vivity lens mini mono vision
Posted , 9 users are following.
HI l am 48 having cataract surgery next month , apart from cataracts my eyes are in good condition and l currently dont need to use glasses. My surgeon says l should go with the Vivity EDOF lens, HE said l have the choice of having both eyes set totally for distance in which case l will need reading glasses or l can have the left non dominant eye set slightly for near or reading l think he said 0.5 of a diopter and the right dominant eye set totally for distance, My question is if l do that will my left eye seem slightly blurry with distance vision, or will l not notice it or adjust to it ,for example if l am watching TV or looking at something is the distance would there be a slight blur
0 likes, 18 replies
jimluck john20510
Edited
I suggest getting some very weak, cheap reading glasses to do experiments with. If you put on a pair of half diopter reading glasses and look into the distance, that will show you what it looks like to be slightly myopic. You can punch out one lens and experience being slightly myopic on one eye.There are incredibly cheap reading glasses available on Amazon.
In recent days I have taken to wearing 1.25 reading glasses over my progressives, for computer work. It's wonderful. As an experiment, I left on the readers and went outside for a walk. I found it a little disconcerting at first but quickly got used to it. I did not feel at all at risk for tripping over curbs and unseen stones or whatever in the path. I could see well enough to navigate the world.
Bear in mind that, at 48, you probably still have some accommodative ability left in your eyes (some ability to change focal length naturally). As you age you will lose more of that and become more needful of external help to adapt your vision to different distances. Having one mildly myopic eye sounds good to me. But that's based on theory and experiments with reading glasses, not direct experience with monovision.
rwbil john20510
Edited
0.5 D is not a lot of difference. You could easily get this much difference between the eyes even if you shoot for Plano.
I suggestion you get contacts and simulate monovision and you can see how the distance works out and you can cheaply try different monovision settings.
john20510 rwbil
Posted
thanks would 0.5D give me any extra reading vision and would it make distance slighly blurry in one eye or make no difference
rwbil john20510
Posted
I suggest you pull out the Vivity Defocus Curve. The goal of monovison is to get higher quality vision with both eyes. So the more monovision you get in your non dominate eye the more you are moving right on the defocus curve, so distance will degrade for that eye and you will gain more close vision.
Everyone results will vary so you might go down one line on distance and gain one line of close.
Again the distance is very easy and cheap to simulate with contacts and see for yourself.
Night-Hawk john20510
Posted
That might give you better intermediate focus vision (like for computer monitor use at 2-3ft) but not for closer reading focus. It might reduce your distance vision in that eye by one or two lines on the eye chart, so maybe 20/25-20/30 instead of 20/20. For closer reading focus you would probably need a lot more like -1.5D though
RonAKA Night-Hawk
Edited
A Vivity at -1.0 D is basically the same for reading as a monofocal at -1.5 D. Both get you out to about -2.5 D at a LogMAR of 0.2.There is a good comparative graph of the Vivity compared to the Alcon monofocal on page 13 of the "FDA P930014 Package Insert". B
RonAKA john20510
Posted
These would be your choices with my comments on using a Vivity lens:
Both eyes set for distance using Vivity in both - This will give you very good but not excellent distance vision, and OK to Poor reading vision. Hard to predict how good it will be for reading, but for sure reading glasses would be needed for smaller print, especially in dimmer light. Your would also have the issue of reduced contrast sensitivity in lower light.
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Vivity in both eyes with the right set for distance and the Left set for -0.5 D - Distance vision should still be pretty good, and you will be able to read better. Since the Vivity is good for about 0.5 D of extended vision this would be somewhat equivalent to micro-monovision of about -1.0 D total. It is a reasonable option but will still leave you short of very good reading vision. And the issue of reduced contrast sensitivity remains.
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Clareon monofocal set for distance in the right eye with a Vivity set for -1.0 D in the left eye - This will give you very good distance vision and very good reading vision. The Clareon in the right eye will make up for the loss of contrast sensitivity with the Vivity lens. This would be my choice if I was to use a Vivity. I was very close to choosing it but backed out at the last minute, and went with two monofocals.
john20510
Edited
Thanks , do you think -0.5 D off the non dominant eye will make hardly any or no noticable difference to the quality if distance vision , for example watching TV. l will try and get hold on contacts to try it
RonAKA john20510
Edited
A Vivity at -0.5 will give a LogMAR of about 0.1 or a Snellen of 20/25 which is pretty good vision. If you have 20/20 in the other eye, you are not going to notice it with both eyes open and watching TV 10 feet away. The real question would be whether of not it will give you the reading you want.
laurie30147 john20510
Edited
Hello. I had my cataracts replaced in January and February of this year. Both eyes have Vivity lenses. I was myopic all my life, but on the order of -3 or -2 D, not as severe as some folks. I always had to wear contacts or glasses for distance vision.
For that reason, my doctor recommended that I keep my close vision with an IOL, so that is what we did for the first eye, which was my right eye. I think this is/was my dominant eye, but the doctor never asked or evaluated that, because his initial plan was to use the same IOL in both eyes. Anyway, this eye ended up at around -1 D (although an earlier quick measurement at the opthalmologist office said it was -1.5 D, so maybe it's somewhere in between).
For the second eye, I asked for a little more distance. (Thanks to this forum, I learned so much about options!). The left eye ended up about -0.5 D. I had never tried monovision with contacts, but after reading in this forum, I felt comfortable with it because the amount of difference between the eyes was going to be relatively small. (Also I had remembered getting by OK with one contact lens in the past, when one eye was irritated and I had to remove a contact. In my youth...)
Conclusions:
My cataracts were getting bad, I almost failed a driver's license test. So I had to do something, and I am very happy. I never had any expectation for perfect vision at all distances. But I am so much better off than I was a few years ago. Maybe better than ever.
I do have a clear floater in my right eye now, sort of a filmy effect when I move my pupil right to left -- when I stop moving my eye, it goes away. At first this worried me, but the eye doc said that this was "vitreous degeneration" and could happen to any aging eye (although I guess the cataract surgery can exacerbate it). I got used to it and it doesn't bother me now. Like my tinnitus. 😃
Laurie
RonAKA laurie30147
Posted
Yes, having the close eye as the dominant eye can work. It is called crossed monovision and that is what I have. If I had it to do all over again, I probably would not do it, but it certainly still works. I expect over time the "who is the boss?" discussions between the eyes will be resolved.
john20510
Edited
He said one eye 20.5 and other 19.5 what does that mean, is that a 1 D difference
RonAKA john20510
Posted
If you are asking about whether he is under correcting one eye, it is not possible to tell that from the lens powers. All these powers indicate is that your vision is not that far from being plano - no correction. Each eye is going to need a different power based on the shape of the cornea and the desired outcome.
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The information you need to know from the IOLMaster print out is the predicted Reference Sphere, and Reference Cylinder. Those numbers relate to what the optometrist will measure once the surgery has healed. If the distance eye is perfect it will test at 0.0 D Sphere. And if you desire an under correction or offset in your other eye, the perfect outcome will be -0.5 D if that is what you want.
Pascal111 john20510
Posted
Hi John, I have exactly this variant since February: Vivity plano (-0.09D) and 2nd eye a little closer (-0.5D). I am glasses-free, use reading glasses (1.0D) for longer reading, but not absolutely necessary. I can get up to 30cm well. Only in case of poor contrast (e.g. newsprint) and poor light is reading glasses necessary.
I am very happy with it. In the distance, it doesn't really stand out, except when you compare the two eyes. Nevertheless, I honestly admit that next time I would keep the mini-monovision even smaller, so plano and -0.3D. with both vivitys on plano you have excellent remote and intermediate vision and come close to 40-50cm. With my Varainte as described I have in the distance 20/20 and 20/25, combined almost 20/20.
Intermediary even 25/20 combined
Good Luck!
john20510 Pascal111
Edited
thankyou, l am still deciding between mini monovision or plano, My main aim is for good distance , so l am not sure about giving up a bit on distance in one eye to get more near, if l go mini mono it will be very tiny amount becasue vivity will give me good intermediate even with plano. l was wondering do most people with vivty go minimono or do they go plano