I’ve just had the first intermediate lens (-1.5D or -1.75D) implanted with the goal of mini-monovision (intermediate/distance). I just read that distance vision encompasses intermediate vision! Just wondering, is there any advantage of mini-monovision over distance for intermediate/distance mini-monovision? Have I made a mistake?
No, I don't think you have made a mistake. Yes, you will get some intermediate vision with a distance set monofocal, but it will only get you good vision down to 2-3 feet. Your -1.5 D eye is needed to get down to 1 foot or so for good reading vision, and get good vision out to 2-3 feet to provide the full range of vision coverage. If you got full distance vision in both eyes, you would need reading glasses for distances less than 2-3 feet.
Thanks so much for the clarification! To be sure I understand, -1.5D would provide good reading vision at 1 foot with still good general vision from 2-3 feet whereas distance vision would not? Would I expect my best vision to be at the 1 foot point or is it more of a range? Is there a general range of vision for -1.5D? Does the range of vision improve if such a lens is placed in both eyes? On a related note, I remember you said to wait until the first eye has settled (6 weeks) before proceeding with the second eye. Would that mean that what I see now at various distances with my operated eye will likely change at least a little over the next few weeks? Many thanks! You are such a valuable resource!
A -1.5 D target on average will give good (20/32) vision down to just over a foot. Peak visual acuity will be at about 2 feet. Good vision should extend out to about 5 feet. However, individual results will vary. Subjectively I find I have useable vision from 8" to about 8 feet with my -1.60 D eye. Not sure if it is 20/32 or not over that range, but it is functional. . Vision will improve very slightly if the same target is used in both eyes. The benefit is quite minor though compared to seeing a full range of vision potentially from 1 foot to infinity with the eyes set to mini-monovision targets. . Vision after surgery will change as the eye heals. At three weeks most will have a good idea where things are going to settle. I had an eye exam at that point but the optometrist would not give me a written prescription as he said the eye could still change. The advice I was given was to wait until 5-6 weeks to be sure the outcome is stable. 6 weeks is a good time to get a full optometrist eye exam and prescription to see what you have really got. I would suggest scheduling the second eye for a date past 6 weeks. The surgeon should review the refraction results of the first eye to see if any adjustment is required in calculating the power for the second eye.
Judeth, download and print Jaeger chart. See how you do now in pretty good light. That is for near vision, and is intended to be viewed from 14 inches away.
Regarding your two question, the first one I don't understand. For the second, I don't think so. How would you describe your vision with the refurbished eye?
For distance, how close do you have to be to read a car license plate during the day with your operated eye, compared to your friends? Easy thing to try when in a parking lot with friends.
Certainly, there is an advantage of mini-monovision over distance only - you'll get better intermediate-distance acuity, and better-though-maybe-not-great near-distance acuity.
I don't have to get my first eye done 'til next year, but I am considering a similar target range of -1.5 D to -2.0 D, to get some decent near and intermediate vision. So I don't think it's a mistake!
Good luck.
Hi Ron,
I tried to send you a copy of my IOL card but the message is being reviewed. Basically I was asking for clarification of the sentence,
The surgeon should review the refraction results of the first eye to see if any adjustment is required in calculating the power for the second eye.
I get easily confused between words like power, target, focus, setting...
For example is the power -1.50 D or -1.75 D? Is saying power of the lens the correct terminology? Other numbers on the IOL card include +16.5 D
and CYL 1.5 - do you know what these numbers mean?
I also wanted to ask you about driving safely. My unoperated eye has a cataract and higher myopia. The surgeon told me I would need some help in that regard but not what such help might be. My optomotrist is booked so my options are to go to another practice or another optomotrist in the same practice.
I just tried on my glasses. Probably better vision overall but my operated eye seems off with the old glasses lens.
Thanks I'll try the Jaeger chart. The vision in my operated eye is clear but limited in terms of range. For example, typing this I have set the font size to 150. That said, it is much clearer than my unoperated eye without glasses and about the same as my unoperated eye with glasses. I haven't left the house since my cataract surgery last week. Trouble is I can't drive like this...
At what distance is your new-eye focus best?
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Wait, 150 point??? that is incredible.
The font size on a modern Jaeger eye chart usually ranges from J10 (about 14-point type in Times New Roman font) to J1 (about 3-point type in Times New Roman).
I would consider going to an optomotrist go get a refraction (prescription).
What I would not do is to get the other eye operated on until you know more.
The +16.5 D is an internal number, that is of some interest, but is not something that you would normally be concerned with directly.
I just tried on my glasses. Probably better vision overall but my operated eye seems off with the old glasses lens.
That sounds right.
Yes, your old glasses should be "off" for the operated eye because your new vision is unlikely to be exactly the same as before the cataracts. And yes, driving can be a problem during the time period before the eye settles and you get new glasses made.
When I had my surgeries, I had a drawer full of old glasses from a lifetime of myopia. I found an old pair that worked okay.
Best to be careful and don't push driving with poor vision. If necessary, you could get a pair of cheap driving glasses made (distance only). Use taxis, get deliveries, ask friends. This period won't last forever.
Judith I am glad your surgery has gone well. What kind of IOL did you eventually get?
I'm speaking of the font size on my laptop not the Jaeger eye chart.
Yes, the refraction is the power of the corrective lens required to give you the best possible distance vision. If your target was -1.5 D and your prescription is -1.5 D then they hit the target. . The 16.5 D is the sphere power of the IOL. It would suggest you were moderately myopic prior to surgery. The Cylinder number is the correction for astigmatism and indicates you got a toric lens. Depending on the brand of lens you got that is either the lowest available cylinder or second lowest. . The advice I got was to wear whatever glasses that you have around and work the best, but not to get a prescription filled until you get the refraction done at 5-6 weeks. . I think in most jurisdictions you need 20/40 with both eyes open to be legal to drive. There are snellen eye test charts that you can download and print to see where you are at without spending the money on a optometrist. For the 6 week check I would get the optometrist to do the prescription though.
For driving you may want to consider wearing a pair of prescription glasses that best corrects your unoperated eye for distance. Then take the lens out of the glasses for the operated eye and let it be correction free. This will give you a rough simulation of mini-monovision if the operated eye is close to -1.50 D.
Hi Lynda,
I've just had the first intermediate monofocal lens (-1.5D or -1.75D) implanted with the goal of mini-monovision (intermediate/distance). I do feel a bit blind with the intermediate lens only!
ok. I meant to say which IOL? Clareon , Eyhance , Tecnis?
I'm speaking of the font size on my laptop not the Jaeger eye chart.
There are 72 font points per inch. So 72 font characters would be 1 inch tall.
150 point font wound be over 2 inch tall characters.
10 point font would be 0.139 inches tall
Thanks Ron!
When you say,
the refraction is the power of the corrective lens required to give you the best possible distance vision. If your target was -1.5 D and your prescription is -1.5 D then they hit the target,
are you referring to a prescription for new glasses once my vision has settled after the 6 week waiting period after cataract surgery?
Yes, I was moderately myopic before LE surgery. RE is still moderately myopic. I got the Alcon monofocal toric lenses.
I only have one pair of glasses but rimless!
I think she means 150% of normal size for her monitor. There is a setting in Windows for this. I use 125% sometimes and 150% at other times. It tells us nothing about her visual acuity without knowing the font size and the screen size.