Over-corrected following cataract operation

Glad to have been able to help a little. Hope that everything goes well with the right eye surgery.

Many thanks.  I have made a careful note of the iol and spectacle strengths that you recommended, to take to the hospital and the opticians.  

I suppose the only remaining question is whether the left eye will definitely need an adjustment after the right eye has been operated on ?  If so, I should mention this when the right eye is done, as it may need to be flagged up and logged in order to qualify to have the treatment done on the National Health Service after I have been discharged from the operation. 

Good plan!

There is just one other point I probably should have mentioned: that the left eye that has had the cataract removed is the non-dominant eye, which is normally set at a higher minus prescription than the oher eye.  

Does that effect the strength I should request for the right eye ? 

You may want to discuss this aspect with your surgeon.

If he recommends that the non-dominant left eye must have a higher minus prescription, then you may make a small change in my earlier suggestion and choose to do the following:

1. Let the surgeon know that your first choice will be having the equivalent spherical prescription of the right eye at -0.25, but that you will be satisfied in the 0 to -0.5 range

2. After you know what the right eye ends up with, have the left eye tweaked to about -0.25 or -0.50 more negative prescription than the right eye. Of course, the same tweaking should take care of the astigmatism in the left eye also.

Hope that this helps.

 

Many thanks.  

Would -0.25 or -0.5 give enough difference between the eyes to give sufficient depth of focus (given the inevitable margin of error in a laser tweak), or would it be safer to request a little more difference between the two prescriptions, or alternatively to achieve this with prescription spectacles ?  

An A4 page of music is not in focus over the whole page using over-the-counter reading specs, because of the different distances from my eye to the top corners and to the bottom middle of the page.  Unfortunately most harpsichord music desks are considerably angled, giving even more differential between the top and bottom. I've attached an image of my harpsichord to show this. 

There is no simple answer to having the ability of good vision over a large range of distances using 2 monofocal lenses.

If you will like to be able to do most of the activities in the house (other than reading or playing music) without the glasses, then having the right eye at about -0.25 and the left eye at about -0.75 will give you that capability. But, you will need to find the best combination of glasses (slight monovision, progressive etc) to be able to read and play music.

In principle, you can have one eye set for reading and one for the music instrument distance and use glasses for everything beyond 3 feet or so, but at this stage, I do not suggest tweaking the left eye by too large an amount to do that.

 

I hope that I don't confuse you more by giving you another option, but will let you decide if you want to consider it seriously.

Essentially in this option, you tweak the left eye to about -0.25D and for the right eye, you get a Symfony lens (instead of a monofocal lens) set for about -1.00D. This should provide you reasonable good vision at all the distances, which you are interested in. The 2 concerns which you should think about are:

1. Whether having the distance vision in the less-dominant eye will be a problem for you and

2. The night vision issue experienced and discussed by me in the "Has Any One Else Noticed this Unusual Vision Issue with Symfony Lens" post by me.

The mixing of a monofocal lens and a Symfony lens has been a non-issue for me. In my case, I use the monofocal lens in the left eye  for good vision at 16 to 19 distance, combined with a Symfony lens in the right eye (dominat eye in my case) at higher distances. The combination seems to work reasonably good for the whole distance range,

16 to 19 was in inches in the above post. This is the reading or the computer screen distance range.

Unfortunately the UK national health service doesn't apply premium lenses, so this probably wouldn't be an option, also I don't know the effect of having the dominant eye set on near vision.

I am getting some glare from the sky in my left eye iol, also a horizontal line across eg streetlights and car headlamps. It has improved since the iol was inserted in mid October but hasn't gone away.

I think that night vision sensitivity may possibly not be as good in the post cataract left eye as the right. Is this something an optician can test ? It might be an issue with night driving or seeing in dim light. There is also a small horizontal line when looking at eg Street Lamps. The eye clinic said this is a crease in the iol and may disappear or can be Lasered. It is less now than shortly after the operation.