Needing cataract surgery in dominant eye, having trouble deciding on what lens to choose near or

Danish,

Thank you for your reply. are use my lazy I pretty much only for slight peripheral vision, to use it fully I must close my dominant eye.

sadly right now I’m limited to using only my insurance network of doctors. I would have to ask my doctor about the lens you’re referring to .

right now they are recommending a monofocal iol lens.

or for an exrta cost a TECINS monofical or a TENICS symfony lens

for i do have a slight stigmatism in my dominant eye as well .

are you familiar with the 2 types of TECNIS lenses?

My vision really isn’t that bad in my dominant eye and as is, if it wasn’t for the cataract forming.

i’m hoping at my "younger" age lol 42 that my eye would be healthy enough to except a lens to see far and to use classes for table work and computer work without a problem. because my lazy good eye just does not want to do the work .

or would the symphony lens be a better option? would that lens make me not have to choose near or far?

Symfony is an EDoF lens. Extended Depth of Focus. The extended focus is set between far and intermediate distance, but will drop by near distance and probably need at least mild readers. if you want focus at all 3 distances, far, intermediate, and near then a Trifocal like PanOptix would do it. The intermediate range is a tiny bit better with Symfony but real world wise comparable.

OK awesome, thanks you all for the feedback, i will ask about the PanOptix as well, think now that i have had little more research from this forum ill make a great decision by paying the extra cost on getting the symphony or PanOptix lens if

possible.

MY surgery is October 8 wish me luck!

How do you feel about having good night vision? Do you drive lot? Now that I read about your dominate and lazy eye, I am not sure if you would be a candidate for any of the premium lenses. Symfony is probably the most forgiving out of all of them, but your doctors would know best and have your full workup .

Yes, just like coppp says, Symfony gives you more range, but not full range.

You could say there are 3 distances, far, intermediate and near.

Intermediate is TV and pc screen, near is reading distance.

One monofocal can cover one of the 3 distances well, often will the surgeon suggest that you have your dominant eye set for far. And then you would probably need glasses for intermediate and near.

A monofocal lens is always the safest choice, it is the one with least risk of visual side effects, and highest chance of the best possible vision, but at a limited range.

The Symfony is very similar to the lens I have in my dominant eye, it covers far and intermediate, most people will need reading glasses for seeing small things close up, but you would probably be glasses free in many daily chores.

The Symfony have some visual side effects when it is dark, it makes some weird stuff around lights, headlights from other cars can be bothersome, but these visual side effects are very individual from person to person, and usually faint within the first year.

The contrast loss in the Symfony is very similar to a monofocal, so in my opinion the Symfony would be a good choice for you, if you are ok with some weird stuff around lights when it is dark.

The Panoptix cover all 3 ranges, it is widely used and works really well. It have the same visual side effects as Symfony, and it have a slightly higher contrast loss, so even that you get full range of vision, the image quality will be slightly lower. When people have two working eyes they don´t feel the contrast loss, but maybe it would not be the best solution for you, if you only have one working eye. You should always listen to the surgeon about this, but Panoptix have just been approved this month in US, so it might be difficult for you to find a surgeon that knowns this lens.

Do you know why your lazy eye is lazy?

I believe a lazy eye often becomes lazy because vision is poor, but it sounds strange with a lazy eye that sees 20/20.

Does this mean that your vision becomes better when you close your dominant eye, or how does it work?

Thanks fir the added info ill have to ask my doctor about these two premium lenses. maybe that’s why I remember her telling me I have to make a decision of near or far.

If this is the case I’m back to square one on that decision

I was born with the lazy eye .

yes my vision becomes better if I close my dominant eye and use my lazy eye but my lazy I will get tired of trying to focus , and will eventually cause a headache .

Thats how im getting by right now to see measurements and Such.

The answer to coppp is no I don’t drive a lot, and as Long as I can remember though I’ve always had a sensitivity to light and have been somewhat night blind. it’s kind of hereditary in my family

"The Panoptix cover all 3 ranges, it is widely used and works really well. It have the same visual side effects as Symfony, and it have a slightly higher contrast loss, so even that you get full range of vision, the image quality will be slightly lower. " - can you please elaborate on this?

can you feel these difference with each eye?

I do feel a difference, but it is kind of strange.

On Lara eye things are "thicker", a line on the pc screen is slightly more thick with Lara, but it is more sharp on the Lisa eye even that it is slightly thinner.

I suspect I could have some early pco in the Lara eye, the last weeks it feels like the Lara eye get less and less sharp, so I am not sure I am comparing on a fair basis right now, but i guess it could also be the trifocal that gets better and better, overall vision is fine.

In two days I will meet them for checkup, and I will ask if they can see signs of pco.

Hi Todd

Wow, I have never heard that before, that the lazy eye could be better than the eye that you are using.

From my own research, I don´t think a surgeon would recommend the Panoptix, when you are only using one eye, but Symfony could be a good choice I think, the Symfony could probably give you enough vision, so you only need readers for the smallest stuff (or using your lazy eye)

Most important is off course you make your own choice, you are the one who have to live it.

Let us know how it turns out 😃

is one eye darker than the other? my natural eye is darker than symfony and i want to think that is because of contrast. someone who got panoptix made similar comment recently.

I worry about my daughter for this scenario. If she inherits early cataracts from me she is going to be in similar situation like Todd. While going through her vision therapy there were specific activities to improve coordination and use of both eyes together. If only patching is done the visual acuity in the lazy eye may improve but the brain continues to ignore it due to years of ignoring. In principle the brain should use both eyes if they both have good acuity but only patching could lead to such a thing was what was told to us. Why it became lazy to begin with with 20/20 acuity is a good question and could be a eye movement issue instead of physiological defect.

Soks-

to maybe ease your mind a little bit.

Although i mentioned cataracts run in my family most of my Relatives had the procedure done at older ages.

I am needing surgery so young in my 1 eye (left) because i had blunt force trauma to it in my late teens & was informed then i would most likely need early cataract surgery @ a younger age.

i had surgery on my lazy eye as a baby & wore a patch as well, but to no avail it did not correct it enough to use it fully.

thanks for the information. my daughter's eye was not visibly lazy so we had no idea what was going on.

update- talk to my eye doctor, she does not recommend The premium type of lenses, because of the type of astigmatism I have.

It will not correct it. and my eye is too damaged to except such type of lens as well.

she said anybody who has had previous trauma to the eye has trouble with these types of lenses .

So back to square one .

Even though I want to choose to see far

She doesn’t recommend this because of my astigmatism that it will impair me from seeing far without a prescription to correct it .

She said if I chose to be nearsighted a bit that it can be corrected even more through Lasik surgery after my cataract surgery. which I have no idea how much this would cost and which is also another procedure! ugh!

Right now I told her I still rather pick a lens to see far. but still have plenty of time to change my mind.

I just Kinda want what every other person wants with their vision, and it is to have to wear glasses as little as possible

So still really uncertain of my outcome

she also did mention of surgery on my lazy eye and put in a lens in it and that she can get it approved but I see this being a waste of time for I don’t use it very much unless I close my dominant eye.

UGH! still really uncertain of my outcome and decision

This surgery stuff is an emotional roller coaster, I understand your dilemmas.

It sounds to me that your eye doctor is very thorough about the hole thing, and I understand that your situation is not "standard".

I understand your wishes, but at the same time, I think you have the highest chance for the best outcome, if you choose what your eye doctor thinks is best for you.

These doctors study many years, and they have experience from thousands of surgeries, they know what they are talking about.

A monofocal set for intermediate vision, as I understand you eye doctor would prefer, will not leave you blind at far vision, you will still have some far vision, probably enough for orientation, so you can walk around in the city or at work without needing correction for far distance. Driving would most likely need correction for far, and really small stuff at near would probably also need glasses.

If she thinks it is a good plan to implant a lens in your lazy eye as well, it must be because she feels it can add something to your overall vision.

I have a "semi"lazy eye myself, I have never used it much before my surgery, because of dense cataracts. If I only look with that eye now, I become slightly dizzy even that i see well. But still this eye is the eye that is giving me reading vision, when I use both eyes combined.

If your eye doctor feels that she can do something useful with that lazy eye, I would surely go for it, you really have nothing to loose.

In all cases, you should pay the extra money for the better lens, if she offer you a better monofocal than standart. I guess it must be an aspheric lens she offers, and maybe even a toric lens to flatten out some of your astigmatism.

Lasik can correct both refraction and astigmatism, you don´t need to decide Lasik now, you can wait and see how it turns out after surgery.

In any case, I think your situation is special, I think you will be best off taking your eye doctors advise, even that I understand you would have wished there were better options.

Best of luck!

Hi Todd:)

If your work need is to retain near vision, this can definitely be accomplished. Lots of docs are stuck in the past! You should probably get a 2nd or 3rd opinion.

I have a monofocal IOL in my dominant Left Eye with -0.25D remaining myopia.

I had about 1.25D astigmatism in LE before cataract surgery and still have about .5D astgimatism afterward. The cataract itself can induce vision similar to that of the typical astigmatism caused by eye shape. I opted not to get the Toric lens in that eye to save $, then spent my $ on a premium toric lens for the other eye. The result is that I still have GREAT near vision, partially HELPED by the remaining astigmatismin the LE, according to my surgeon.

SO - think about getting another consult and ask about aiming for near to intermediate with the IOL, i.e., -0.5D to -0.75D in your LE. Then you could easily wear weak glasses for distance.

Best wishes in your search.:)

thanks, I did put in for a second opinion , and I thought real hard on taking my doctors advice, we'll see what the second opinion comes up with and go from there . if I hear a lot of the same things from the second opinion almost likely go with my doctors advice. And hopefully LASIK afterwards in future will make my vision even better like she says.

what did you decide or do? Im going through similar with choosing toric lens to maintain near vision knowing i will need glasses for distance despite knowing most prefer to gain distant vision IT is confusing

hello ara,

as much as i really wanted to choose far vision & the toric lens would of really helped. sadly my doctor had told me im not a a candidate for this lens for the type of stigmatism I have the lens will not fix.

that I would have to have glasses to correct this anyways.

so that being said I have chosen to see close which is really a bummer for i will still need glasses for far.

my doctor did say though after the surgery in the near future I can get Lasik that can correct a lot of my stigmatism and make my vision even better but that’s down the road and much more dollars to spend.

I would’ve really loved to get a second opinion but my insurance is dragging their feet, & my vision is not getting any better. I have a progressive cataract so seems by the day its getting worse.

this forum is really great though helped me out trying figure things out dont be afraid to shoot out some questions for more info on your typical case

my surgery is October 8 wish me luck.

and good luck to you!

i do wish you luck i have gleaned from this forum that most are happy just to be able to see . The rest is just icing on tbe cake . i too have a fast growing cataract. Lets decide its a blessing of sorts so we cant dwell on pros and cons too long. Let me know how it goes

yes thanks & will do.