Those with monofocals set for distance, how is your intermediate vision?

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I've been leaning towards Symfony but I've been told it is not the best option for me overall.  I am in the computer IT field which is why intermediate distance is important to me, I would also like to continue to drive safely.  Since I already have night vision issues caused by my cataracts/astigmatism, I have already learned to be accustomed to it, so didn't think it would be a huge deal to me.   I also never wore glasses so it would be a big lifestyle change for me, I tried to wear glasses for like the past 1.5 months and still not getting used to it..

However on my left eye, since I have astigmatism that is slightly irregular (2.5D's worth), and also (the bigger issue) had an episode of CSR (central serous) that left me with some central vision distortion are the reasons why I am being suggested to go with monofocals.

I am going with a Toric, but I heard torics are hard to do a lens exchange with so this decision is very important..

So those with monofocals set for distance, how is your intermediate (computer) vision?  Your visual acuity without glasses?

Thank you, also to those who have answered my previous discussions

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  • Posted

    Three opinions later, I have had both eyes done in April, 2018 with Symphony Toric lenses.  I do computer work all day long.  I too never wore glasses, nor wanted to.  All in all my vision is crisp, clear and colors are sharper.  Daytime driving is noticeably easier and now I can see signs while driving.   Nighttime driving was problematic for me in the first maybe 6 weeks.  I'd witness severe starburst and halos around headlights and streetlights, like starbursts coming at me down the highway and concentric circles particularly in red lights but others as well.   Concentric circles are appx 10 circles around 1 light alone.  The doctor kept telling me the brain needs to get used to it and I thought no way!  But now I don't think about it much and am learning to adjust.  That honestly was/is the hardest part.  Other than that getting used to dusk after a full day of light takes a bit to get used to.  All and all I am quite happy with my vision. May I suggest you to get several opinions before you do anything.  If you don't mind me asking, are you in the UK o US?  Apparently after listening to others on here, if you reside in the UK it takes appx. 4-6 weeks to do the second eye and some get quite frustrated as one eye not yet done; therefore, making vision quite troublesome.  I'm in the U.S. and the second eye was done 2 weeks later which was a real plus.  

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    • Posted

      Thank you for your response and sharing your experience.  I am in the U.S. as well, my surgeon says he typically waits at least a month to do the second eye.

      Right now I have what I call "moderate" starbursts.  You say you have "severe", but are you still able to drive at night with them just fine?  Is it still "severe" after 6 weeks? 

      May I also ask what were your previous two opinions?

      Yes trying to get more opinions.  My current surgeon recommends the monofocal, but still gives Symfony as an option.  A friend who works with a retina specialist says he doesn't recommend Symfony because of my past episode of CSR (chance of re-occurrence).  Another general ophthalmologist, just said generally people with macular disease do not do well with 'premium" IOLS but do best with high quality monofocals.   But to me, if I get another episode of CSR, it seems I'm screwed no matter what.  Monofocals seem to be the safer pick as my issues seems to have a good amount of risk, is what I gather when I try to ask about Symfony..

      So if people with monofocals set for distance get decent computer vision still, I may be ok with that..

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    • Posted

      Yes it was bad seeing things differently when your brain is used to only seeing things one way, but I have adjusted.  The doctor's don't really tell you what you should get but ask what you want the outcome to be and go from there.  Since I knew I didn't want glasses at all, and I wanted to see near, far and in between, they all suggested these lenses.  Hope this helps.

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    • Posted

      Hi maria ... I'm reading your posts with interest because I have one Symfony lens in one eye and am trying to decide whether to go with a Symfony lens or a mono lens in the other (natural) eye. I've had the Symfony lens in one eye for over 7 months now and I don't think the severe artifacts I see in dim/dark light have changed in all that time. Depending on the driving conditions at night (mostly headlights. streetlights and reflections from road signs), the artifacts I see can be very severe. I still don't know if having a 2nd Symfony lens would reduce the artifacts I'm seeing. Have the severe starbursts/halos you see gotten any better over time ... or is it just that your mind has adjusted to the starbursts/halos better? Thank you.

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    • Posted

      I don't think they have gotten better I think it's just have I have adapted to it.  They did tell me that I wouldn't see like I was 20 again (I'm 51) and that it takes your mind getting used to it.  I thought to myself that is a bunch of #!^!%@.  But to be honest with you, I panicked at first thinking OMG how will I get through this because you are constantly looking for things and your are constantly thinking about how you were and how are you in present.  I don't think about it anymore as much so I believe it is mental.  I would talk to your doctor. I went on YouTube as well as saw several videos actually done by doctors who have had procedures done to them.  It's tough for anyone to say this is better or that is better until you've had it done.  Let's face it, it's your eyes.  Nothing to play with.  And I would suggest several opinions like I mentioned.  Please keep us posted in your outcome after all is done.  Wish you the best!  

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    • Posted

      Thank you very much for the reply maria. In the 7 months since my one eye was done, I can relate to what you're saying because I'm experiencing the same thing. Everything seems fine with me ... until I have to deal with the night driving issues or when I sit in a theater to watch movies. I need to figure out if having a mono lens in my other eye would somehow be more beneficial to having a 2nd Symfony lens implanted ... or if it would be more detrimental somehow.

      I know the big benefit with having 2 Symfony lenses is to (hopefully) be glasses free, but to me the above issues are a heckuva price to pay. I also wonder if having a Symfony lens in one eye (like I do now) and having a mono lens in the other eye would be similar to having mono-vision (with 2 mono-focal lenses) ... except maybe even a little better since the Symfony lens focusses over more than 1 focal point. Does anybody know? (Then again, in that last scenario, I think you would still have to deal with the night vision issues with the Symfony lens, even if the Symfony lens is only in 1 eye). (I'm thinking out loud now). :-)

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    • Posted

      Yeah, unsure about that monofocal but the doctor's should have the best advice.  I know that when I got the first lens put it I was frustrated because everything was still blurry.  But as soon as I got the second eye done the eyes worked together and made a huge difference!  Even at that time I would take my hand to cover one eye, then the other and get myself even more frustrated because one eye would see distance and the other would not.  As soon as I saw the doctor he then explained that they did one eye for distance, and the other lens (both Symfony torics) for up close and not to do that because that is not the normal way we see by holding up one hand to the eye. Lol.   I had no clue that he even did that, nor did he tell me that before he implanted the lenses.  But it doesn't matter because the view is now almost perfect so he obviously knew what he was doing. smile 

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  • Posted

    Coppp,

    Everyone's eyes are different. Some people with monofocals set for distance would be able to use a computer while many others will not. I have a Restor 2.5D multifocal IOL and the defocus curve for this lens is very similar to Alcon's Acrysof monofocals (until the near focus point kicks in).

    I can say conclusively that, with me eyes, I would not possibly be able to use a computer without glasses with a monofocal IOL. My vision degrades into the 20/40 range at around 4 ft and would continue to drop were it not for the second focus point that allows me to use my computer. You have to remember that to some people, "using a computer" might mean a single 27" monitor 18" away at 1080P resolution. This is a relatively large screen with with low pixel density, so text will be pretty large. I have (3) screens, all running at 1440P (a 34", 21:9 in the center with twin 27" monitors in portrait mode at the sides). This means text is much smaller and the screen distance varies significantly. This is a very different scenario than the first one I gave you.  

    Due to presbyopia, I was wearing reading glass all the time for computer work and reading before surgery. Post surgery I now never need glasses for computers or reading (in good lighting), only when I need to do something like removing a splinter.

    An EDOF lens like Symfony should provide pretty good vision in the range needed for computer monitors. You may be one of the lucky ones who gets a monofocal set for distance and can still see at computer distance but I don't believe that there is any way to accurately predict this in advance. I would definitely advise you to get multiple opinions on this and spend as much time as possible doing research before making a permanent choice.

    Note that if you are able to wear contact lenses you could also go with a monofocal IOL set for distance and wear a multifocal contact which would give you a second focal point for computer work. Not everyone can adjust to them, however, but I wear one in my non-operated eye and it's fantastic for me. 

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    • Posted

      Sweet monitor setup.  Few years ago, I used to set my (older) clients monitor at 1080p but they would get upset with me, they would downgrade the resolutions on purpose to see bigger text.  Unfortunately now I fully understand them, I now have to set my Windows OS text setting at 125% for myself. eek

      Thanks for your advice

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    • Posted

      I do a lot of CAD work and large spreadsheets so I can't work with the 125% text setting. I tried it when my presbyopia got bad but ended up switching back and just wearing readers. 

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  • Posted

    I have one eye with a toric monofocal IOL targeted for distance vision.

    It ended up close to PLANO but with 1D residual astigmatism however so I get about 20/25 or 20/30 instead of 20/20 because of that, I can get 20/20 or better with eyeglasses to correct that.

    For computer vision about 30" or so viewing distance from my PC monitor I need to add +0.75D or +1.00D with glasses to get good focus.  My other eye with a natural lens after correction for its 2D astigmatism, also needs +0.75D for computer vision focus. 

    For nearer reading of a smartphone I need about +1.50D glasses for comfortable viewing at 20" or so.  I need +2.00D or so for closer fine print reading.

    A Symfony toric is supposed to provide about +1.50D focus range so if ended up near the target should give good distance as well as computer and smartphone focus distance.  Only fine print without good lighting would need reading glasses.

    When my other eye needs cataract surgery perhaps in a few more years, I would consider the Symfony Toric IOL for that eye since I use computer and smartphone distance a lot.  Another option would be a monofocal toric set for about -1.00D nearsighted, but that would reduce distance vision.

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    • Posted

      Thanks for sharing your experience and advice, especially since you have a Toric IOL.  

      Do you happen to know (or guess) what your visual acuity like at computer distance w/o glasses?

      I just measured my monitor distance, it's at 25"

       

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  • Posted

    If you are doing cataract surgery on both eyes, an alternative to Symfony toric would be two monofocal toric IOLs with mini-monovision.  Target one monofocal eye for good distance vision and the other monofocal eye for good intermediate vision about -1.00D or so.  That difference between the eyes is small enough that it should be comfortable.  I've tested that combo with a pair of eyeglasses with only one lens for one eye and it worked well for computer work for me.

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    • Posted

      I spoke very briefly with my surgeon about monovision.  It didn't sound like a good fit, like it would give me a headache.  But we didn't discuss mini-monovision, will look into that..

      ps. just read your reply to me at the other forum , thanks! cheesygrin

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