Are you happy? Any input?
I went for mini-monovision, with my left, non-dominant eye set for intermediate vision and my right eye set for distance. I need reading glasses for near vision inside about 20 to 22 inches, except that I can read lit computer and phone screens closer because of the better contrast.
I'm pretty happy with the results, but being formerly myopic, I sometimes think I should have gone for near and intermediate. While I formerly wore glasses and had them with me all of the time, now I have to seek out my reading glasses whenever I encounter small type, especially in poor lighting. Sometimes I don't have reading glasses with me, but there are credit card magnifiers, folding reading glasses, and other reading aids available that are easy to carry around.
My vision is otherwise seamless. My right eye takes over for distance and my left eye takes over for intermediate (and a degree of near vision). It's not noticeable to me that one eye or the other is predominating unless the predominant eye is blocked. The only time that I've noticed one eye affecting the vision of the other is with near vision. If I close my right (distance) eye, I think I can see just a tiny bit better when reading without my glasses.
Right now I see fine with reading glasses having the same magnification in each lens, but I think it might be better if I had different magnifications in the two lenses to correct each eye for optimal near focus. There are companies that sell customized reading glasses, but the ones I've seen are pricey. I may look to see if I can find two pairs of reading glasses with different magnifications where the lenses can be switched and use those for longer reading sessions.
What was the diopter difference between the two eyes after surgery?
I was diagnosed with Cataracts in both eyes and Narrow-Angle Glacoma in the LE. The LE was the worst so I opted surgery on the LE first since the RE isn't symptomatic yet. I had the surgery in mid April. I opted for an intermediate lens in the LE so I could see my computer screen and dashboard on my car and driving day and night is fine. The surgeon did a good job and my sight in my LE is better than expected.
So far my near and intermediate vision is good in the LE. I use the RE for distance at 20/40 and it works well. The Glaucoma seems to be gone due to the fact the new lens is much thinner than the cataract and the Narrow Angle is no longer an problem. The only issue I have is Negative Dysphotosia, but the symptoms are going away slowly. If your spouse isn't on the computer all day which might be bothersome, I would recommend looking into mini-monovision as a solution.
My experience with mini monovision is almost identical to what BobDob has written. My right non-dominate eye was done first and was targeted for intermediate vision. The goal was -1.0 and at my last appointment I was told it was -1.25. I love having this mid-range vision as I find it allows me to function well without glasses for almost all of my daily activities. My left dominate eye was targeted for better distance vision and ended up close to plano. This allows me to drive, watch TV, etc., without the need for glasses. I will say my adjustment has not been totally seamless. I frequently have this sense of blur around my left eye, even though the vision is good. I do have lots of floaters in that eye (I had them prior to surgery) which is partially responsible for the blur but I notice it most when I am using my mid-range vision and I wonder if my dominate eye does not automatically allow the other eye to take over. I do miss my near vision but, like BobDob, I see well for close work using a single vision reader from the dollar store. I plan to purchase a pair of prescription progressive glasses which would provide me with perfect vision for all ranges for those times when I don't want to bother with continually putting on and taking off my readers. Overall, I am happy that I didn't target distance for both eyes because I love my mid-range vision. After 50+ years of wearing contacts for extreme myopia (-10), this is a pretty amazing result. (I should add that I did go with a toric lens for both eyes to correct my astigmatism.)
If your spouse isn't on the computer all day which might be bothersome, I would recommend looking into mini-monovision as a solution.
She is on PC 8hrs a day, 4 days a week. Then she gives 12 hrs of group fitness classes in the week in front of her clients (30 people on average).
So she has to be able to see them to interact a with them.
She is in her early 40s and her subjective refractory values from the right +0.5 -0.25 103 °, left +0.5 -0.75 137 °.
Left eye will be operated first.
Six weeks after my second cataract surgery, my right eye was measured at +.25 with -.25 astigmatism and the left eye at -.75 with -.50 astigmatism. I should note that my left eye had been measured after surgery four months previously at -1.50, so it either adjusted +.75 diopters in that time or one of the measurements was not accurate.
Yes, my experience is similar (except that my right eye is dominant). I don't have the sense of blur with my right (distance) eye, but on occasion sort of sense a slight blur with my left eye when watching our 65-inch television from about 8 feet away. That's the only time I sense it, but in reality I am seeing the tv clearly. As with your floaters, I have a pre-existing large circular floater called a Weiss ring in my left eye that I don't usually notice but probably accounts for the sense of blurriness.
While I'm retired and no longer on a PC every day, I still have long sessions on my laptop and don't find it bothersome. I do wear reading glasses at times with the laptop. I also am occasionally on the house PC (using a monitor) and don't think I would have a problem with long sessions. Worst case, your wife would need prescription computer glasses to get her through the day.
Hi I did mini monovision kind of with both options . i had my left eye lens replaced with a toric intermediate lens about 6 years ago. At that stage my right eye was fine and was better for distance. I could see the computer screen and my phone if I squinted but was more comfortable with reading glasses. About a month ago I had a cataract removed from my right eye and had a near distance toric lens put in. The day after surgery my measurements were left eye -o.75 and right eye -2.25 . I go back to the dr tomorrow for the last check up. I have not used reading glasses since the operation. I love not using them. However in bright light I sometimes find it hard to focus in the distance. When it settles down I ntend to get prescription distance glasses for seeing plays and concerts but in general hope to be glasses free.
Really helpful comments from everyone; I'm following as I need to make a similar decision.
@WorriedHusband, given your wife has had accommodation all her life and will just have to accept losing that, I offer my experience with that transition (because yes, at first it really sucked: I felt ancient and didn't want to need reading glasses ever). It takes some getting used to, but ends up not being so bad if you work it right.
The real annoyance is when you have to pull out glasses when you're on the go. So, say, in grocery stores to read normal labels (some of those are microscopic so we'll never see those...they require a snapshot with the cell phone and then magnification). Restaurants to read menus (although they are usually dim so a small light like on a cell phone can often fix that). Glancing at your cell phone (although as Viking noted, the contrast is greater so phones are easier, as are computer screens). Someone hands you a business card or something and you can't read it. THAT's annoying.
For longer sessions like working all day at a computer, or, say, sewing something or doing detailed work up close, needing glasses won't have as much annoyance. Some people I know who need reading glasses for everything just buy a whole bunch of them and scatter them around where they are likely to use them: by the computer, by the bed, in the crafts room, etc. Having done one eye and begun to see that there simply will be some compromise, and that I was living with bad vision anyway (and that truly what I can now see is so crystal clear it's stupendous) ... well, I now realize that needing glasses when I'm at the computer for long sessions would be okay. You pack some glasses along with the charging cable and no big deal.
Since the Tecnis ZKB00 that I have is a bit weak in the intermediate range, I am noticing that I lose some clarity in places I had not expected. In museums, I have to lean in towards the labels which is a bit awkward when there are others looking at the piece too. Once I noticed it in the kitchen. The car dashboard might be a tad blurry (but I have only driven a handful of times since the new lens so need to assess that more. In general, dashboard things are a bit larger and you memorize them anyway so if they're a bit blurry you'll still understand them). But again, needing glasses just for driving wouldn't be so bad...because you just keep them in the car...although personally I LOVE the far vision I now have so I wouldn't want to need far glasses.
Another thing to consider, and nobody mentions it, is whether the food on her plate will be blurry, which is kind of an appetite killer. That's happened to me a few times in my life, and I didn't like it.
Hopefully that helps you imagine how the day to day logistics would go...in the end, as I observe the people around me and how they handle presbyopia, the people I admire are those who don't judge themselves for their need to have reading glasses...they just anticipate the need, have the glasses handy, pull them out and put them on their face, and continue on.
All good points, Tamarinda. I would add that whether she needs reading or computer glasses all depends on where she ends up with both eyes. With my mini-monovision, I see from about 20 inches out to distance fine. I have no problem seeing the dashboard and no problem seeing a computer monitor. Inside 20 inches, I can still read 12-point and larger fonts and even smaller fonts when there is good contrast. I only need reading glasses for tiny fonts or small fonts in dim or low-contrast conditions. That being said, there are no guarantees where anyone is going to exactly end up after this surgery.
Is mini monovision what your wife is leaning towards?
Yes mini monovision set for distance. Left eye 0.00 and right eye with difference of .5. Nothing final yet.
The idea of EDOF or Trifocal IOLs scares her.
We are in the mountains currently, hiking holiday. First 2 days her vision was very blurry and seeing her suffer made me really sad. Since yesterday her vision is sharp again.
Heart breaking dealing with this yo yo bluriness. Operation date is set for 3rd week of August for left eye.
Wife is not opposed to glasses. Infact she just wants to be able to see sharp.
Tamarinda, what about bifocal blended glasses? Just leave them on at all times with clear glass towards the top and reading towards the bottom?
For us all there is a certain level of worry and frightened about unknown. I was never really comfortable with my decision to go with EDOF lenses but knew my requirements were not the same as others. I was and am very active - working full time tor a good number of years to come and the opportunity to be less glasses dependent was just too appealing. I have not regretted my decision but do know the back and forth I put myself through with lens selection wasn't a fun time.
Hi Husband! I've never tried those progressive glasses. Lots of folks have and I bet they can offer their experience.
WorriedHusband, I can't offer any advice on mini-monovision.If your wife is willing to tolerate glasses, and is fearful of EDOF or tri-focals, then this may be a good option.Seems like then the question is whether it is preferable to need glasses for near, or for distance.
Thought I'd mention one thing I read from one of the articles I linked before, particularly since it relates to a new device (Vivior) just developed in Switzerland. Don't know where this technology stands now, or if it would be helpful for you and your wife, but thought I'd copy some sections below: "Within the next few years it’s going to be ludicrous to even think that at some point we chose an IOL without objective data, This new technology, named Vivior, is a wearable monitor fitted on the patient’s own spectacles or a clear pair of spectacles if the patient does not currently wear glasses, which over a number of days tracks viewing distance, activity, head position, ambient light and other context parameters. Measurements are monitored, recorded and saved to the cloud for processing and analysis.
*It gives you all the information you need on the patient’s visual lifestyle, an objective defocus curve, the true time they use specific viewing distances. By using Vivior in our trials, we realized how misleading patient-reported information might be. Patients don’t know what they need, and if they do, they don’t know how to tell us what they need. And we are not particularly good listeners, anyhow,” *
*A device that provides us with objective criteria for IOL selection is going to be really helpful,” he said. For instance, he noticed during the Vivior study that everyone underestimates the amount of time spent for near vision. *
Interesting technology. Sounds like that could come at quite a cost. With the millions of surgeries they do and for Canada long wait times as it is wonder if they'd make that available under national healthcare. What's really needed is ability to tweak the power once IOL is implanted.