Definitely an Ey(en)hance for me!

I thought I was going blind before, wearing my glasses, and even at times with my contacts; everything was so shaded and blurry. My prescription a year ago was -13 D (left eye), and -12.5 D (right eye), with about -1.0 of astigmatism. It used to be stable for the past decade at around -11.50 D (LE) and -10.25 D (RE) until at least a year ago. I went in for my bi-yearly checkup (instead of yearly thanks to Covid and OHIP ripping off optometrists in Ontario), and my optometrist couldn’t figure out why I wasn’t get my usual sharp distance vision with gas permeable contact lenses – my eyes kept fluctuating a lot just in the hour I was there, so she did more tests and discovered early stages of cataracts. Because of my high myopia, these cataracts were really messing with my vision, despite being relatively early on in terms of developing. She sent me to a cataract clinic, who started the ball rolling – as into my deep dive into the dark recesses of the world of IOLs, lol. Choices, choices, and yet more choices… yet still somewhat of a crapshoot in the end.
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I had the cataract replaced in my first eye (RE) yesterday (06-03-23) with an Eyhance IOL targeted to -1.25 D. Just prior to yesterday’s surgery on the right eye, I discussed it again with the surgeon who was thinking of -1.25 to -1.50 for that eye (RE), but I told him that I didn’t want to take the chance of going as high as -1.50, but was okay with -1.25 if he could hit that. He responded that the increments for this lens was .33 to .50 and that he would do his best, but it wasn’t an exact science (actually felt good to hear him say that, lol). He wasn’t sure until he opened the eye(s) and used the ORA scan whether or not he’d need to use a Toric lens, but which he did ending up using for my right eye. I’m scheduled to have the left eye done tomorrow (08-03-23) with another Eyhance lens, with a target of -0.50 D (see first comment).
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I was given three eye drop prescriptions to fill the week before my surgery (an antibiotic, an anti-inflammatory, and a steroid), and instructed to start the first two the day before surgery and then again the morning of the surgery – didn’t start the steroid til afterward. I’m supposed to use the antibiotic for a week, and the other two for a month after the surgery. On the day of the surgery itself, I was given a combination of drugs via IV to just relax me during the surgery (not to put me out), and they put seven types of drops in my eyes prior to surgery (antibiotics and for freezing) – all of which I was told about, and given handouts about, weeks before the surgery itself. They had also required that I fill out a detailed list of previous medical conditions, and any prescription medications I was on. After they took me into the surgery room, they applied more drops, then the surgeon draped a protective shield over my face and upper body, and then he cut an incision in the shield over my eye and inserted some other type of protective wrap around the area. He did the insertion by hand instead of using the laser system “package” (which cost another $1100 CAD which I couldn’t afford). A lot of what this laser package does was already done in the pre-op tests already. The surgeons usually do the insertion of the lens by hand anyway when cataract surgery is done in a hospital in Canada, at least, since most hospitals aren’t equipped with that level of technology, so my surgeon wasn’t bothered by me not paying for the extra tech.
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The surgery itself, was both weirdly cool and unnerving. They shine a bright light into the eye being operated upon (the other eye is covered by the surgical shield), and although my eye was completely frozen, I was worried that I’d be aware of the knife cutting into my eye, or the surgeon breaking up the old lens, but I wasn’t aware of either. It seemed only maybe five to ten minutes before I was told to look at a red light, which was the ORA taking a scan of my opened eye, which meant the part I was worried about was already done. I’d been instructed to keep looking straight up to where the light (mostly) was, and at times I could see what looked like small shards floating above me (the broken lens??) and even after the lens must have been removed, I still had a sort of “ghost” image of the surgeon sitting beside me – I could see his outline, but the “filler” was grey. So can we actually see something even without our eye’s lens? It didn’t seem to take very long before the surgeon said, “Okay, we’re done, you can close your eye if you want.”. I’d been told the actual surgery took about twenty minutes, and it looks like it was. When I sat up, of course I felt kinda woozy and since my pupil was huge from all of the drops they’d put in it, so the vision was blurry (completely blurry in my left eye since I wasn’t wearing glasses), and they assisted me walking out to the recovery room where they went over again, what to expect, about following the rest of the eye drop schedule, what to be concerned about, and what I could and should not do for the next two weeks. I was given a pair of black sunglasses that I was told to always wear outside for the next two weeks, whether it was sunny out or not.
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I was able to walk out of the clinic about ninety minutes after I’d first entered the clinic, accompanied by my support person. Vision was of course still blurry, and my depth perception was wonky, but I could still see a lot better than when I walked in wearing my thick glasses early. Hours later after I’d gotten home, just out of interest, I put the lens of my glasses up to my left eye (-13.0 D) and opened the “new” right eye to look into the mirror at the same time, and immediately wished that I hadn’t – I almost threw up. So definitely no wearing of glasses with a lens removed for me. In general though, after the surgery yesterday, and today, there was very little discomfort in the surgery eye itself. It felt like there was maybe a tiny bit of something in the eye, but nothing that made me want to rub it, or feel that I needed to flush it out, etc – pretty minimal. It took til this morning for the pupil to return to it’s regular size (about 2mm), so my vision was a lot more stable today. I’ve been putting lubricating eye drops in my eye after I finish the prescription drops, so my eyes aren’t feeling dry or itchy at all – though from what I’ve read, that could change. I had bought a pair of non prescription (plain glass) glasses to wear around until I got used to the new eyes – and to protect them from dust or anything else that might fly around, especially since I was told to be careful to not rub my eyes for at least three weeks, as I could dislodge the new lens). So earlier today, I cut out a piece of a Kleenex box to fit into the left lens of them, and I’m preferring that to the completely blurred vision from my left eye messing with the good vision in my right eye. Depth perception is better this way, as is looking at the computer screen or anything else.
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And oh yeah, have I mentioned yet, how amazing it feels to have the pretty much sharp, clear, vibrant vision that I’m experiencing today in at least one eye!!! I am so very happy with this lens and my current results. Although my near vision isn’t quite what I had hoped for (maybe 8"), as is my distance vision (seems about 20/40 right now - was hoping for 20/30), this is only the first day after the surgery, and right now, if it even stays at what it is, I’ll be as happy as can be, especially with the left eye being targeted tomorrow more towards distance. Definitely a game changer for my life! Thanks to everyone here who contributed towards my final choices, whether you’re aware of it or not. Sorry if this is too long, but I was trying to give a full cohesive picture.
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My vision (right eye) first day after surgery…
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Sharpness (print):

  • I can read the letter sized page I hung on the wall containing a multi-coloured chart for my eye drops pretty clearly at 5’ (print: black on white, black on medium yellow, white on medium teal, and white on medium brick red). Not sure what size the fonts are but the chart fills about 2/3 of the page vertically, and 3/4 horizontally.
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  • Reading print via my computer browser zoomed to 110% is sharp and clear from about 19" to over 40" (using a MacBook Pro laptop - screen size 15" / 1680 x 1050 resolution). Decreasing the zoom to 90% still gives me sharp print (black on pale grey) over the same distance. I just reduced the font size in my menu lists from 15pt to 13pt which is sharp and clear.
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    Overall clarity:
  • Contrast quality in daylight is excellent, even in a dimly lit closet, as is image clarity. Contrast was still good inside the house as the sun started to go down (around 5:30 pm EST). Colours are true. The pictures on my walls are full of detail and the subtleties are easy to see (now from about seven feet with right eye only). I used to do desktop publishing and design as well as make my own clothing, so I’m very particular about colours. I’m always correcting people about the subtleties between shades of colours.
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  • Haven’t been walking outside in the dark yet, depth perception is too off between the two eyes until I get the second eye done. HOWEVER, I’m noticing a huge drop in contrast, and vision in general, in an almost completely dark room. I’m used to walking around in near darkness in my home, but I just walked into the living room with my left eye blocked, and closed the blinds before turning on a lamp, and could hardly see anything in the room. If I hadn’t already known that there was a brown coffee table sitting about a foot in front of me, I wouldn’t have known with the Eyhance eye at that level of light. When I removed the block from my untouched left eye, everything might have been blurry, but the contrasts in that dark room showed up far far better. I probably would be able to navigate that room far better with just my highly myopic blurry left eye then I would with just the new Eyhance eye. Whites looked mid grey and dark objects were almost undistinguishable. Good to know before I head outside with both eyes using the Eyhance lens. Unfortunately, this probably will not improve so I will need to make sure that I carry a flashlight at night. Sure hope it doesn’t affect my night driving very much.
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  • I haven’t noticed any “transition” problems. The accommodation appears to be very smooth in this one eye. I’m not noticing any real delay in focus when say, looking up from the laptop screen to a picture on the wall (from 19" up to 60"), or even from the laptop screen to the light switch on the wall in the hall (from about 19" up to 10’).
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    Near & Intermediate Vision: Can read my cellphone (6" screen) clearly at about 12". However, I can clearly see the small print on a small hand cream bottle (about 3.5" tall) from around 12" to 22". And interestingly enough, the instructions on the side of a large bottle of Tylenol are sharp and clear at 2’. Am needing cheap readers of about +1.75 for some closer things though.
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    Distance Vision: According to a printed Snellen Chart at 10’, I’m about 20/40 for distance right now, although I can see some of the 20/30 line. My hallway is medium lit, and it’s a little sharper when I turn the light on. My bird feeders are about 35’ from where I sit on the deck, and they are pretty clear, not completely sharp, but I can determine what small bird is eating on them (couldn’t do that with my glasses, which were only giving me barely 20/50 in the right eye – left eye was blurry even at 20/100). I can even see the bird feeder at the back of the yard (approx 110’) – it’s a little fuzzy, but I can see if something is sitting on a perch attached to it. The windows are pretty sharp on the two-story brick house behind me that’s about 200’ behind me. And I could read the street sign earlier this afternoon clearly at approx 35’.
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    Visual Distortions:
  • Mild floaters started day after surgery:, which I expected as I had them before. They were only really noticeable before if I had been straining my eyes and not getting enough sleep. They got quite strong today after putting in the required trio of drops (see above), but then eased off considerably about two hours later to a mild occasional state again.
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  • Noticing a small flickering to the outside bottom left of the right eye from time to time, mainly when in bright light (inside house), but it’s not constant at all.
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  • Light sensitivity increased, though I always have been sensitive and it was a lot better the next day, after my pupil had gone back to it’s regular size (around 2mm). Needed to put on a pair of light tinted sunglasses to wear inside this morning when I first opened the blinds and curtains, but that eased off a couple of hours later. No distortions when looking at a bare led or fluorescent bulb.

I ended up having my surgery done in a different clinic than the clinic my optometrist initially sent me to, as the first place wasn’t experienced (or offered) a specific lens I began to be interested in after researching them all extensively for a couple of months. I started out being interested in the Vivity and PanOptix. Was thinking of using them both in different eyes, or perhaps just one of them mixed with a monodical, but after reading more and reports (studies and actual outcomes by uses) of loss of contrast with the Vivity in particular, I decided against them both. I was already experiencing halo and glare problems due to my high myopia and then the cataracts starting, and had learned to compensate for them, so wasn’t really worried about that aspect. Was very concerned though about loss of contrast and loss of colour definition especially in dimmer lighting, so moved on (read too many outcomes for both of not being able to see the moon clearly unless there was backlighting such as street lights).
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I then became very interested in the Tennis Synergy, which led me to the clinic I ended up having my surgery in. I know the Synergy is somewhat hit and miss – how it is placed is extremely important, so you need someone who is experienced with it – but read quite a few outcomes of pilots, truck drivers and hunters who had exceptional outcomes with it, so thought I’d give it a try. But then I started to read more and more good stuff about the Tennis Eyhance (was considering the Clareon monodical also), so that is what I ended up deciding to go with, and so far am extremely happy with my choice. Thanks to more months of research everywhere, and especially with help from people here sharing their results and the discussions in general about the different lenses available – so thank you all! I chose a target of -1.0 D for my right eye, and -0.50 D for my left eye. As many of you already know, I won’t know what exactly my outcomes will be for around a month, and I go to see my optometrist.
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I know everyone suggests to wait at least a month between doing surgery on the second eye, even my surgeon would have preferred to leave more time between the surgeries, but with my extremely high myopia, he knew that it would be too difficult to manage the differences between the eyes for any length of time. And yes, I could have searched for a soft lens that I could maybe wear in between the surgeries, but since I wasn’t even getting good distance vision with gas permeable lenses which usually give sharper distance vision in a higher myopia than a soft lens, I didn’t think it worth the trouble. I know soft lens technology has improved, but I’d already gotten a start in not wearing my contacts for a month before pre-op testing (as required), which meant I couldn’t drive myself anywhere to even start that search (I don’t live in a city). And truthfully, from reading so many outcomes of people’s surgeries versus what their targets were, waiting that time between the two eyes did not seem to make that much of a difference, so… I was very sure that my own targets that had taken me so much time to decide upon were not going to change no matter what the actual outcome of the first surgery was, and they haven’t. Another bonus is that the healing time for both eyes will be completed at almost the same time, so I won’t have to start those types of restrictions all over again. If my eyes do change for the worse down the line, or even for the better, I don’t think that the time between my surgeries would have had anything to do with it.

When I made the comment about losing so much contrast in the Eyhance eye in an almost completely dark room, I had been in a bright room non stop for a couple of hours, working on the computer, and I’m wondering if that had influenced my vision? I redid my contrast test in the almost completely dark room, after walking around the house when it was medium to dimly lit for the last couple of hours, changing my focus as I completed different tasks and watching some TV. I turned off all of the lights except for a couple of night lights in the living room and hallway, and my results were a lot better. There wasn’t any real difference between both eyes. The white paper on the coffee table was a lot lighter, and I could define the dark furniture a lot better this time around. Maybe the Eyhance eye just needed some extra time to adjust to the dark?

Wow! Let me digest that! Sounds amazingly positive, though, thus far…

Watching a 42" LED TV from nine feet away is amazing. Sharp picture, I’m seeing details of human faces in particular that I’d never seen before. The subtitles are clear and so easy to read now. Completely different from watching with my glasses before, or even when I watched with contact lenses.

So glad you’re happy so far, and thanks for the very detailed report. I imagine that 6 weeks from now, once your eyes are healed, you will be even more delighted with your vision. Best of luck with your other eye!

Yes, it really is! I’m looking forward to the other eye being done tomorrow. Though also kinda scared in case something goes wrong and it doesn’t turn out as well as the right eye.

Thank you. Here’s hoping, fingers crossed.

It sounds like you have had a really successful surgery. One never knows for sure, and it is always a relief to have the eye done and see good results. I think you will get very good close vision with a target of -1.25 D with the Eyhance lens. That should give you something very similar to what I have in my close eye. I find I need some +1.25 D readers very infrequently, but some very small print does need it. But, I never bother to take them with me when I leave the house. I can manage to do shopping etc without the bother of bringing glasses along.
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I’m sure you are looking forward to having both eyes done and being free of the thick glasses or hassle of contacts. Wishing you all the best for your second surgery tomorrow.

Just something to mention is that the monofocal vision has really great range for the first days because the capsular bag and the eye are still trying to figure out what’s going on, but the practical range will show up later when the healing process moves along.

In any case, the initial experience sounds definitely very positive for you. I was also probably scared of eyhance for nothing.

Very good news to hear. I am sure everything will go well today too. It will be nice to have it done and seeing everything with both eyes. Keep us posted.

Yes, I’m hoping they stay at least close to what they are now, but will continue worrying til my first month at least is over. On Wednesday when they did the follow up on the right eye done last Monday, I had 20/25 which the surgeon said was phenomenal, but earlier today, it was 20/30, but the optometrist there said that they will fluctuate and not to worry. Near and intermediate were still strong, sharp and crisp. The test today on my left eye, done yesterday (Wednesday), had it at 20/20, but it will probably drop also. I had targeted -0.5 D but the surgeon told me yesterday that he got -0.36 – which I am okay with, as the two eyes are working seamlessly together, today at least. Everything looks very sharp using them together. I can see the dashboard with the left eye alone, but it’s a bit blurry – that’s at about 24".

At my follow-up check on my first eye (RE), two days after surgery, it tested 20/25 (I was reading just a little better than 20/40 on the Snellen chart I have at home at ten feet, so I thought that the clinics results were a bit too good). I could read J2 on their Jaeger chart at about 14" – the same that I was reading at home. The surgeon said that that was a phenomenal result. He was really excited about it, lol. However, today, three days after surgery, it felt a little blurrier and when they tested it again, it was down to 20/30. Their optometrist said not to worry though, that it was going to fluctuate for a while. He seemed to think it would stay with a good distance result in the end. My near vision seemed a bit better today, and my intermediate still blows my mind. I could clearly read the small microwave instructions on the side of a small medium frozen dinner box at about twenty inches – the same with the really small print on the back of a smallish herbal tea box. I saw on my chart that the surgeon was targeting -1.25 D on the right eye (not -1.0 D I thought it was), which I had told him was okay to do. I asked him what he thought he’d got, and he looked up my scans from surgery and said that he’d reached -1.21 D. Will be interesting to see what my regular optometrist finds when I see her in a month’s time.
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Had my left eye done yesterday (08-03-23), also with the Eyhance. I had asked for a target of -0.50 D on this eye, and when he was done, the surgeon said, sorry, but the best he could do was -0.36 D, which is fine with me. The distance vision today, one day later has been amazing, testing 20/20 at the clinic, which I know can and probably will change, but today the way both eyes were working together so seamlessly gives me hope. I can’t tell where one ends and the other starts. The near and intermediate with the left eye isn’t great (which makes sense), I can see the “Ultra For Dry Eyes” (white print on medium dark pink) on a hydraSense Gel Drops box at about 40", though it’s kind of blurry. I could see the dashboard in my sister’s van okay with the left eye at about 24", a bit blurry, but discernable. With both eyes together though, everything was sharp from about 12" out. it was amazing. Still cautiously hopeful.
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Looking out at the snow outside, I can really see the “coolness” of the colour temperature of these lenses. Colours are definitely vibrant and “true”, but the whiteness of the snow outside is definitely in the 5000K (daylight) range. There is almost a faint blueness to the white, it is so vibrant. I’m not sure how this fits into the discussion (or matters at all) about the blue filter in our natural lenses, but even though my vision haven’t been great over the past couple of years, I’m pretty sure that the snow wasn’t that “cold” of a white with my natural lenses – otherwise, it wouldn’t stand out to me so much now (photographic memory).

Thanks, Ron. Yes, so far the surgery on the second eye has been really good. The surgeon told me that he got -0.36 D on the left eye yesterday. Distance vision today in that eye has been great, I tested 20/20 at the clinic with it today, but I know it will probably change. No real near vision with that eye, and the intermediate doesn’t really get clear til about 40". Though, I just tried reading my laptop’s screen with that eye and I can see it at about 24" (browser print zoomed to 95% on a 15" laptop screen), but there seems to be a weird “smudge out” effect in the very center of the eye – noticed that reading print on the TV also – it’s not noticeable when using both eyes though.
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The surgeon said that he got -1.21 D with the right eye done on Monday. The distance vision with it wasn’t quite as good today as it was yesterday. They tested it at 20/25 yesterday, and today it was 20/30. Still good results considering how good the near and intermediate vision still is. I’ve been decreasing the size of the fonts on my phone, my tablet and the laptop today. I had the print on my phone set to 110% before and now it’s down to 95% and I could see it fine at about 10". I could see it even if I went smaller, but this is quicker. Both eyes together are great. It really is fantastic after all of these years of negotiating with gas permeable lenses. I have a pair of cheap readers that are either +1.50 or =1.75 that I’ve used once or twice for really really fine print, but the intermediate vision on this right eye is so amazing that for even small print like ingredients on cans and boxes, all I’ve had to do was to hold it arm’s length, and it’s really sharp.

Thanks. I posted a new comment about the second surgery. So far, pretty freaking good, lol. Hopefully, it will stay at least close to that analysis.

Curious. Had you tried mini-monovision before the implants?

Glad things are going well! Have been interested in reading your detailed accounts. Question: Would you pick those exact focal targets again or would you change? I am aware that the results are slightly different than original targets. Also, I asked somewhere here before if you had given mini -monovision a trial first? I am thinking of similar targets to what you have but I have been unable to try mini-mono as I couldn’t get contact lenses in for some reason.

Interesting comment about the blue light filter. I guess the world looks slightly blue without it! I wear amber sunglasses a lot which really changes that.

" I had asked for a target of -0.50 D on this eye, and when he was done, the surgeon said, sorry, but the best he could do was -0.36 D, which is fine with me."
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I don’t remember the powers that were likely to be used, but the surgeon would be choosing between this power, and the next higher one would leave you at -0.75 D which is quite a bit over what you wanted. The next lower one would leave you at +0.02 D, or very slightly far sighted. That would be fine for distance vision (if that is the actual result), but would cut into your close vision in this eye. I think he made a very good choice to leave you at -0.36 D. And of course you will not really know where you ended up until the eye fully heals and you have a full refraction done by your optometrist.
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On colours it is really hard to compare them based on memory. Our brain normalizes colours to what you think they should be. This can be easily seen with indoor florescent lighting. There are warm versions and cool white versions of the lamps. When they are all one type in a room we see the light as being normal. However, when somebody replaces a warm white tube with a cool white in the middle of the room, those ones stick out like a sore thumb. But, based on theory the colour balance for a clear lens like the Eyhance should be cool white as you are getting the full amount of blue light that previously was being filtered out by the natural lens. Unless you are doing digital darkroom work, it is unlikely to have any impact. We get used to what we have. I never realized how yellow my vision had turned due to cataracts until I got a new lens in one eye, and compared it to the other eye.

Yes, I am very happy with what he got with the left eye. I knew there was a chance it could have landed at -0.25 D, so -0.36 D is a good balance I think. Definitely wouldn’t have wanted more than the -0.50 D. The vision in that eye is very sharp at distance, so it’s balancing out the near and intermediate boost to the right eye nicely. I understand what you mean about remembering colours, except that I have a photographic memory which maintains images in my brain, not through my external vision, so I have very clear comparisons to work from. When I was looking outside at the snow, I was reminded of my initial reaction when I first lit up a 5000K LED bulb (the cool fluorescent ones show a little differently), and that sharp cool white from it, which I loved, although I use a variety inside the house. But for sharp instant clarity, they’re my first choice. Interestingly enough, the black glasses they gave me to wear outside, have a distinct blue tint inside, and when wearing them outside, the snow looks more of a normal “daylight” kelvin range. I guess mimicking that natural blue filter we’re born with and balancing things out. The cataracts in my eyes were still early stage so they weren’t changing my colour vision that much yet, at least not with contacts. My glasses had all of the extra coatings for high-index lenses (anti-reflective, UV-blocking, etc), and since everything was so much smaller through them, things looked a bit darker inside, and vision from my left eye wasn’t giving much than a blur from about a foot out.

No, not really. The retina of my left eye tried to detach a couple of times years ago, and although it didn’t succeed, I was left far sighted in that eye, in addition to the high myopia I already had. I was left (at the time) at -09.75 D, and +1.50 D in that one eye. The far sightedness aspect would make me kinda queasy and dizzy when focusing on anything within three to four feet, when my contacts (or glasses) were set as usual for distance (I used have to have decent near vision in that eye also). So the optometrist(s) started backing off the prescription distance in that eye when making me up contacts or glasses, which stopped the queasy feeling, but also diminished my distance vision in that eye, so it was no longer my dominant eye. There was a small amount of a discrepancy between the eyes, but I didn’t really notice it that much until the past year or so when the cataracts started messing with my vision in general. The left eye was hit the worst, and even with contacts, it hasn’t been giving me clear vision at any distance, and that was very noticeable to me and hard to deal with. That was one of the reasons I didn’t want much of a difference between the two eyes with the IOLs, just in case. I would use my right eye for both distance and near, because even backed off, the left eye still wasn’t giving me any really useable near vision, but I always was very aware of choosing to use the right eye for up close. What I’m noticing now after surgery on both eyes, is that I am not noticing the switch over at all. Both eyes are working together as a team, and I’m no longer conscious of one eye doing something different than the other.