Use of contact lens in one eye with iol in other eye - high myopia

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The surgeon has just written to suggest the use of a contact lens in the right eye, to use the existing monofocal iol set for distance in the left (non-dominant eye).

The right eye is -15 sphere. -0.75 cyl x172 6/6+   The left eye (with the iol is +0.5 sphere = 0.75 cyl x10 6/6+

There is a small cataract starting in my right eye, but vision seems reasonably good with glasses.

I tried a distance contact lens in my right eye briefly in the optician's consulting room, but the vision wasn't very clear - the optician thought that might be due to the small cataract. Therefore the result was not conclusive. 

The range of focus seems greater in my right eye - either because the spectacle lens has a larger range of focus, or because I have a very small amount of accommodation left.  (I am 63 years old).   My concern is having to wear different glasses, or progressive glasses with a small area to see clearly at near, armslength and full distance focus.

My work involves reading, smartphone and laptop (near), playing the organ (armslength), reading students' music while teaching (about 3-4 ft away).

I have posted previosly, but am starting a new discussion about the combination of iol and contact lens.

  

 

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9 Replies

  • Posted

    1. There is no potential problem in using a combination of an IOL in one eye and a contact lens in the other eye. I used such a combination for years.

    2. My suggestion will be to just use a regular contact lens for the right eye, which gives us the best focus at about 32 inches. This is only a small amount of monovision, which you should be easily able to adjust to.

    You may still need to use reading glasses when you are trying to read fine print at about 16 inches.

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    • Posted

      Thank you.  The distances I regularly need are:

      reading and smartphone 15 or 16 ins

      laptop: 17 ins

      piano: 18.8 - 20 ins

      harpsichord: 19 - 23 ins (The large range is due to the angle of the music desk)

      teaching: 32 ins

      I could connect a separate screen and keyboard to my laptop bring the distance nearer to that of the organ and piano.

      The above range of distance I need is what is concerning me about monofocal iols !

      Could the optometrist check how advanced the cataract is, and whether I do in fact have some accommodation left ?

       

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    • Posted

      All you can do is to try the contact lens in the right eye with the best focus at about 32 or 26 inches and see how well you do. If then. you have to use the reading glasses for fine print, then you figure out the next step. You have been thinking about this for quite a few weeks. So, you have to just take the step. Trying out a contact lens  is easy.

      This will be a good test for the future when you may need an IOL.

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    • Posted

      Thanks - I'll ask the optician, then see how much the accommodation I still have gives some range of focus.  

      I suppose I can use progressive specs to cover the different reading distances if necessary?  

      Can the contact lens correct the astigmatism in that eye?

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    • Posted

      Would a contact lens

      have a greater range of focus than a monofocal iol?

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    • Posted

      No. A typical contact lens will have a similar range of focus as a monofocal iol.
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    • Posted

      Thank you.     If I need to use reading glasses for fine print, would each lens of the glasses need to be a different strenght for the sphere and cylinder (given the mild astigmatism I have) ?
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    • Posted

      If you wear the contact lens with the astigmatism correction (and with the best focus at 26 - 32 inches) in the right eye most of the time and just put on the reading glasses for reading, you may even be able to use even the standard +1.25 or +1.50 reading glasses available in the stores. When wearing those for reading, you may even be able to read the music at about 30 inches away because of the left eye (while still reading at about 16 inches) , since the 2 eyes will be working together.
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