Symfony multifocal - night and low light vision issues

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Hi,

My name is Claude and I am a 47 yrs old male and 2 yrs ago I had the Symfony Multifocals in both eyes. It took some time to get used to them and I see almost perfect during the day when natural light is available. For reading I uses some cheap OTC ( +2). The issue with these lenses is at night (or dusk) when I drive.

My vision becomes unclear ... a traffic light in the distance at night doesn't have straight contour around the lights and is a bit blurry. I don't even know what to call that optical illusion.

Or if a go to Costco and all those ceiling artificial lights give me a headache and dizziness and everything seems weird.

After a few complaints my doctor proposed to change my predominant eye from a Symfony multifocal to a monofocal lens. But he warned me I would lose close and intermediate vision in that eye.... which now I am afraid and confused. So its a trade off ... Question is what to do?

what do you think? what would you choose?

A slight better night vision or a better close/midrange daytime vision?

I guess a 3rd option would be to take both Symfony out and replace them with simple monofocal and use progressive glasses.

thank you all for helping me in this so complicated decision.

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  • Posted

    Have you tried polaroid lenses for nighttime? I have trouble with church lights. Some days it doesnt seem so bad like in department stores. I wonder if sometimes my eyes are dry. Are you putting artificial tears in when this happens? Im getting used to the night driving by not looking directly at oncoming headlights.

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    • Posted

      Hello Mollyjr - no I haven't tried those. I was asked to try some yellow tint glasses for driving but i haven't done that yet.

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  • Posted

    Have you tried polaroid lenses for nighttime? I have trouble with church lights. Some days it doesnt seem so bad like in department stores. I wonder if sometimes my eyes are dry. Are you putting artificial tears in when this happens? Im getting used to the night driving by not looking directly at oncoming headlights.

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  • Posted

    Hi Claude - I am from Canada as well and had cataract surgery at 53 18 months ago and have Symfony lenses too. At night I see either a slight fuzziness around some lights and others at a certain distance have 8 concentric rings around them (like red traffic lights). As a get nearer ti the light rings disappear. I have very good vision during day or inside (Costco lights don't bother me) . I don't need readers for reading unless font is very tiny like soup labels or pill bottles. I have a pair of readers at +1.25 for those times or doing extensive reading or when lighting isn't optimal I can see well to read at 11 inches to distance so I don't typically wear glasses at all.

    Did you find the night vision improved at all? Glare was very bad first 6 months for me - but gradually improved. Used to keep interior dome light on in my car when driving as that helped constrict my pupils but I haven't done that in awhile.

    Do you have any remaining astigmatism - that could account for dome of the issues. I had a bit in both eyes bit at my last checkup with regular optometrist right eye is better and went from a little astigmatism to zero. LE still has some so if I close RE lighting has more glare. Fortunately with both eyes open RE takes over.

    Have you gotten another opinion from a surgeon? I was under the impression an exchange is possible within first 6 months only but there maybe some that are done later than that.

    Did you know about the night vision compromise prior to surgery? Often doctors don't spend enough time discussing that and some not at all. I found my doc did - thought maybe in Canada as they ate paid same no matter what lens you choose they are likely more upfront with trade-off. But then again they have so little time and on surgery day mine performed them back to back all day at the hospital.

    Overall I am pleased with Symfony and not sure I would want to go back to wearing glasses. Had that since childhood. Got this diagnosis at 53 - my patents in late 70s still don't have cataracts! But been doing things like snorkeling that I was never able to do (and see everything) - I am not wanting to give that up.

    But if I were in your shoes and unhappy with results I would definitely seek out a referral to another surgeon. Just make sure they have experience with that. My own surgeon flat out said before surgery if I wanted an w change he wold not be able to do that. Not sure anyone in my province would have that expertise.

    B

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    • Posted

      Hi SueAn2,

      I live in Toronto myself and I went to the best surgeon here, big name.

      Unfortunately his explanations were not detailed enough and didn't know I will have the night vision issues that I have now.

      When I look back now, before the surgery I did have astigmatism in my LE (-0.5) after the surgery it increased to -0.75 and I start to believe that you are right and this astigmatism could be the cause of my issue.

      The RE had 0 astigmatism before and now is -0.5 but its better then my LE at night.

      Each place the lighting is not proper i have the feeling I need to strain my eyes to see mid range or far.

      The LE now sees double at night especially on a dark background like TV or a traffic light at night and the Dr said he could do a YAG surgery for that (since there is scar tissues on the capsule) but then he won't be able to exchange the IOL lens after.

      I should probably get a referral to a different surgeon for a second opinion. My current doctor said he would try to remove and replace the current IOL however there could be complications being 2 years after the original surgery.

      Its a catch 22... unsure what the best course of action is. Perhaps these Symfony Multifocals are not so good for candidates with Astigmatism.

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    • Posted

      Hi Claude - I live in New Brunswick but lived most of my life in Montreal.

      Symfony does have a toric version of the lens to correct astigmatism but I believe astigmatism has to be at least -1.0 or worse. I think lasik can also correct astigmatism and if that corrects the issue would be safer than an exchange. Have you seen your regular optometrist? He or she can give you an exact prescription which would tell you more of what's going on. If you have that - post here and a number of us will weigh in with our thoughts/opinions..

      seeing another specialist for another opinion is a good idea - should be plenty in Toronto. Do you know anyone there who had successful cataract surgery that would recommend someone? Hopefully more willing to dialogue with you. I had a page full of questions when I went for my consult and even though his office was full and long wait he took the time to answer all my questions and provide explanation of the trade-offs for different lenses.

      wish you well. Not easy dealing with vision issues and harder to get at exact reason why something isn't right.

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  • Posted

    IMO, you spend daytime awake and nighttime asleep, so if you are doing well in the daytime, then IMO it makes more sense to keep the Symfony lenses. But that's just my opinion. I am actually in the opposite situation as you, considering upgrading to the Symfony because I am not happy with my mid-range vision.

    Are there any situations other than department store lights that are a problem for you? Indoors during the dusk and evening hours, how are you doing?

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    • Posted

      Hi Mary,

      I have to strain my eyes in low light environments for mid and far range vision.

      I do have some astigmatism (-0.75 and -0.5) and that might contribute to this issue, I don't know.

      Watching TV, subtitles on a black background don;t have clear shape and contour , my LE sees a bit double and so does my RE but less.

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    • Posted

      Claude the white lettering on black background are you seeing the letters double or is it more like a highlighting?

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    • Posted

      image

      This is what my left eyes sees when looking at white letters on a black screen. The surgeon says he could fix that with a YAG laser but after that he won't be able to exchange the IOL lens.

      It is indeed a trade off I wish they could be more precise in telling us what you;ll see and what not before making a lens selection and trial in error.

      So will i see better at night if I go with a LE monofocal and RE a multifocal ?

      what will happen with my day close and mid range vision?

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    • Posted

      Not sure a YAG will clear up double vision. It is usually used when one has PCO (clouding of capsular bag.

      It could be due to your eyes not working together well since one eye still gas a cataract and their is too much of a difference between your eyes to see well. Have you experimented with a contact lens to see if you can eliminate the double vision?

      Also would your doc have tried to diagnose the type of double vision you have?

      Binocular double vision are cases where double vision occurs in both eyes, because they are not working together as they should. If you can cover one eye to get rid of the double vision, it’s binocular double vision.

      Monocular double vision, in which only the images from one eye is doubled sometimes produces an effect known as ghosting, where the doubled-images appear to be very close together. If you cover the unaffected eye, you’ll still experience double vision. This is often an early sign of a cataract – a cloudy part in the lens of the eye. The light coming into your eyes can be scattered by the cataract, causing double vision .

      If you are at all uncertain about whether you want to exchange the lens do not have a YAG. Often if it isn't pco your problem won't go away.

      It might be best if cataract in your other eye is affecting your vision to go ahead and have a monofocal for best corrected distance put in to see if things are better.

      You may even want to seek out another specialist for a second opinion - it doesn't hurt to do that and you may gain some valuable insight and i formation that your first doctor didn't see (and make sure 2nd opinion doc is not affiliated with first in a y way).

      Good luck Claude

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    • Posted

      Thanks so much SueAnn.

      The double vision is only from the RE only - which has the same multifocal Symfony lens as the other eye. So the my Dr says its because of the capsule in this RE has become a bit opaque and he can fix it with a YAG laser. I kind of lost my trust in this surgeon a bit.

      There is no cataract at this point.

      And I think you're right. I will ask my optometrist to refer me to a different surgeon and explain me the risk the benefits and all the pros and cons.

      I still think optometry should be an exact science with known and measurable results before surgery 😃

      as always thanks for all your support.

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    • Posted

      Unfortunately it can't be an exact science yet. Since lens being much thinner than natural lens and moving during healing process can affect vision .25 diopter either way (even if power calculation is accurate. However it is better than years ago. Hope you ate able to find another specialist who can help you out.

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  • Posted

    Hello Clyde,

    I have one symfony lens, for a few months, with many of the same issues. My Dr. suggested a monofocal for my 2nd eye. He has done this with other patients for similar reasons, or because one eye was done at a different time. You will need reading glasses, but will still have intermediate vision with your symfony lens. Vision will function similarly to mono mini-vision.

    There is no perfect lens, all choices have some trade offs. However, 2 years is a long time to wait for an exchange. Most Drs. recommend 6 months or less. So I would definitely find a surgeon who had expert experience on lens exchange.

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    • Posted

      It really depends upon your lifestyle, your activities, and what is most important to you. For me, higher quality vision, is more important than wearing reading glasses. I am scheduled for the 2nd eye with monofocal in three weeks. Will let you all know how it goes!

      I can add that the yellow tinted anti-glare glasses did not help. I also tried driving with sun glasses, which helped some. I wear sun glasses when shopping in some stores to eliminate the glare.

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