. Our Canadian Medicare system may be a little different. I am seeing a private clinic however surgery is covered by Medicare. Perhaps that is why our clinics discuss both monofocal and premium lens. If I opt for premium lens I pay the hospital.

So in your opinion even if both my nofocal lens and multifocal lenses were covered for patients you would still advise them against a multifocal?

I would imagine most cataract patients are retired. I am in my early 50's employed full time and likely will be for another 10 years. Am really concerned about being able to do my job without good near and intermediate vision.

Appreciate your input.

If you don't mind another question I have as I contemplate lens selection. Given I am younger than many cataract patients are there other disadvantages to going with a multifocal (other than glare halos and starbursts) vs monofocal. Thinking more down the road as I age - are there eye conditions I may develop that would be worse for me with a multifocal? This is one question I have written down to ask my surgeon. Even if all goes well for me with a multifocal I am not sure I would want short term gain for long term pain.

Really appreciate your input.

Hi Simon.  Thank you for your advice.  I must admit I am put off having different dioptres per eye as I don't get on with my monofocal contact lenses although admittedly I don't know what the difference is - will check that out.  I just know that in certain situations I start to feel a bit queasy with looking far one minute and near the next and I feel more confident driving with my (equal) glasses on esp at night.  With a -1 dioptre difference would I notice that very much?  (Contributor mark 65089 is not getting on with the monovision achieved by his cataract surgery - see post about 2 hrs ago - of -1.5)

Don't do it !!!!

I am 49

May I ask why? I assume you went with multifocals. Is it the night vision or is it also surgeon didn't get the power right so daytime vision not good either?

Jenny,

Yes I did read through this entire thread. I totally understand your hesitation and trying to gather all info as possible.

Your pre-surgery script is the same as mine. Not sure if this matters/helps, but I always did plan CR-39 plastic for glasses. The high index drove me nuts because I could only in the center of the lens. And once I needed progressives I didn't understand how they could ever work at the bottom (i.e. reading strength). So only CR-39 really worked for me.

I have worn glasses since I was 5 yrs old. I did contacts late in high school until ~35. I stopped because my eyes would get too dry during allergy season. In my early 50's now.

While I have worn glasses for so long, I am really ready to stop. For some reason they are bothering one side of my nose; no matter how much they have been adjusted. Half of it might just be in my head :-)

When I started out, the idea of -1D in both made sense. It would mean I could legally drive without glasses and still have some up close.

I do not read, so wasn't concerned about needing glasses for that.

I do sit in front of a computer all day, but was ok with glasses for that (more in a minute). Since the smallest readers are -1D, that would have been -2D which would be good for the computer (I have been basically doing -1.5D right now, and it is ok).

I had been using progressive glasses before surgery and computer was slightly difficult because I needed to look through the narrow zone. Post surgery, computer has been terrible. So that means I would need different glasses for computer if I want 'comfort' (and I really do). So that means I will need glasses for the computer no matter what.

Prior to surgery I tried contacts to simulate -1D and it seemed OK. With the cataracts and strong contacts, it wasn't a perfect test. Distance things on the road where blurry, but I could drive. I probably would have used glasses when not driving to work (i.e. going new places or on trips).

I can say that with 0D, seeing down the road is great. I can also see the TV without glasses; which means I can sit in bed without glasses and I can lay on the couch and not worry about bending my glasses or them being off center.

At work, with contact in Left to give 0D, I can tell that putting the readers on & off is starting to become a habit. Besides, I know they make readers that are 0D on top, so that is another option to realize is out there.

When driving, I really want to be able to see the dash (do not care if it is slightly blurry) without glasses. Not sure if that is possible with 0D. But I know two people (my father and a friend a couple years old than me) that supposedly had 0D in both and can see the dash good enough. But they don't have their script so I know what they really have :-(

So that leaves "do things around the house". With my current -1.5D Left (with not noticable astig) and 0D Right (with noticable astig), getting around is doable. That totally goes away with the contact to get to 0D in Left. This is the thing that bothers me; I do like that. However, if I put on glasses (i.e. -1.5 in Left, 0 in Right), I can notice the difference in the size of things between the two eyes (i.e. the thing that causes double vision).

So I am trying to convince myself that I am ok with grabbing glasses just to look at the phone, and doing things around the house.

You would think that wouldn't be a problem since I needed glasses for everything before (other than looking at very small things when I took off my glasses).

It interesting that you recommend that I swap the left for 0D (which is where I am leaning), but you are not planning to do that. Can you tell me more about why you feel that?

For you, I would definitly try contacts at the power your are thinking. My doc gave me trial lens. If you are thinking about -2, as you know, you mayneed glasses for very close up. The thing is, if you like to read, you might find that readers might still be needed as most people need -2.5 or higher for reading; but -2D should be doable. With -1.5D, I have to hold my phone out at about 1/2 to 3/4 arms length.

I feel, for me, having the option is probably more of a problem then what I end up with. It would almost be better if I didn't have a choice :-)

But (like you is seems) our vision is very important.

To Simoneye:

Many thanks for all of your input here and being willing to deal with our hypotheticals….Here's one from me in the USA.

~

I’ve had my left eye cataract repaired for distance vision with a toric lens to fix astigmatism as well.  It’s been 20/20 in the 6 months since surgery.

~

My right eye doesn’t need surgery (wish I’d known that going in) and can be corrected to 20/20 with a -6.50 rgp lens or to monovision with a -4.50 lens. For walking around, I prefer the -4.5, for long projects involving lots of reading and computer work, I find the -6.50 coupled with a pair of “cheaters” works well.

~

Because I wore glasses for 60 years, I’m wondering if this plan makes any sense or whether it would cause more problems.  Instead of having the 2d eye fixed (and not sure what option to take for that), does it make any sense to have a one pair of glasses for all circumstances with progressive lenses and transition coating to also eliminate sunglasses as well. Left eye would be blank on top with progressives for computer work and reading; right eye would basically be my old Rx:  distance top with less power progressively below.  On paper it seems to make sense; however, in practice, would I be flirting with headaches, double-vision and a lot of “my brain doesn’t want to accept this” signals?

A difference of circa 2 Diopters between two eyes is usually well tolerated - corrected by spectacles

A difference of say over 4 duopters is often troublesome aka anisometropia

Simon Kelly

Hi Mark, I agree, having a choice makes things so much more complicated! I saw my optician today, who is brilliant.  She has confirmed to me that I am going to go for -2 in each eye and if the surgeon misses slightly it's better that he goes for something less, i.e. between 0 and -2, not -2.5 or higher. This is because at -2 you can see to 30cm without glasses so I should be able to read a book and use a computer with glasses (she told me to pull it closer).  At -2 I should be able to wander round the house unaided, but will need specs for driving and possibly just being out and about.  I cannot imagine what it would be like to not have to put my specs on as soon as I open my eyes.

The problem with the surgery is it is not an exact science; its not just a case of removing the natural lense and putting in a -2 lense.  There are complicated calculations to be done, and there is absolutely no guarantee that the surgeon will hit the mark - as is documented quite a bit on here.  My optician said do not go for 0 as if the surgeon misses it, i could end up long sighted which is a real no-no for someone like me who has always been so short sighted.

The one thing the optician stressed that no one has mentioned before is that between the eyes being done I need to get some cheap specs for -2, so that when the second eye is done I immediately have something to put on as without them I wouldn't be able to drive to the opticians!

Finally, she confirmed that my monovision contacts have a .5 dioptre difference - which I don't like.  So I am really hoping that my clever surgeon can match 'em up!

Jenny glad you have a plan.

That all sounds similar to what my doc said when we decided to shot for -1D in both. We did -1D so I could drive without glasses. At -2D you will need glasses for driving.

Because it is not exact, that is why they took into account what happened with my Left/first eye (i.e. tried for -1D but got -2D with no astig; which later changed to -1.5D with slighty astig). So they tweaked what they thought I needed for Right (in order to get -1D) and bumped it by the 1D difference we got with the Left.

As I documented, the Right is at 0D with astig (after 2 wks it seemed to be -0.5 no astig). So that either means we didn't need to fudge the calc for the Right or the two eyes really are that different. Since the cataract in the Left was right in the center, I have a feeling the initial calc for the Left was off a little. The cataract in the Right was on the side, so it probably had a good calc.

So it took me more than 2 weeks for it to settle in. I say that because the eyes seemed to change by 0.5D and astig. That could be that it really did change, or wasn't healed enough to get an accurate reading.

As far as between surgeries I thought I mentioned I did a contact on the uncorrected eye. You will want trial contacts to get you to -2D; I do NOT recommended doing it with glasses. Getting from -12 to -2 is a large swing. You will be very surprised in how different the size of images will be in each eye (everything is going to look much bigger to you). You will very much notice that the image in uncorrected eye will be much smaller than the operated eye. You want a contact because it gets the correction as close as possible to your eye. You think you had problems with the mini-mono, you really won't like it glasses :-)

My doc gave me daily trial lens. While my glasses were -12, the contact was -10. It wasn't perfect, but it WAY better than trying the glasses.

It is interesting that you had only a 0.5D mono difference and you didn't like it. I would have thought/hoped that would have been tolerable. That makes me think hard about what to change my Left to. I was thinking about doing -0.5D to get a little close (i.e. mini mono) and just in case it comes out 0D.

So after your appt, and reading all of this, do you still feel I should go for 0D? Also, can you explain you reasoning?

When say "-6.50 rgp lens", I assume you are talking about a contact.

For me, I have glasses with progressives, for the Left -1.5D and Right 0D. If I don't think about it, then I cannot tell the difference. But if I close one eye or the other, I can tell images are a difference size; which is what contributes to double-vision. When I have a contact in the Left, the difference goes away.

My glasses don't seem right to me, but it could be the image difference or something else.

For me, the progressive doesn't work as well as they did prior to surgery with my -12 glasses. I think that is because one eye is just going to the + range, and the other is going from - to 0 then +.

Anyway, my point is, for me things are different between contact and glasses. So you might want to try glasses before you pay for them. The doc should have a set of frames where he can pop in those round lens you see in the drawer in the room. They look terrible, but worth trying for 5 minutes.

You said "right eye would basically be my old Rx:  distance top with less power progressively below". Not sure what that means. I sounds like the Left would be 0D on top and the +2.5 (or so) for reading. Then for the right you would have -6.5 on the top or -4.5 on top?

Jenny, in may last one when I said "do you still feel I should go for 0D", That was referring to my comment from yesterday about swapping the Left to get from -1.5D to something else. You said you would go for 0D to make it equal to the Right (which they say I cannot change since the capsule was popped).

Also, I recommend you get trial contacts and try the -2D. It will help you feel better that you made the right choice for you.

Exactly.  The right eye with a -4.5 or -6.5 contact is fine, but I'm wondering if that RX on the top of a progressive would be a problem with the glass lens. After surgery on the left eye, I took out the left lens in my specs and was seeing double. Optician explained it was because the glass lens was away from the eye. When I put in a 30-year-old rgp (rigid gas permeable) contact, the double vision went away. The double vision basically was, if I looked at a roofline in the distance, there'd be a ghost image of the same roofline separated from the main image.

That's good you can handle the 2D difference with the contact. My brain isn't letting me deal with 1.5D difference.

If you are saying you would do a -6.5D or -4.5D right contact and then do the glasses with 0D in the right for the top, then I would think you will still tolerate it. The glases would transition through the progressive part by the same amount.

If you are saying you would do -6.5D or -4.5D for the top of the right side in glasses, I would think you would get that double vision again for distance. And it would still be there for reading.

For me, my progressive glasses (with -1.5D top for left and 0D top for right) gives me grief beyond the image size difference; I think for the reasons I meantioned in my last post.

It is too bad the right doesn't need surgery yet. Is there just no cataract at all, or not big enough yet? I would poke at that see if the will do it. Either way, your right natural lens will be 'yellowed' (natural part of aging even without cataracts), maybe you can complain about that to get them to do it???

Of course, when you are ready to do it, you will have to decide if you want it to be 0D or -2D. Which will put you in the same boat as Jenny and myself :-)

Mark:  You hit all the issues right on the mark.

1. The cataract in my right eye is tiny and off to the side. Closing one eye at a time, colors still seem equally bright. Of course, the cataract in my left eye was small, too, but in the line of fine vision. Doc does say that "balancing vision" is a legitimate reason for surgery in my situation.

2. I tolerate the -2D difference quite well in walking around. It's OK for reading phone and menus, but not so good for sitting down to read a book or doing long stints on the computer.

3. So ... to you & Jenny ... pls keep posting and I'll follow your experiences.  I'm OK going along as things are until I see the doc again in October. But I'm also 70 and wonder how long geriatrics keep using the rgp lenses (gas permeable contacts) and whether it would be wise to get the surgery out of the way while I'm in good health.

4. Maybe there's are good reasons docs lean towards the double distance fix--they have better luck with those fixes and the having-to-wear-cheaters isn't the worst thing in the world unless you're a woman trying to put on makeup, a guy trying to fish an eyelast out of his eye, or crawling under a sink to fix faucets and not seeing well.

I paid $1700 for the toric lens (Boston MA prices) to fix my astigmatism in the left eye and haven't regretted it for a moment. Pls let us know how things go and what your plans will be for Round 2. If I had a do-over, I'd like to think I'd have gone for the -1.5 or -2.0 option, but the lure of seeing 20/20 w/o glasses for the first time in my life was strong. I drove 2600 miles in 9 days this spring with the left eye 20/20 and the right eye at (I think) -2 (a -4.5 rgp on top of a -6.5 eye) and had no vision or headache issues.

Did your lens fee include any tweaking that may be needed post operation? Seems pricey. I was told price for Symfony lens would be $900 Cdn per eye. Surgery itself covered under Medicare. Will be inquiring on next visit whether there could be additional charges if I need additional procedures.

Interesting the colors seem as bright. I totally noticed how colors changed now that blues were making it through (the yellowing of the natural lens blocks blules). The pavement looked different, the walls in my house. I was prepared for the image size to change (being -12D) but didn't realize about the colors.

I like the -1.5D difference when I get up and getting eating and shaving. I can glance at my phone to see what going on there. But otherwise, I do not like it. TV and driving is always slightly blurry because my brain won't just use the Right image.

Some people it works for and others it does not. That is why a good doc with have people try it.

Not sure about using the rgp or not. If it works for you, I would think it would be ok; those lenses never die.

They will have you stop using it for at least 2 weeks befor they measure the eye for the new lens. Contacts (other than the newer soft ones) slightly change the shape of your eye. So they will want that gone to get an accurate reading.

My dad just had is done and he is in is late 70's, so if you decided to wait it shouldn't be a problem. But if you can do it now why not? Might has enjoy the eyes as long as you can.

I have been playing with contacts for a couple weeks and decided I want to do equal and both at distance. If they are not equal, then you can never use cheap readers, you will need custom glasses. I have learned there are 'cheap' readers that are clear on top. They also do that in safety glasses. Which makes sense since so many people have 20/20.

Think about all the people that got lasik when they were young and now need readers.

And YES, working on my car and get dust&rust from eye was so easy when I could just pull off my glasses. I will no longer have that :-(

But I will be able to drive with no glasses and see down the road. I will be able to watch TV and be able to lay on my side and not worry about my glasses 'moving' such that I cannot see.

I saw my doc today and we are moving towards doing 0D in the left. Now have an appt with the surgeon (end of June) to determine how to get there; lens swap or lasik.

Sue,

I am 52 so am in the same boat (was -12D).

I sit in front of a computer basically all day.

I already determined I will need glasses for the computer, so that helped me.

I am not a reader, so that didn't matter.

But the household stuff did concern me.

My dad, late 70's, was about -10D. We got far in both and likes it. His doc never talked about doing anything else.

He says he can see the dash in his car; of course it is slightly blurry but he can read it.

I asked him about doing things at the sink last night, he said sometimes he does cheaters and sometimes not, depended on whether he already had them on :-)

He reads the morning paper, but doesn't mind putting on cheaters.

I am not sure what is actual script is, but based on what he gathered from his doc, it seems one eye is 0D and the other is -0.25D.

He got plain monofocals.

He said "life isn't perfect, you jsut get used to it".

Remember, we have had sooo many years getting use to what we have. What if we were born far sighted? We would never had know seeing up close.

A friend, a couple years older than me, recently had his done. Both eyes are far. He loves it. He also says he can see the dash while driving.

Have no clue what his actually came out to. But he said he could see computer with cheaper -2D, but doc said to get -1.5D and he got the expensive gamer ones. He says they are great. He also said he can see things way done the road. So his must be close to 0D, if not actually 0D.

He got torx, so they cannot be multifocal.

So their experiences helped pushed me to get equalled out at 0D.

The other way I looked at it, is that I needed glasses before for everything (other than cleaning my eyes after working on the car), so why I am worrying so much about needing them for looking at my phone and close things??? Becuase I was tyring to get perfection in all cases, and it is not possible. So for me, not having glasses for: TV, seeing down the road while driving, and the dream of some day driving with regular sunglasses is also what got me to 0D. Mono just didn't work for me. Plus with the eyes equal I will be able play&pick whatever cheaters I want for whatever task. And I don't have to worry about losing custom glasses.

Really just need to decide what you want to do without glasses. I can see doing make-up being an issue. They do make mirrors for that, so not sure if that would work for you. Maybe something worth trying. Can always buy one and take it back. 

Hi Sue: Only 1 eye, fixed for distance & astigmatism. Had the ideal result, then doc said 2D eye was fine and she didn't want to operate on a healthy eye since then, she says it's Considered OK to operate on it to balance vision. I've gone around and around (this site creates questions). The simplest solution is to go for 20/20 again in the 2D eye, do. away with contacts (unless I want one for monovision at times) and use cheaters to be able to read. Of course I'm doing OK WITH NO LENS in right eye (read phone in bed, newspaper in morning up very close, walk around with -4.5 contact for 90% of daily life and use -6.5 to really see well at distance or then pair with cheaters for lengthy computer time or heavy reading. Only real drawback: Rightbeye can get scratchy with gas perm contact. (Apologies for typos--typing on iPhone in parking lot waiting for my wife with -4.5 rep in right eye).

Interesting that we all started out far from perfect and now are trying to get as close to perfect as possible. In the final analysis I'll be a happy to have healthy eyes and figure out the best way to deal with the downsides. To those of us who've worn heavy classes (sore ears, noses et al), a lightweight pair of cheaters for shorter times is nothing. I have friends who seem to have a pair in every room of the house, plus by the computer and in the car)! Have a good weekend

Just took me FOREVER to get to that point.

Alot of pondering and talking with people.

Then I stumbled on this site at just right time and was so glad I found people going through the same thoughts and issues.

Here in the UK my eyes are scheduled to be done quite far apart. Anti infection drops are needed for four weeks after surgery, then a check up when they will see what the eye has settled down to.

after this the second eye will be scheduled for surgery but I expect this to be a 4 to 6 week wait. I hope they can get both eyes the same as I don't tolerate much of a difference bet the eyes.

If they are both at -2 I am told I will be able to see clearlyat 330 cm. anything beyond that will need specs/contacts so I'm thinking varfocals of both.

Did Alexandra expand on her experience?

I'd still go for 0 simply because I want equal eyes but I would be asking the surgeon to go for a slight minus if he overshoots it as a) you don't mind having a minus difference all that much and b) II'm told suddenly being long sighted is very difficult to adjust to if you've been short sighted all yr life.

I just hope I don't get a detached retina or another complication which leads me to not be able to drive. I live in a village which has an infrequent bus service so if it goes wrong I'll have to buy a bike!!

Jenny,

You said "varfocals for both". Did mean are now thinking about doing far monofocals for both?

Even with the 4-6 weeks needed between procedures, you should still be able to scheduled that second procedure when you are scheduling the first one. That is make it for 4-6 weeks after, so we are not pushed out further. That is what my surgeon did.

Sorry, didn't see you reply directly to me before posting my last one.

I think the generation of my parents are more accepting than we are. My parents are in their mid 70's and still don't have cataracts. They've never worn glasses for distance (I have since age of 12). They where reader glasses. They are most curious about my decision. Feels odd to go through this before then I must say.

Out of curiosity when you say I could try out a make up mirror (my 15 year old daughter has one) do you think after cataract surgery I would be able to see my eyes with that without glasses? Mayb vI am wrong but thought I would lose all near vision with a monofocal. That is what I think I would consider focusing for near instead of distance (if I opt for monofocal) . I wear glasses for distance so after surgery it would kind of be what I have now.

Just jumping in (uninvited).  There's always a solution.  None of our choices is going to be perfect.  This site was my last hope of finding that solution. And, for me, some of the situations I thought would be most inconvenient (ie, having cheaters by the computer or breakfast table) are nothing. Just my 2 cents.

Don't mind anyone jumping in and putting their 2 cents in. More I am aware if outcomes Hopefully better prepared I will be.

So were you already wearing cheaters before cataract surgery? I am not so that's why I think I would prefer wearing glasses for distance rather than for closeup. That's my situation now prior to cataract surgery. I am -3 in right eye and -2.25 in left currently.

Thanks for weighing in - lol

For starters, you're the one-eyed person running the land of the visually challenged from what I Can 'see.' You're not compromised heavily from an Rx perspective.

I was -6.5 and -7.5 and going along just fine. I had a pair of $700 glasses with progressive and transition lenses. It was a progression of wearing glasses for almost 60 years.

About 6-7 years ago, my optometrist said I had small and slowly growing cataracts. It turns out that the one in my left eye was in the line of my fine vision and needed surgery.

That's what led to having my left eye done for 20/20 and my presence here, wondering what to do with the right eye that doesn't really need surgery.

So that's where I am, corrected to 20/20 in my left eye and -6.5 in the right with 3 daily options: No contact in right eye (can read iPhone or newspaper if I don't mind it being at the end of my nose), a -4.5 rgp (gas perm) which works well in daily life or a -6.5 which you'd think would be great for seingndistance. However it doesn't work that way. With the strong left eye, distance vision already is great. But, with that contact in my right eye, Incan wear cheaters and read comfortably ornwork themcomputer with good 'computer distance' vision. I'm learning that being flexible will help us adapt to all situations.

Hope this helps a bit.

Sue, yes they are more accepting. But I do have a friend our age that likes both being far.

As far as the mirror, I would think you should see in it fine. Instead of it being a reader set of glasses that does the magnification, it is the mirror.

If you can see clearly far, you should be able to see clearly near (with cheaters). What happens is that you lose focal length, which is why it is blurry. So by putting on cheaters, you are putting changing the focal length in order to see things clearly. Basically, it makes everything bigger so you can see it. It is kind of like binoculars. You can see the object off in the distance but it is too small. WIth the binoculars it makes it bigger so you can see it. The image is still clear, just larger.

So you shouldn't be worried about it being clear, just what you would need to do to get it clear (i.e. readers or mirror).

I suggested you try the mirror, so you see how 'bigger' 'looks'. So can see if you like it. Put on your contacts that corrects you to 20/20. Then look at the mirror. That should give you a good idea. If you only havve glasses, then be sure to look through the 20/20 part when looking at the mirror (tape up the progressive part to help force you to). This won't as good of a test (vs contacts), but will still give you a good idea; by that I mean the overall image size, but if you like what you see trying with glasses, it should only be better with contacts/cataracts.

wgriff, Do you know which eye is your dominant eye? If not, you can google to find easy ways to find out. I wonder if it is your left since having that corrected, and the right at -2D, sounds like it is working so well for you.

You said "-6.5 which you'd think would be great for seingndistance. However it doesn't work that way". Does that mean with the -6.5 (so eye is 0D), that your distance is not good? Or that it didn't improve what you were already getting with the left being 20/20?

It does make sense that if you can live with 0D & -2D, then it would still be ok with cheaters on.

Maybe I mis-read one of your previous replies, but I thought you said you would have the right corrected to 20/20 when it was time for you to do the surgery?

Don't know dominant eye.

Distance vision is fine using just left eye. It's maybe a tad better with contact for 20/20 in right eye. I suspected it might be more dramatic, but the big surprise was with that 20/20 contact, making both eyes 20/20, wearing cheaters made close vision really sharp for long stints on computer or reading. I could get by with right eye being -2, but balancing both eyes make the change for close work much better.

Thanks - will give the make-up mirror a try. Normally I don't wear glasses around the house at all except for TV. Putting a lot of thought into % of time I spend with and without glasses to see if that helps me make up my mind. Your comments lead me down another pathway of thought that no matter which I choose life should go on just fine and Inwill need glasses like I do today.

I first noticed deterioration in vision last summer when I had trouble reading numbers on jerseys of my daughter's soccer team, license plates in front of

Me and roadsigns. I had been to optomestrist about 7 months prior to get new glasses (with little change in prescription and no mention of cataract). So this was a surprise in January (same optometrist) said I had cataracts and I would need to see opthamologist as she couldn't do much to correct my vision.

All in all there is a definite pull for me to go with the Symfony lens (maybe combine it with another IOL). Willing to accept glare and halies at.night. From what I can tell those don't affect TV watching or daytime sources of light. But reading here I can see there could be other issues if power is off (guess that doesn't happen with monofocals?). Or Unforeseen issues with my eyes.

When I see my eye surgeon again want to know if there are additional costs involved with multifocals (other than lens) should additional treatments be needed). Also as I age would other eye issues like macular degeneration be something more difficult with multifocals vs monofocals.

Lol - my head hurts with all this playing 'what if'. Soon enough it'll be accepting 'what is'. Getting older definitely not fun. Just didn't think it would creep up on me this early.

But still have to be thankful for good health and I live in an age cataracts can be dealt with / to have them young in another generation would be far more debilitating.

I've got a question for people who have had surgery already - was it done under local or general anaesthetic?  My elderly mum had her op under a local but a private consultant suggested I should have mine done under a general.  Any thoughts on this?

Hi.  You said in your fourth paragraph your right eye doesn't really need surgery.  If I didn't have a cataract in my right eye I wouldn't have it done.  It's only my left that is really bad and needs doing.  All surgery has a risk attached and it sounds like you've got it worked out very well.

I haven't had cataract surgery yet however have had consult with my surgeon already once and he told me they would give me a sedative and numb my eye - need to be awake. Not sure they do this surgery under general.

Hi Alexandra, Jenny here.  Your 2 brief comments were eye-raising for me - can you elaborate on why you wouldn't recommend multifocals?

Because it' on the NHS it is up to them to plan the second eye surgery, but I am assured it will be pretty soon after the 4 week check cos they know it will be very difficult for me with a -2 and a -12 eye/s.

I meant varifocals (bad typing tsk!) - yes, to go over the -2 eyes when both done.  I don't want to trade the close-up vision for distance but would love to be able to wear contacts again (difficult since I turned 40 and eyes started changing)

Hi Jenny:  You've got me pegged. I've got my vision issues sorted out OK after a few days of initial panic.  Now, at age 70, I wonder how long I can wear the rgp lenses.  They do tend to get scratchy if you're using your eyes intently and have a way of picking up irritating particles.

    I'm fortunate to be in basic good health and wonder if it would be wise to have vision issues sorted out now, figuring some complicating issue might arise in the coming years. Also my surgeon, the same lady who said the right eye was OK (a small cataract off to the side and not seeming to develop quickly) also now says that "balancing my vision" would be a valid medical decision. But, for now, I'm happy to let things ride.

   My situation isn't perfect but neither is any of ours--ours being the folks who post here. The good news is that we all seem to adjust and do fine and can echo being grateful for the implants that have revolutionized cataract surgery and entrich our lives. 

   I've been lucky to live in an era when penicillen was a new wonder drug (certainly saved me), the arthroscope made common surgeries (hernia, knee) less invasive, and lens implants came along.

   Lots to be thankful for.

'Glad' to hear that you like balanced with cheaters, to get the best close up.

That is what I am experiencing. And since I sit in front a computer most of the day, that is why I am leaning towards getting my Left changed to match my right.

So when you do get surgery on your Right, what will you do?

I do not, nor do I know anyone, that has experienced the Symfony lens, so I cannot comment on that. Mine are plain monofocals, and so where my dads. My friend got Torx.

If need glasses for TV, then I assume you need them for driving. So yes, figure out what you use them for and what you want to use them for later.

Do not try multifocals unless you try multifocal contacts to see if you like how they work.

Personally, I would avoid the multifocals. If you don't like, they could be stuck with them. At least with monofocal, you have many choices on how to resolve any things you don't like.

And yes, getting the 'accepting what is', is the hard part for me.

All they did what put stuff on my eyes. Fully awake for all of it. They want you to be alert so you can look at the '3 dots of light'.

It was a total piece of cake, about 10 minutes; over before I knew it. The prep they do before (drops, goop, drops, goop, drops) what the longest part. They don't even have you take off your shoes.

I didn't have the choice, but if I did, I wouldn't alway do local. I don't the like idea of being knocked out.

I haven't adjusted just fine, yet. But I plan to.

That is why I can trying to get my Left re-done.

But could I live with this if I REALLY had too, I would have to say yes.

So you are correct that whatever any of use end up with, we can find a way to live with it. Just trying to get the best 'living with it' scenario :-)

Do a google search for makeup readers. They allow you to flip one lens from side to side so you can apply makeup to one eye at a time and see what you're doing.

I had lasik and I'm having cataract surgery on one eye soon. I'm getting a monofocal lens for distance, so if I can't see well enough close up, I plan on getting a pair of those makeup readers.

I did have lasik and I'm getting distance lenses at least for my first lens in a few weeks (monofocal).

I really had no idea those existed. Haven't seen anything like that in Canada. Thanks

I didn't either until I did an online search to find out what people do who can't see well enough to put on makeup. I think you will probably have to buy them online, but maybe they have them in stores also, I'm not sure. If you do a google search for makeup readers and click on "images" after the results come up, you can see what different ones look like. I plan on getting a monofocal IOL for distance for my first cataract surgery next month and like you I want to be prepared for what I'll do if I can't see well enough to put on makeup.

For me, I already had cataracts. Was talking about getting lasik to clean up the astigmastism I ended up.

I have settled on far, they are going to look at my left at the end of the month; with the plan to make it far, like my Right.

Hi: I'm leaning towards something on the monovision side when I get the right eye done. Then investigate a pair or Rx glasses with progressive lenses for any lengthy computer/reading stints. Left eye would (if I have my +|- right) a 0 to +2 range and the right eye the reverse. Sounds strange but I think it might work well.

Had left eye done for distance after being hugely nearsighted all my life. Paid $1600 for the Toric astigmatism-correcting lens. Was perfect from Day 1 and still 20-20 after 9 months. The big problem was double vision when Intried using my glasses w/left lens removed. Everything had a shadow image. In desperation I put in a 30-year-old contact (rgp) that leaves right eye still nearsighted but solved the double vision. By the 2d day I'd adapted to the monovision and had optometrist prescribe a new lens (hugely more comfortable) with that same Rx. It's amazing what one adapts to. Surgeon originally surprised me at the followup by saying right eye was fine with only a small cataract that doesn't seem to be growing fast and isn't affecting vision. At the 6-month she said 'balancing my vision' would be a valid reason to operate on the other eye. After lots of thought, I realize I like my present circumstances. I also got a 2d contact tongive me 20/20!distance but it seems almost overpowering when I use it outside for driving or walking. However it works great (with a pair of cheaters) for lots of close work or writing stints on the computer. I've realized that cataract surgery does wonders but there's no one fix solves all situations. I have a friend who paid big bucks for multifocus lenses and now is 20/40 in each eye. He's OK with it but will wear glasses to see fine print in graphics when watching TV.

Just make sure you try a pair of glasses like that; with one at 0D and one at the -2D. The double vision effects are different with glasses vs contacts.

With my current state (-1.5D L, 0D R), when I have corrective glasses on, I can see the differences in the image sizes with the glasses on. WIth a contact in the L, I do not see it. My engineering brain cannot handle the glasses :-( Of course, I cannot get my brain to kick in on the mono vision either. So you might not notice what I do, but I would certainly try it before committing to a lens. BTW - you don't need to buy glases, my doc had these weird frames that we could put those round monical looking things into. Just make sure you look at things at different distances.

Hi Mark - I was referring to where you said "Think about all the people that got lasik when they were young and now need readers." I actually don't need readers all the time now after having lasik, but I'm still going to have my eyes done with monofocals set for distance and if I need readers after, that's fine. I also don't think intermediate vision like putting on makeup will be as bad as is being discussed here, but I'm not entirely sure.

And for someone like me who had lasik, multifocal lenses are not recommended and from all I've read, people who had lasik should only get monofocal lenses.

Ah, that comment. Makes sense.

But I am surpirsed you don't need readers. Come to think of it, my brother (one year younger than me) who also had lasik years ago has put off readers longer than me. Not sure why that is, but glad that has been the case. But either way, yeah, once you have cataracts any accomidation (i.e. your natural lens being able to focus on close things) will be totally gone; the IOL do not bent at all.

Interesting that lasik people should only get monofocal. Must have something to do with the cornea re-shape (from the lasik) that impacts how the multifocals work. My understanding is that the mutilfocals are 'rings' for the different distances; the cornea re-shape probably bends the light and hits the multifocal in a weird places. 

Hi Nina - if you are interested the Symfony lens isn't really a multifocal- it's a new class of IOL 'extended depth of focus'. If you google you can see those with previous lasik done can get the Symfony lens.

Interesting about different lens. I know I asked about torx for the L and he said I shouldn't mix that with the monofocal. Because lens makeup is different, the colors one sees cand be different. Maybe he just knows that is something I wouldn't want; maybe if it just fine for others.

I also thought I saw some threads (maybe on other forums) about mixed results with Symfony. Nothing is perfect, so what is probably gains you, you ight be giving something else up (maybe it was night driving???). But again, I recall it depended on the person; just another personal preference thing.

Yeah is definitely WAY too much. I have heard a lot of people an handle up to 2D. So what you are experiencing, with mono, is 'normal'.

But what you are expecting from the glasses, to turn the mono into 0D for both, might not be as simple/easy as it should be.

Yes the Symfony lens can be associated with halo and glare (less than multifocal) - you can also get that with mionofocal (chatted with someone e yesterday who sees those with monofocals). Other compromise is near - you don't get as near a vision as with a multifocal (ie phone book or pill bottles you may need readers).

Symfony lens also comes in a toric version.

Did the person you talked to (about the halo and glare) have their capsule popped yet? After surgery (at different points in time based on the person) will get a 'cloudy' capsule, and it causes those things. When that happens, they laser the capsule. I had that done with my R.

The other cause is for people with large pupils (which I have). The pupil diolates bigger than the lens and light hits the edge of the lens and can cause glare. I get that at night with the light is coming from above my eye.

No I don't believe she did. She also developed astigmatism in one eye due to surgery.

Re large pupils - little concerned as I have those as well. Trying to find out what diameter is considered too large that when displayed goes beyond lens. Would you have come across that info?

I read that younger people naturally have larger pupils as their eyes do dialate more than older people. One of my concerns having cataract surgery at 53. Perhaps rather than neuro adapt to halo and glare we just get less as we age due to pupils dialate from less- lol.

Wondering if some lenses are bigger than others which would help?

Aside from that, I think since multifocals can potentially cause so many problems in general even in people who didn't have lasik that's especially why it's not recommend for those who had lasik.

Thanks Sue, but I don't want to risk any complications since having cataract surgery for people who had lasik is more complicated due to them having to use more complicated formulas to do the pre-surgery calculations. They also used to almost always need a person's pre-lasik records to do the cataract surgery, but that is not really needed necessarily anymore. In any event, I can't get them anymore since it was too long ago.

For me personally, it's not worth the risk even if it works in some people.

Also, I'm sure some people who had lasik get multifocal IOLs and it turns out fine, but for me personally, I want whatever has the lowest risk of complications.

I'm also considering doing mini-monovision except I need to have the surgery on my non-dominant eye first since it's really bad, and I'm having it done for distance, so I'm not sure how great it works with doing the non-dominant eye set for distance.

They had hoped my minor astig in my R would have gone away, but it did not. I never compared my current reading with my previous glasses.

Yes, younger people have larger pupils. As you age, the pupil gets lazy and doesn't open up as much. So over time what I see in my R is supposed to go away. The surgeon said if I really do not like it, they could put in a piggyback lens to get rid of it; even if it is has no correction. I guess they piggybacks more often than you think. By having that in, the light hits it first and makes is so it doesn't hit the edge of the IOL (which is what is happening). I am not worrying/considering that until I have the L straigthened out.

I would think the monofocal would have the biggest optical zone. I do not know if any brands are better than others.

So there are options for addressing any issues. Just need to weigh them as you go through all of this. There is really no way to know what each person will experience, so they cannot say what will happen. There are too many factors: power of IOL, how quickly the capsule forms around the IOL, how the eye heals, your age, the eye sahpe in general, etc.

Yes, multifocals are hard for a 'normal' eye to handle. That is why people considering it should be trying those should test it with multifocal contacts. If they cannot handle that, then they won't with cataracts. But even if they can, there are no guarntees.

I totally understand the low risk thoughts. That is why I went with monofocals and didn't even try torx. Too worried about it staying perfectly in place while healing. Plus it seems mine changes a little each time I get them checked; so how could they pick it for the IOL? And since mine was a small enough amount that it wasn't worth it. 

I agree Mark - si many variables involved and no way of knowing in advance. When they finally get a lens perfected that they can adjust power once it's in your eye all will be much better.

Given my age am concerned I will get glare and halos however my work colleague was golfing a couple of weeks ago with someone that had cataract surgery and opted for monofocals (setfor distance in both eyes) as he plays a lot of golf. He mentioned he gets glare and halos. But since the man was younger it could very well be the pupil size thing which nothing can be done about except time perhaps.

I thought most IOLs were 6mm in diameter a few are 5 - not sure how that plays into it. I just checked the Symfony and it is 6mm.

If he hasn't had his capsules popped, it could be as simple as just needing that. The younger you are, or how good the surgeon cleans everything, the quicker that becomes needed. My understanding is that everyone will need it at some point. My father is 75 and had his cataracts done a few months ago, he just has is popped.

The other causes can be surface of your cornea and your tear layer. If the surface is rough, that can cause glare. And sometimes, the glare can come from the tear layer itself. For me, say laying in bed watching TV, I see glare off the top & bottom of the TV. If I just pull down (or up) my eye lid, it goes away. So at least part of it, for me, is related to surface/tear. Of course, none of that has to do with getting cataracts. I probably had that all along but never noticed with my -12 glasses. With PRK they can smooth out the surface.

The other part, the reflects I get at night when light comes in from the top, it the IOL. The pupil is so big, that the light is able to hit the edge of the IOL and then it bounces around inside the lens. Same thing one gets with glasses that have polished edges; when thsoe edges are well beyond the frame. I heard some if can be midigated on how the edge of the lens is done. Not sure if rounded or flat fixes it, but I think if it has what is needed to the reflections then it has some other downside with placement/staying place; something to that affect.

Hi.  i contributed to this thread in the recent past and have been following the posts.  My left cataract is to be operated on this Monday, 10th July, with the right eye being done fairly soon afterwards as there's a cataract there too.  Lovely!  I am not even 50!  i will get to talk to the surgeon just before surgery but I am set on monofocals set for -2 in each eye.  I don't mind continuing to wear glasses or contacts to correct my vision and consider this the least-risky option.  What do you think?  I note that you had a 6.5D difference in your eyes and you managed to sort this by wearing one contact?  I am hoping that I can do the same between surgeries as I will be left with -2 in the left and -12 in the right!  I am told the second eye will be done quickly afterwards but I am still expecting an 8 week gap.  Who knows what I will be able to do in this time?  Any reassurance you can give please?

I'll be interested to see how this all works out. I'd think you'd want to have a contact to bring the 2d eye 'up' to -2 now. That will help post-op and also to test drive what you'll have in the final outcome. But that's just me (very much a layman) speculating. I had a 30year-old RGP lens around that 30 years ago got me to 20/20 and now to -2. Just luck and desperation to try and get rid of the double vision. It worked instantly for me. Hope this gives some reassurance.

Haven't been allowed to wear contacts at all for 4 weeks prior to the surgery any anyway my monovision ones weren't the best so I haven't worn contacts for quite a while.  I will go the opticians just before my 4 week check post surgery to order some -2 glasses otherwise I won't be able to see a thing after the second eye is done.  The other option is 0/0 but I am used to having very close vision without specs and so wish to keep that - make up, seeing the shower bottles etc.

Surprised you can't wear a contact in the eye that's not going to be operated on first...Good luck with all this ... 

Yes, when I say "capsule pop" I mean the YAG procedure.

Would expect the number to be higher than half though.

If based on what you read here you'd expect so but most people who are happy with outcomes and don't have to have a YAG due to PCO never post about it. Last weekend chatted with someone who had monofocals 7 years ago and he never heard of PCO. Sometimes all our reading and research has us believing there are more bad experiences than good when in fact opposite is true.

You will REALLY want a contact for the Right eye. I was -12D and I can tell you there is no way you will get by with glasses. My operated eye was -2D then went to -1.5D, so I would expect you to have a similar experience. The problem is the size of the image that your eye will see will be GREATLY different, the double vision that creates is horrible.

I had only 2 weeks between surgeries and the eye doc gave me trial dailys to get by.

They told me to wear contacts for 2 weeks prior to them taking the measurements, because they are worried about it impacting the shape of the eye. But once they do the measurements, it shouldn't really matter.

I hope realize you might not end up right at -2D. I was shooting for -1D and they said I could be anywhere from -2D to 0D. First, the lens do not come in fine enough increments. For the power you are trying, I think they come in 0.5 increments. For example, if your script was really -12.25 and they can hit it exactly, you will be either -1.75 or -2.25. Then, being -12D, the error in doing the calculation goes up. And then there is how you eye settles after the lens is in there.

Not saying you won't get exactly -2D, but I wanted to make sure you have realistic expectations.

Like I said, the plan we were doing was -1D in both. After the Left came out -2D, they factored that into the calc for the Right (so it would still be -1D). The Right came out 0D! The Left settled at -1.5D, so obviously the Left calc was either off just a bit or the lens increments caused that. Either way, the Right calc must have been good because if they didn't factor in the 1D diff we thought I had with the Left, the Right would have been -1D. I say that because the lens (to get me to -1D) only come in 1D increments [as I found out afterwards].

After stuggling with what I have, I decided 0D in both is actually the best. I just cannot handle monovision, so I needed to pick something that is equal in both. wgriff (like many others) can handle the monovision.

I picked 0D because that way I can see clearly when driving and watching TV.

No matter what, even if I got the -1D we tried for, I would still need glases for the computer. I could get by with driving and TV, but would probably end up wearing them anyway. So I'd reather have at least one thing that doesn't need glasses. I choose driving and TV. The car dashboard might be slightly blurry, but it is more than doable (I know two others that went with 0D and they confirmed it for me).

The -1D would give you general overall functionality (i.e. getting around the house and driving) without glasses. But it wouldn't be clear for all of them. If I did end up with the -1D, I would have been fine with it. But the monovision threw everything off for me.

Do you mean that it is much easier for them to get to 0/0 than to try for a minus 1 or minus 2?  I realise it isn't an exact science at all and I too HATE monovision (tried contact lenses, hated it) so I thought by asking the surgeon to try for -2 it would give a margin of error and it'd still be ok.  I haven't even met the surgeon let alone discuss options with him.  This will happen on Monday before my op but I would have really liked to have the time to speak to him beforehand, such are the pressures on the NHS time does not allow for this. 

I was put off going for 0/0 as I thought it would drive me mad constantly putting my glasses on/off to read fine print - phone, book, supermarket labels, given that I am used to wearing them all the time.  I thought with -2D I could get new specs and possibly varifocal contacts.  (Ive worn RGP for many years without a problem, it's only when I hit 40 things weren't so good as my near vision deteriorated with age)

Now I don't know what to do ... help!

First, sorry if my comments threw you into a panic. I hope you read enough of this thread to know there is always to fix; no matter what happens.

My Right came out 0D (with astig), so not touching that one yet. Later on I will probably get Lasik to fix the astig.

The Left is still -1.5D. I go in at the end of the month to see about getting it fixed. I am going to go for 0D. I am not sure how close they can get the Left to 0D. But I'd rather have the IOL get the two eys as close as possible; then fix it with Lasik if need be.

It is easier for them to pick a new power, now that the IOL is already in there. Just not sure if they can swap it or not.

Trying for 0D at the start is a tough call. Ideally, that is probably what people should do; but risks stop most cases. My friend and father didn't have a choice, their doc just always go for 0D. My friend came out very close to 0D and loves it; not sure of his power beforehand, maybe -6). My father was around -10.5D and ended up at -0.25D and 0D; he loves it. So not sure if they just got lucky or the measurements they had were more accurate than mine or their powers were low enough that they stayed into the 0.5 increment range & the script sync'd with it just right.

I can say, the LAST thing you want is to be far sighted. So shooting less than 0D is safer, from that perspective. With that said, they Lasik far sighted people, so I would think that would be an option worst-case.

I think you have to find out how sure they are about the measurements and your eye. My guess is that trying for -2D keeps you in that 0.5 increment range, and give them a better shot at hitting -2D. I believe my surgeon said the increment changes near 10D for the IOL (realize a -12D glasses is more like a -10D-ish in an IOL; much like contacts are a lower power than glasses). Something else to maybe discuss.

Knowing there is risk about over shooting, I would definitely undershoot. So if you tried 0D, they would pick a lens that keeps you under that; maybe -0.5D or -0.75D. Or just stick with your -2D plan.

My guess is that if you do -2D, just plan to wear glasses all the time (other than reading). If that is ok with you, then maybe just stick with your current plan.

Remember, worst-case there is doing a IOL swap or Lasik. If your eyes end up close to each other they may not approve the swap; unless you make a good case about double vision, etc. And if they do not, and you cannot live it with it, then just get lasik. Once you are near -2D, I would think lasik can always be done to tweak it to what you like. I know it is no problem adjusting minor astigs.

If you are still unsure, and are unable to talk with the surgeon, then probably best to just stick to the plan.

You said some great things there, Mark, and it's clearing the fog in my mind!  -2 still needs specs for most things, take them off for reading/phone etc.  If they achieved something bet 0 and -1 I wouldn't need specs for driving or distance but would need to put glasses on for close up, is that right?  (I notice the cataract being done on Monday is right in the middle of my eye - is that good?!)  

-1D is legal for driving. I found it was blurrier than I would probably like, so I would probably have worn glasses unless I was going to work (places I know).

Yes, they do the worst eye first. As far as how that would impact how accurate the calc is, that is unclear. My left was in the middle of eye as well.

Well, as long as the surgeon gets somewhere between 0 and -2 I should be ok as I don't really mind wearing glasses for near/far or whatever.  The important thing for me is that they are even, so actually the more worrying time will be when the second eye is done which I am expecting will be September sometime.  How much can they alter the dioptre with lasik?  (e.g. -1.5 to -1 or -1.5 to 0)?

Regular lasik can typically be up to -6D or -7D, I believe. Beyond that, there typically isn't enough cornea thickness. I had checked into it MANY years ago. They said they could maybe get me to -3D, but then it would regress to maybe -5D. So I never did it.

What I do not know is if cataracts has any impact on it. The cornea is still just as thick, so that wouldn't be an issue, just not sure if the power of the IOL has any bearing on it. I would think not, but never asked that one.

And yes, equal is the most important. Now realize that 0.25D difference would be close enough. Even 0.5D probably is too.

I was curious also so I found out Alexandra posted on the thread "Looking for feedback on Tecnis Symfony".

Among other things, she said "I need glasses to read - Have had an awful time with symphony - Mine was decebtered sbd I developed posterior opacity just had yag this week hoping it gets better"

********************

I guess she meant "mine was decentered and I developed posterior opacity just had yag this week hoping it gets better"

I decided quite a while ago I was going to have the monofocals and am not considering a multifocal.  I am kind of thinking now as long as they get somewhere between 0.5 and -2 I should be ok.  The most important thing for me is to get as near to equal eyes as possible and I will have to adapt to whatever I end up with using specs/varifocals/varifocals contacts etc.  I wonder how people manage who can't afford to buy all these things ...

Hi Simon.  You may have read my post yesterday about my cataract surgery being postponed.  In addition the surgeon was doubtful I will be offered surgery to balance my eyes any time soon, leaving me at -2/-12.5 for an unknown amount of time.  I am now reconsidering going private in order to get both eyes done quickly to -2 but am keen to use a surgeon outside of Gloucestershire now, having not had a lot of luck so far, what with the multifocals being suggested by one I saw, and then him telling me he would speak to the NHS chap so I didn't need to see him myself, and then yesterday's chap planning for 0 without ever having met me.  What's the best way to find a recommended cataract specialist in, say, Worcestershire or Wiltshire?    Can you help?  I really just want to get my eyes done and move on with my life.  I was first diagnosed with the cataract a year ago.