Need help to decide between monovision and mini-monovision

Thank you derek40125. I have already decided not to go with Symfony lens as I know the possibility of halos and other side effects is more with multi-focal lens. 

I already have mono vision (right eye is near sighted and left eye is far sighted). Lately I am noticing both my eyes are becoming more and more near sighted. Therefore, I am wondering if I should go with mini monovision (18 inches for clear cell phone reading). So I have to decide between 14 inches and 18 inches cell phone distance for right eye. The left eye is going to be set for distance and will have mono focal. ​Thank you, again. 

Any you mention you already have monovision- is this with contact lenses?  And if so what is the diopter difference between left and right eye.  As Derek mentions it would be very difficult for anyone to tell you how much monovision a person’s brain can adjust too.  My cataracts when diagnosed were bad enough that I could not simulate monovision with contact lenses so I decided against it.   Not to throw a wrench in your plans but perhaps a Symfony lens set for intermediate would give you both that computer vision and 14 inch reading  vision (likely closer as I can read at 11 inches and my surgeon targeted it for plano).   If the Symfony lens is targeted for intermediate the less likely you would see the concentric circles.    

If going with monofocals I personally would target intermediate and hope for best I could read.  There is always that possibility target won’t be achieved by .25 either way due to IOLs coming in increments of .50 diopters and settling of IOL.   surgeon can always make adjust with 2nd eye target when it comes time for that surgery.

If you had to choose which is more important to you reading distance or computer?   And I realize that can change too with time.  I do a lot of computer work with my job so that yo me was an important criteria when choosing a lens.

Thanks Sue.An. I have always had natural monovision. I never wore glasses or contacts for any activity. I have always used my right eye for near and left eye for distance. Therefore, I assume it would not be a problem to adopt the same with similar mono focal IOLs replacements. I know natural lens has more adaptability and I cannot expect the same functionality with a IOL once I get surgery done. I have decided against Symfony due to a higher chances of halos and other side effects. Your reply is helping me decide better. My job is to be on the computer throughout the day. However, I also using my phone for nearly the same amount of time every day. I think the responses on this post are helping with making a choice more easily. I am thankful for that.

Thank you Night-Hawk. My arms are long. So from what you are saying, I think 18" for my right eye should work. During my first appointment, my surgeon asked me whether I hold my phone close or far. I promptly replied 'far'. Since I had told him I want mini monovision he noted 18" for right eye on his chart. As you also say mini monovision is easier to adapt I think it would work great for me. Once I get my right eye done I will see how things go and decide on whether to get the left eye done immediately or wait for some time 

Greg98553. I agree. We both have almost the same type of vision. I don't know how much astigmatism you have. My surgeon has said that I have slight astigmatism (cylinder - .75) in both eyes. Since he will be using ORA technology during surgery to calculate the power of my IOL, this will be addressed. I am praying for your surgery to be a great success. Thanks for sharing your info. I am also leaning towards mini monovision. Hope it goes well.

I do not have any astigmatism.  By the way, my cataract surgery on my right eye was scheduled  yesterday for December and I'll go in for measurements in November. My left eye is now 20/25 and the cataract is not bad right now.   My left eye is dominant, so I've decided to continue using it for distance and have my right eye set for intermediate vision with a monofocal lens. My ophthalmologist plans to set the IOL in my right eye for -1.25D. I hope things turn out as planned.   

Hi michael74313. I am glad all worked out good for you. When you say “set the second eye 1/2 diopter in for slightly better near vision" what do you mean in terms of inches for the nearest good vision. I am impressed that even with both eye set for distance you are still able to hold your cell phone at 12 -14 inches. The doctors are not able to guarantee that in my case. So I am specifying 18" and mini monovision and hoping that I will still see closer than that because of my good eyesight now. I am afraid that if I go with both eyes for distance and my near vision is not good after surgery I will be stuck with glasses for ever. I rather have to wear glasses for driving and occasionally for reading fine print. Is the likelihood of achieving that with my plan possible? You mentioned the problem with depth perception. Is that problem less with mini monovision. If so, I shouldn't be worrying about that, I am guessing. I have my surgery this Friday for the right eye which is being set for near vision. No astigmatism correction as the doctor will use ORA technology during surgery to calculate my power without natural lens. Hopefully, the results will be close to what we expect. I will go for the left eye surgery two weeks later. Thank you for sharing your experience.

I honestly think it varies from person to person. You can google to get an approximation for diopters and inches. I know for me, after my doctor did my right (non-dominant) eye and set it to distance I just couldn't see well up close at all. But, I could see my computer just fine. So, he then set my second (dominant) eye 1/2 diopter in slightly. Now, both eyes working together see better at all ranges. My doctor also did not even say I would see the computer without glasses. I think doctors do this so as to stay as conservative as possible. Compromised depth perception should not be a problem with mini monovision. Most people can tolerate a 1D difference. Mine are set to -1/2D difference. Just keep in mind that there is also an error factor so if you do target for 1D difference you could wind up with even 1.5D difference which would be too much for me. I tested with contacts before surgery on the second eye to see what I could tolerate. With my doctor's advice, I chose -0.5D and my eyes "work together" at all ranges to see better than I would with one eye alone if that makes sense. I'm not sure what your current plan is at this time. I thought about symfony and multilens but in the end, I'm glad (with my doctor's help and advice) that I chose a mono focal lens.

Yes doctors tend to be conservative when taking about expected outcomes. As you say there ate variables outside their control which can make you slightly more near sighted or far sighted than target. Old sales pitch holds true to under promise and over deliver.

better that than some who promise the moon and downplay side affects.

Thank you, michael74313. I agree. Each person has a different need. I have told my doctor what my needs are. I trust his judgment on deciding what the difference is diopter between the two eyes should be. May be once I get my right eye done tomorrow and I know what power has been used I will have the opportunity to decide how much difference we should keep when getting the lens for the left eye which is my dominant eye and would be set for distance. Or maybe I won't have that opportunity after having fixed the right eye at 18" for near vision. Anyway, since I have conveyed to my doctor that I need mini monovision and he has noted that on his chart I have stopped thinking much on this. My surgery is tomorrow. I will continue to post the outcome and plan so more people can benefit from my experience. My doctor says that after the right eye is set for near and if you try to get Symfony lens for the left eye you will risk some confusion in your brain. In other words he is not for mix and match in my case. Not sure why.

Thanks, Sue.An. I agree. Most doctors would do that. Under promise and over deliver. Hope my doctor is doing this too. That will make me very very happy 😃

Good luck tomorrow anu1942. Wishing you a successful outcome.

Thank you Sue.An. And thank you all others for your well wishes. Thankfully, the recovery from surgery is quick. No inflammation or discomfort whatsoever. It's been 48 hrs. since I got my right eye done for near vision using 22.0D AcrySoft mono focal lens. The eye is still adjusting. However, I am not having a good feeling about my outcome. May be this is common with all patients on the 2nd or 3rd day. Actually, I am able to read on my cell phone at 16-18 inches. I am not able to see clearly on my 49" TV at about 12 feet away. My left eye is week in both near and distance. So it is not helping.

During recovery I had halos around can lights in the house and that resolved on the 2nd day. But I developed another issue. I started experiencing flickers on the right side of my operative eye at irregular intervals. Especially when I am looking at my cell phone, iPad, or Computer screen with bright white background. It's hard to explain what these visual disturbances are. No flashes of light similar to retina problem. Just feels like something being closed and then opened again half way from side. I got a little concerned at first because I was really shaking my legs during surgery. With anesthesia I was totally asleep (which was not supposed to be the case). I was supposed to respond to doctors instructions. Also, I seem to have restless leg syndrome. I started shaking my legs intermittently and they were trying real hard to talk to me and tell me not to do that. Finally they held my legs and doctor continued to perform surgery. Not sure that caused any type of injury to the eye or displaced the lens. How do I find out? When I saw the doctor’s assistant the next morning of surgery everything looked good to her. She said still much dilated.

Are my symptoms of flickers common? I called the doctor on call and he said to wait if I am not having any other problem with vision. Hopefully, these will resolve.

all these symptoms could very well be normal any. Results from eye being dilated, drops and healing. some recover quicker than others. your brain too is adjusting to processing new vision. flickering can occur from light hotting side if IOL. That could disappear with time. Write your concerns and questions down for your next appointment with surgeon. do you have a other scheduled appointment?

Thank you. I hope so. It's day four. Everything else looks fine. Eye is healing well and reading on cell phone and computer is more crisp. However, the issue with flicker on the right edge of the eye is still bothering me. Now I can reproduce this effect by looking at tip of a pen or my finger pointed at me at about 6-8 inches away from my face. When I look at a small object at this distance I get a half circle closing in on the vision only from the right side. It's like looking through a pipe/ring but it is only on the right side. Sometimes this comes and goes like a flicker even when I am not looking close. Usually when there are bright lights around me. All this started on the second day. So I am wondering if this is going to be permanent problem. Should something be done quickly or should I wait and see how things settle. What is a safe period for intervention if needed.

this is likely due to either your eye dilating beyond IOL - happens in younger patients vs older ones or light is catching on exge of your IOL. This happens with the square edge IOLs vs round edge ones. However square edge IOLs do better job at preventing PCO so it's a matter of which would you prefer.

in either case most people tend to adjust and notice it less and less. If it is your pupil dilating beyond IOL that too will diminish as you get older.

You likely wont want yo do a lens exchange unless vision us a problem and to point it is not tolerable. It takes 6 weeks to heal so all this could also be due to healing and drop regiment. Hang in there Anu till 6 weeks and if still bothersome make an appointment with your surgeon to discuss.

That seems correct assessment of my situation. I saw doctor's office yesterday. They say it is negative dysphotopsia . It is like an arch shaped shadow in the field of vision. It has increased today. They expect that I will not notice it much as time passes. Near vision in my right eye is 20/25. I did not get good distance vision.

Knowing the outcome of my near eye what precautions I should take for my left eye which will be operated on in two weeks. Or what changes we should make. Should they change type of lens? Would a switch to laser surgery help. Also, I did not get a good range even though it is mini monovision. I can see from 18 inches to a few feet but don't see clearly at 10 -12 feet. I cannot see my TV very clear. Do I need to specify any length for distance vision or let them do whatever is standard. Where does distant vision begin? I am just trying to make sure that with distance vision corrected I will be able to watch television and drive without any issues. Any advice would be very helpful. Thank you!

Hi Anu -wondering if there is any urgency to having your other eye operated on so soon. Are able to wait on that surgery to see where first eye has settled in 6 week's time?

Let's hope that negative dysphotopsia decreases over tome for you. For most it does.

With monofocal lenses (although some people get more range) the expectation doctors give is that you'll have good vision at one of the 3 distances near, intermediate or distance and wear glasses for other distances. It sounds as though you want to gain more distance in the other eye. Perhaps targeting for -.25 so with settling you dont end up too farsighted (and provided you have no trouble with monovision). the other option would be to look at an extended depth of focus lens like Symfony. that would blend your vision better and give you good eyesight from distance to 16 inches. However you would have more night time glare/halos and see the concentric circles we all talk about. That is the trade-off to getting more range of focus. If trade-off not something you want another monofocal targeted for -.25 would give you very usable vision and leaving you with needing glasses for reading only.

Are you able make an appointment to discuss different scenarios with your doctor?

Please take your time with the decision - better to wait till you are sure of what you want. if it were me I would wait at least the 6 weeks to see how first surgery settles and heals. Wishing you the best.

Sorry you asked for definition of distances. Generally near is considered up to 18 inches away for reading books cell phone menus etc. Intermediate vision is from 18 to 40 inches (computer, speedometer on car, household tasks etc). Distance is beyond 40 inches for watching TV driving watching live sporting event movies etc.

You'll find small variations to these definitions on the net.

Ok. Great. Thank you, Sue.An for helping me with all my questions. The only reason I wasn't going to wait for doing the second eye was to see better all round and not just cell phone and computer. Looks like my near vision range is 18 to 40 inches in my right eye. Therefore if the left eye can take care beyond 40 inches I would be good. Symphony sounds like a good plan. Even a trade off like halos and rings can be considered if there is no negative byphotopsia to add to that. I know that no one can guarantee anything in terms of outcome of an eye surgery. The doctor is of the opinion that Symfony in one eye and mono focal in the other may cause confusion. But I am thinking that if I am adjusting to the natural (multi focal) lens in my left and mono focal in the right eye then why can't I do that with symfony in my left eye. In my other post I had comments from some folks that they waited even for years for the second eye with milder cataract and got Symfony for that eye and are able to adjust well. If I can get glasses made that will add distance vision to my right eye and progressive vision to my left (I already have that for left eye from prior to my surgery) then I am good. Is waiting too long likely to cause any problems?

18 to 40" is pretty good for your intermediate and near vision. I get clear vision from about 4feet and beyond with my distance vision corrected IOL eye, so that would be a good match between them if you can achieve similar in your other eye.

If you do not have a cataract in the unoperated eye that is affecting your vision personally I would wait. Try wearing a contact in that eye if you can. Contacts are great way to experiment with monovision and see how that would be before having surgery. Both my eyes needed surgery so I could not experiment with them. And I had a 6 week wait between surgeries. In Canada where I live there is a minimum amount of time we have to wait (4 weeks).

There should be no issue mixing a Symfony lens with a monofocal. There are people on this forum who have that setup and do fine.. In my opinion it would be easier to blend the vision between the 2 eyes this way. Provided you are Ok with the halos at night.

If you need surgery on 2nd eye due to cataract try and wait 4 weeks as you'll want the doc to adjust target to 2nd. More important if you decide on snother monofocal vs Symfony lens.

Like Sue said, if you can tolerate contacts, try that option first. If you can wear contacts, see if your optometrist can let you try samples of different multifocal contact lenses (you might need to sample several different ones but they should be free).

If you get one that works you'll be close to simulating a Symfony + a monofocal IOL. My "good" eye plus multifocal contact now gives me clear vision from about 18" to infinity. Note though that these types of lenses don't work for everyone and they tend to require more trial and error (and time with your optometrist). You won't be able to simulate any possible artifacts from the Symfony but it would be a really good simulation of your blended vision. For example, will be be able to tolerate 3 hours in front of a computer with this combination?

One week post surgery. My near vision is good except for some blurriness like what you would experience with floaters. I am using drops in operative eye except for occasional one drop of Systane in the left eye. I can read cell phone text from 16-18 inches away and I can work on computer from about 24-26 inches. With just near eye I don't get as good satisfaction as with both eyes working together. Would mini mono vision really work for me? With that said, I want to see if I can consider Symfony in the dominant eye at a later date when the issues with halos and rings is minimized by some improvement to the IOL. Can I test mini monovision by getting glasses made in such as way that only left eye gets distance vision and the lens on right eye has no power. If I get used to this without issues then mono focal in the left eye would be a safe approach I am thinking. When I am wearing glasses with left eye having only distance focus will I be able to work at the computer and see text on my cell phone or I will need to take the glasses off is what I am wondering.

With eyeglasses you could only test mini monovision if the power difference between the two eyes would be 2D or less otherwise the image in one eye is too much larger than the other to get used to. However if the difference is greater than 2D, you could use a contact lens in one eye to test mini-monovision, since being closer to the eye the image difference is much smaller.

Anu are you able to wear a contact lens in unoperated eye? That would simulate mini or full monovision much better. Doubtful glasses could do that unless small difference. I managed to poke the lens out of one side of my eye glasses while I waited out 6 weeks till next surgery (which was necessary as cataracts affected both eyes). It certainly wasnt ideal and most times i went glasses free as I had a symfony lens that took over all viewing unless reading material was closer than 10 inches then other eye took over.

Just got back from my appointment. The vision in near eye is 20/25 with slight straining. They said I have done well so they removed all restrictions like not lifting weights or avoid bending etc.. I cannot drive without long distance assistance with glasses. So I drove with my old long distance only eye glasses OD: SPH -2.50, CYL -0.75, AXIS 180 and OS: SPH -0.75, CYL -0.75, AXIS 20 which I am using at home as well to watch television.

I requested them for my current prescription so that I can make a temporary pair for driving. So they gave me this OD: -2.00 SPH and OS: -1.75 SPH + 0.75 x 115 Add OD:+2.5 OS: +2.5

If I can use the old prescription eye glasses without issues then should I continue or should I get new glasses made with new bi-focal prescription above?

I don't know how to tell difference between the two eyes in terms or power. Can I rely on glasses for monovision trial or contact is the only way. Can you please help?

Thank you so much for continued support.

From the clear focus range you are getting in your right eye with a monofocal IOL of 16" to 40" or so, I would estimate that eye probably achieved about -1.25D to -1.50D or so power plus your existing astigmatism (though that could have possibly gotten worse due to the incision from the surgery). The focus range you get is about what I get if I use 1.25D or so reading glasses on my right eye that has a monofocal IOL set for distance focus. Thats a typical intermediate focus range, good for smartphone and computer viewing but will not give great focus beyond 4feet or so, just as you describe.

After a month or two, you should get an optometrist basic eye exam to find out exactly where your right eye ended up, and could get a new distance pair of eyeglasses made to give good distance vision for driving with both eyes. Could also experiment with a pair to test mini monovision then too.

Your left eye with about -1.0D power and some astigmatism, should be similar to your right eye's focus range, maybe slightly further distance? That would be a good comparison to check on since you know what your left eye's eyeglasses Rx is.

My eye surgeon told me his target for distance focus on my right eye would be -0.25D. Did your surgeon tell you his target power for your right eye other than the focus distance? He should have said say -1.25D target or similar for intermediate focus range, then typically it should end up ideally about +/- 0.25D from the target due to the IOL coming in 0.5D power steps, though there is always other uncertainties such as how the eye heals that can cause an error larger than that plus possible residual astigmatism that is unpredictable.

In my own case my right eye with the toric monofocal IOL ended up within 0.25D from the power target but there was 1.0D of residual astigmatism where the desired max astigmatism target is 0.5D or less - so I typically get 20/25-30/30 distance vision due to that, though the eye's vision does vary so many days I can get 20/20 at least part of the day, so perhaps my residual astigmatism varies a bit depending on how dry the eye is, etc.

OK, the new eyeglasses Rx they gave you was in +cylinder format, whereas your old Rx was in -cylinder format. Converting the new left eye Rx to -cylinder format to compare them it would be: -0.75 SPH -0.75 CYL x25 - so thats very close to your old left eye Rx (just 5 degrees different axis, close enough).

If your right eye Rx is indeed now near -2.00 SPH then you appear to be within the 2D difference in Rx between the two eyes, so you might be able to just trying popping out the old right lens in a pair of old eyeglasses and use the old left eye lens and you should have the monovision equivalent to test with, left eye set for distance vision and right eye for near vision. If your right eye is -2.00 SPH thats closer to full monovision however, compared to mini-monovision which would be if the right eye was closer to -1.00 SPH. But if you can handle the 2D difference of monovision then thats OK, if not you could plan on setting your left eye IOL in the future to target slightly nearsighed perhaps about -0.50D or so to reduce the difference between the eyes. With your current left eye without eyeglasses, you are mini-monovision already with -0.75 SPH with a little astigmatism that makes it effectively closer to a little over -1.00 SPH equivalent, so about 1D difference between the left eye and right eye without eyeglasses. But thats for intermediate and near focus mini-monvision, where you probably want distance and intermediate/some near monovision which requires some left eye correction?

Thank you, Night Hawk for explaining in so much detail. Of course I don't understand everything but I am getting some idea. This morning, I went to my optometrist's office and requested them to pop the right lens from my old distance vision eye glasses. While I was walking toward his office and looked down I felt that I was walking down a slope. Perhaps that's the depth perception issue doctors are talking about with monovision. It's scary! Anyway, after I got the right lens from the eye glass removed I am left with in my left eye -2.50 SPH, -0.75 CYL, and 180 AXIS. This with my operated eye having -1.75 SPH, 0.75 CYL, and 175 axis seems to be working as monovision. It is good for distance but not so good for near. May be because eye is still recovering from surgery. Should I continue to train my brain to adapt this combination? Thanks, again !!

Ok. I think I want to restate the above. As you mentioned and I am experiencing it that monovision is working without eyeglasses better. When I use my old eyeglasses with right lens removed it gives me a mild headache. Also the near vision gets blurry with that. It seems that the intermediate vision in my untreated left eye is helping with my overall near vision, especially while working on my computer. So as you said going with full distance IOL in left eye might not work very well. So if I ended up getting left eye a slightly nearsighted (as you mentioned a reduction of -0.50 or so) then I will have to depend on eyeglasses for all out door activities. Right? My other choice seems to be a multi focal lens like Symfony or some other IOL. My doctor said it will cause confusion. That gives me a scare. But I read in many places that it works. However it is a complex matter. So I need time to decide on the left eye. Since I don't have much cataract issue and I may be able to wait some. The only way I can wait is by using eyeglasses for distance when I am outdoors, driving etc. . I have tried it. I have to briefly remove eye glasses while grocery shopping etc.. Would this be causing any problem if I pulled on this way for a few months?

Anu I think you would find a contact lens for your unoperated eye a much better solution than eyeglasses. Your optometrist can provide you with samples (usually free of charge). Given I had cataracts bad enough in both eyes I couldn't try contact lenses. As you dont have a cataract in that eye affecting your eyesight you may find a contact lens will buy you time. In a year or 2 there may be more options in lenses than there are now for cataract surgery.

Yes a contact lens for the left eye sounds like a good thing to try, could try different powers too such as the -0.5D or so and try to find the power you can deal with and not have headaches, etc. Full monovision can be tough to deal with as you discovered, so have to reduce it to mini-monovision.

At this point, you can read computer and smartphone clearly without glasses correct? In that case if you can wait for left eye surgery for years (same as me) you could just get a new Rx for distance single vision eyeglasses and use that for driving, watching TV, etc and then take off the glasses for the computer and phone reading.

When the left eye eventually requires surgery, could decide based on whats available at that time - thats what I am doing, using eyeglasses until then.

Agree with you both, Sue.An and Night Hawk. I prefer that too. Rushing into doing the left eye surgery would not be a wise step at this point. I will see how cataract in left eye progresses. I am thankful that my right eye surgery went smoothly. I wish I had considered 20 - 26 inches for near and told the doctor when he decided on 18 inches near for my right eye. Anyway, there is always a positive side to everything. I will find the best contact and/or eyeglasses for my current needs and move on. I will always be in touch here to see what are the new developments. You guys are doing such a great job of guiding people in the best possible way. The support I received on this forum is priceless. Thank you, again!

Wishing you all the best Anu. Do check in and let us know how you're getting on.

Thank you, Sue.An. I am back. And this time with updates on my left eye. I had a couple of appointments with the surgeon. The right eye is settling very well. I can read 20/20 at 18" and I can work on the computer without glasses but I think both eyes are working when I am at the computer. If I cover my left eye I strain a bit. When I get second eye done for distance, I am not sure it will help with the computer work at all. If not will I need glasses for computer or will I need to pull the computer a bit closer. Currently it is at 25 inches. May be at 20 inches will work.

I talked to my surgeon about issue with depth perception after doing the left eye for distance. He said initially, there may be some problem but I will do well as I am already accustomed to natural mono vision for a long time.

I am almost forgetting the negative disphotopsia. I really like my cell phone vision. It is the best. Also able to read magazines and other normal size fonts easily. I know I have been advised to wait at least 6 weeks before doing the second eye. However, it does not work well for me from insurance perspective and other considerations. So I am kind of debating whether to go ahead and do the left eye for distance now within a week or so. If not I may end up waiting too long. It will not be a problem since I can either get a pair of progressive glasses or use distance eye glasses for outdoors. I am very comfortable at home without glasses.

Today, my surgery counselor will call me today and give me the earliest available date. I am wondering what to do.

does that other eye have a cataract that needs surgery? was thinking it didn't need surgery yet. It's a personal decision. if me and eye didnt have cataract needing surgery i would opt for a contact lens (or at least experiment with different ones to see if that would work).

Correct, the cataract is moderate grade according to eye report. I clearly see a yellowish tint on the vision when I close the right eye and see. Distance vision in the left eye is 20/200 ( this is what the technician told me today that was testing). An ophthalmologist friend also says I should get it done sooner than later for the reason that I will get used to my monovision better with distance in my left eye. I am definitely not completely closed to considering a wait if there are any risks in going forward with getting distance vision in my left eye with surgery. I know that surgery always carries risk. But wouldn't I need it some time in the future as cataract grows more dense? Other than that if the right eye has settled and I am comfortable with my near vision, shouldn't I get this out of the way. Just thinking aloud. Please tell me freely whatever you personal views are. It will benefit in my own evaluation of the situation. Thanks

Hi Anu - if the vision in your unoperated eye can correct to 20/20 with glasses or a contact lens there is no need to have the surgery. Not sure what your opthamolgist means by if you get it operated on sooner rather than later you'll get used to monovision better. To mean this should be simulated with a contact lens before cataract affects your vision to see how well you tolerate it. A mini monovision (.50 or .75 diopters) doesn't bother most people but not everyone can tolerate monovision whether they have the second surgery sooner or not. I definitely would not do that without simulating it with contact lenses. You mentioned waiting may have insurance implications but i wonder why that would be. Here in canada our medicare health insurance only covers the surgeries once vision cannot be corrected to 20/40 or better. Basically one fails the vision test to drive.

As said this is a personal decision so not trying to convince you otherwise. If after trying glasses and contacts your vision isn't something you can get on with then whether the cataract is bad enough or not having the surgery sooner would be better.

But even if that is route you decide give yourself 4 weeks for operated eye to heal. Your vision is still settling and could change a bit and especially if you are considering monovision you'll want to target your 2nd eye based on where first eye ends up.

Good luck Anu.

Hi Sue.An. I am so glad I always check here before getting anything done with my eye. Today out of abundant precaution I went to my local optometrist to ask how long I can wait on my left eye cataract and if eye glasses will work for my day-to-day activities. He looked at everything and strongly suggested to cancel surgery. He in fact pointed out that the right eye cataract surgery wasn't at hundred percent. He said there are wrinkles on the lens due to it's placement. According to him the vision in the operated eye isn't that great either. He took pictures of the lens from side on his computer and showed me the two wrinkles on the lens. He said the placement of lens is not good. It's like a rush job. He has asked me to wait for a long time before next eye surgery. I am thankful I take advice on this matter. I could get into a much bigger problem if I went ahead with my left eye surgery. Thank you for sharing your views so candidly. I appreciate that. Can you all suggest what should I do next about my operated eye as I have discovered this problem?

Always tricky to bring this up with surgeon who operated. They often take offense or brush it off saying everything is perfect. But I wouldn't want this person to operate on my other eye if not satisfied with the job done on first eye. Do you live in a large city or near one? Perhaps seek out another surgeon for 2nd opinion - ask around your friends and family for who they used if satisfied with outcome.

It is important to research and choose a good surgeon as it's not easily undone.

Correct. I already had three appointments at this surgeon's office. They all seem to have ignored the issue they must have seen. I also saw a previous surgeon I was considering to go with at an institution and he supported my surgeon in terms of his work. Only the optometrist told me clearly that this job wasn't done right. He thinks that the haptic arms of the lens might be improperly paced or not pushed in place correctly which is causing the lens to wrinkle (it is AcrySoft lense) . The picture he took shows two foggy vertical bands which he says looks like a wrinkle through his device. Perhaps the negative disphotopsia is due to this reason or the problem may be presenting itself in the way negative disphotopsia presents. I saw images of eye within a blog on negative disphotopsia which look similar to what my eye looks when light is focused on it from side and photos taken. I do live in a big metro and I can find some surgeon to look at this. Is this something to be urgently checked out by an ophthalmologist?

Hi Anu - hard to say definitely but again if I were in your shoes I would seek out someone as soon as possible.here is what I found on the net as solutions if that is indeed the situation with your lens:

"If the intraocular lens is only slightly decentered, a change in prescription glasses can compensate for the problem. Interestingly, if the intraocular lens is totally out of position and settled in the vitreous of the eye, sometimes it can be left in the eye and a secondary lens can be placed without removing the lens. Both of these options avoid the risk of removing or manipulating the dislocated lens. "

Unfortunately the only other solution is a lens exchange. But a surgeon is the only person that is going to be able to diagnose and propose a solution. Hoping for the best for you.

I should also add that many cataract surgeons (my own included) don't do any of the repair/complicated surgeries or exchanges. My surgeon let me know that upfront. These procedures require more skill so when you start researching you will need to find a specialist that has that experience.

Actually, I noticed the problem on the third day of surgery. My surgery was done on Friday and on Saturday I went for the postop. I asked the optometrist that looked at my eye whether the lens was well-centered. She said right in the center, bulls eye! Then I came home and within 2 hours I had the first symptoms of negative disphotopsia. I looked in the mirror and saw two sparkly bubbles like air or oil drop. I called their emergency line and they said the disphotopsia was uncommon. I waited till Monday and saw the same optometrist in their setup and told her about the sparklies near the center of my pupil. They said they don't see anything but it is reflection of the lens is some lighting at some angle. I ignored it since my vision was okay and it still is okay. No vision problems. But then my local optometrist told me today that these are two wrinkles on the lens. Is is really malalignment . I will be seeing a retina specialist on Nov 13th. He is the only other ophthalmologist I know and have appointment available with. So I will ask him who refer me to someone. I hope this is not a very serious condition. Since I don't have vision issues, I am guessing it may even be Posterior Capsule Wrinkles. Only an expert can tell.

sounds like the right plan to see a retina specialist. Do hope you find some answers.

Hi Sue.An. Some update 8 weeks post surgery on my right eye with monofocal IOL . Post surgery I had substantial negative dysphotopsia and near vision was 20/30. My optometrist was concerned about some wrinkles as well. I followed up with my retina specialist and he thought it was mild PCO and wan't concerned about the wrinkles. He said they will settle. No issues with retina in both eye either. He has asked me to see him after 6 months. I went to my optometrist this morning and he said he does not see much of wrinkles. He said the vision has changed in both eyes and gave me this prescription for progressive glasses OD: SPH -1.50 CYL-D.S. Add +3.0 OS: SPH -1.25 CYL -0.75 AXIS: 017 Add- +3.0 . I am almost 20/20 for near. He said I have cataract in my left eye but if I can pull on with glasses for 2-3 years it would be good. Any suggestions, comments would be helpful. Thank you!

with the -1.50 ate you now also 20/20 for distance? The add of +3.0 is so that you can read (near vision).

If you see well with new glasses I agree you don't need to consider cataract surgery on the other eye until it affects your vision to point where prescription cannot give you better than 20/40 vision.