Questions about my recent contact lens trial
Posted , 6 users are following.
Based on the posts in this forum, I decided to go with a contact lens trial to determine how much monovision I want to target for my cataract surgery in May 2023. My uncorrected vision is -3.00 in the left eye and -2.00 in the right eye… so I have naturally occurring monovision of -1.0. I also have .75 of astigmatism in the left eye. For the past two weeks, I’ve used +2 contacts in both eyes, which give me plano in the dominant right eye, and -1.0 of monovision in the left. For comparison purposes, I also have a pair of prescription glasses, which gives me clear 20/20 vision in both eyes. Even though I get excellent, clear vision with the monovision contacts, there is a blur that I don’t see when wearing the glasses. The blur apparently comes from the non-dominant -1.0 eye for distance and intermediate, and from the dominant plano eye for near vision. It almost seems like a slight ghosting or double-vision, and it’s significant enough to conclude that -1.0 monovision is too much for me. A secondary problem is that the near vision is only clear at about 20”, which isn’t quite as close as I’d like. So at this point, I’m looking for advice on what contact lenses to try next when I have my appointment in a couple days. Here are the questions I have…
I saw in a previous post where -1.0 monovision could be achieved with a monofocal lens set for distance in the dominant eye, and a Vivity set to -.5 in the non-dominant eye. Would that -1.0 monovision be the same amount of monovision I’m seeing with current contacts lens trial? Or, because the Vivity targets -.5, would it be only half the monovision I’m getting with the current contacts? If it’s the latter, I might then trial contact lenses with a bit less monovision to see if the blur goes away.
A different option I’m seriously considering is a Clareon Panoptix in the non-dominant eye, and a Clareon Vivity in the dominant. In theory, the Panoptix would provide acceptable near vision, and the Vivity in the dominant eye would lessen any halo or glare from the Panoptix. However, there is the concern that those lenses wouldn’t allow all the light to pass through, so the end result would be less clear that my glasses or current contacts. My question is, would a contact lens trial using multifocal contacts simulate the Panoptix/Vivity loss of light, so that I could compare the multifocal lenses to the clear vision I see with my glasses?
0 likes, 10 replies
RonAKA gwa
Edited
Assuming your right eye is dominant you would want to correct your left eye to -1.5 to simulate monovision with it as the near eye. That means you would use a -1.5 D contact. However, you say you have 0.75 D of astigmatism. So ideally you should use a toric contact that is -1.5 D sphere, and -0.75 D cylinder. Your other eye without astigmatism and to correct to plano needs the -2.0 non toric. I would not recommend correcting to leave your left eye at -1.0 as it will not give you enough to read well. Going to -1.25 may be ok, but -1.5 D is more reliable.
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If you go with a Vivity in the near eye, it will add about 0.5 D of near vision, so your monovision can be 0.5 D less. This will give you a little better distance vision in that eye, but raises the risk of optical side effects from the Vivity. A PanOptix in the near eye is also an option, but I have a friend that says her reading is not good with a PanOptix. She uses +1.75 readers even outside. And of course with a PanOptix you increase the risk of optical effects. My friend says she is afraid to drive at night with them.
The Synergy is said to provide better reading vision than the PanOptix, but poorer distance, and probably has the highest risk of optical side effects.
gwa RonAKA
Posted
I agree that the left eye at -1.0 isn’t getting the job done for reading. It only gets me to about 20” comfortably with my cell phone, which is only functionally borderline. I did try on a -1.0 toric in the left eye, but decided not to trial it because it didn’t seem to help. But perhaps I need to try out a -1.50 toric for a couple weeks to see how that goes.
I’ve read about those who have had bad results with Panoptix… but the data seems to suggest that it works out well for most people. It leaves me wondering if bad results might be due to other contributing factors… were your friend’s eyes completely healthy, or were there other eye complications that might have caused a bad outcome with Panoptix?
With the Vivity, how much do you think the Clareon Vivity corrects the optical side effects? Do you think that trying a -1.5 multifocal contact in the left eye for a couple weeks simulate the loss of light and loss of contrast I might see with the Vivity?
RonAKA gwa
Posted
I don't have all the details on my friend's bad experience with PanOptix. She has said if she had it to do over again she would not get them again. I suspect the doctor much have had a bit of a miss on the + side for power.
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I am not sure that a MF contact would simulate the Vivity or PanOptix. They may be totally different technology.
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Trialing the -1.5 D is worth a try. Most places will give out a trial pack of 5 contacts for free. They get them at no cost from the manufacturer.
Night-Hawk gwa
Posted
Yep -1.0D is best for getting intermediate vision like for a computer monitor 24-36" away, thats what I use for that. It can barely give me smartphone reading if I hold the phone as far away as my arm can reach. I need -1.5 or -2.0D for good sharp reading at closer than 24"
jimluck gwa
Posted
GWA, why do you assume the slight blur is due to monovision? I would have guessed it was due to uncorrected astigmatism. Are the contacts you are using designed to correct astigmatism? Does the slight blur go away if you correct both eyes to plano with contacts?
gwa jimluck
Posted
I’m not using a toric contact. They had me try one, but it didn’t seem to help. Perhaps I could give that a try though… the person I’m working with seemed to be willing to let me try as many contact lens options as I want.
The reason I don’t think the blur is caused by the astigmatism is because it occurs at all distances. It occurs at far and intermediate distances, where the left eye with the astigmatism is blurred and the right eye is clear… that could be explained by the astigmatism in the left eye. But it also occurs at near distances, where the left eye is clear and the right eye is blurred. The blurring in both eyes is similar, and doesn’t seem to be the kind of blurring that you’d see from a weakened eye… it’s almost like a slight doubling.
I don’t have contacts that correct both eyes to plano, but I do have prescription glasses that do. Both eyes with the glasses are perfectly clear with no doubling.
RonAKA gwa
Posted
My right distance eye has 0.5 D astigmatism. I see very well with it at 20/20+. My left eye has 0.75 D irregular astigmatism. This astigmatism is a bit of an issue. It creates a light drop shadow to the right on letters. It is more visible when it is white text on a black background.
rwbil gwa
Edited
First Vivity is a EDOF IOL. Using Vivity set to Plano and doing Monovision set -0.5 is not the same.
My advice is use a Toric IOL to correct for astigmatisms to remove that factor. In fact start with toric contacts set to plano for both eyes and see what your Visual Quality is. Then in the non-dominate eye start stepping back into the myopia range in -0.5 increments.
Then come back and report results.
I should add your natural lens accommodates and changes shape for close vision.
john20510 gwa
Posted
lm getting vivity next month -0.5D in the non dominant eye and plano in the dominant eye, my surgeon said l wont notice or hardly notice any difference in my distance vision with the -0.5 eye and disatance will seem just as good in that eye as the plano eye but l will get slighly better reading vision, do you think thats true
rwbil john20510
Edited
I think it is 90% true. Moving down the defocus curve -0.5 for argument sake let’s say it takes you from 20/20 to 20/25. I can tell you from personal experience the brain takes the image from both eyes to produce better results than either eye can do individually. In one eye I see 20/20 and in the other 20/20-2, but together I see 20/15-2. Be interesting to know if others have similar results. So your distance vision might be slightly degrades where it could be bilaterally.But you will pick up some close vision maybe a line.