Monofocal IOL for NEAR: How far can you see? Also what power glasses would you need for distance?
Would you need a pair for intermediate distance too?
If you go with distance monofocals, my doctor advised everything upto 6 feet would be blurry without glasses. And would probably need near and intermediate glasses.
I find it hard to believe that most people would have blurred vision up to 6 feet. While a few might, the doc might say that to avoid any liability or have your expectations set too high. My doc said I would not be able to read a computer screen while the nurse said I would not have a problem with it. As it turns out, (my eyes are set for distance), I can easily read my computer screen and I can even read my phone. So, they don't want you to have any expectations out of the range they set it to (near, mid-range, or distance).
I went with distance and I see just fine an "arm's length" away or in other words 18 inches away. After the first eye was done, I found it difficult to read "up close" / near so when they did the second eye, they set it for distance but only 1/2 diopter in biased to near and I can read just fine anything that is 16-18 inches away including my phone. Both eyes working together see better at all ranges than either eye by itself.
With that said, if you still prefer to go with the IOL near, you might want to consider "mini-mono vision" so that one eye is set for near while the second (usually the dominant one) is set to intermediate so that you can easily read a computer screen without glasses. I'm on the computer ALL the time and I have no trouble whatsoever seeing the computer. I never need glasses when driving or reading the computer or doing most things up close. Once in a while I throw on a pair or use a "credit card" magnifier for reading really small print.
I would not recommend mono vision for many reasons but mini-mono vision is often a great compromise and works really well. For me, 1/2 diopter difference has worked out great.
Assuming no other visual issues and no astigmatism, if the monofocal is set for -2.25 to get good near vision, one should be able to see 20/20 at about 18 inches, better than 20/25 between 15 and 23 inches, and better than 20/40 between 12 and 32 inches.
Again, assuming no other visual issues and no astigmatism, if the monofocal is set for -0.25 to get good distance vision, you should be able to see 20/20 at 13 feet and beyond, 20/25 or better beyond about 5 feet and, 20/40 or better down to about 32 inches.
Depending on what your requirement is at any distance (depending on the activity), you may need to wear corrective glasses.
Hi Soks, I had the exact same questions! I had heard everything from "you will only see well at one distance and need glasses for everything else," to post-op patients telling me they were corrected for distance with monofocals and could still mostly read except fine print. Very confusing and anxiety-inducing. Trying to compare to my own pre-existing range was difficult, too, since (at age 58) I was told everything from "you already have no accommodation," to "you probably still have some accommodation." All I knew is that I didn't want to be 20/20 (I had a near panic attack trying to see my phone while wearing a contact lens) and that I wanted to be a little near-sighted. Would selecting a mild near-focus mean bifocals or progressives all the time? That could be worse than needing readers for everything close up. I ultimately did select a near-focus target, and fortunately at 2-weeks post-op my range of vision is very good! I am so relieved. Distance is only a little blurry; I can still read most print, and intermediate is excellent (see my thread "Choosing Intermediate/Near Monofocal Lens . . .". I will post the actual numbers in the next day or two. I have NO idea if this is typical, however, and am hoping someone can post here about whether there is any way to predict (even approximately) pre-op what one's range might be with a monofocal IOL. I hope just knowing a decent range is even possible will help ease your anxiety!
Thanks at201 . . . started my post before you posted this. The more information, the better!
Thanks for the reply. What do you mean by monofocal is set to -2.25 and -0.25?
I do have astigmatism in one eye but vision in that (dominant) eye is still clear.
michael74313, I totally agree about the liability. I would have the same reservation if I were the surgeon, since results are never guaranteed and I wouldn't want to be in a position of a patient saying "you said I would see X . . .," especially since it is an elective surgery with inherent risks. I guess sharing anecdotes here does serve a purpose; to report some "best-case" scenarios (along with the worst) without fear of liability.
Thanks for the reply. I do not want to do monovision as I am with monovision right now. Right eye is good for distance and affected eye is still good for near. It bother me a lot when things out of sight from the good eye are blurry and then become clear.
Are the results that BellaD and micheal74313 describe typical? And do you guys see any halos or night issues?
I have no halos or night issues at all. I think one is far less likely to have any of those issues with a monofocal lens.
Correct - I'm not suggesting mono vision but rather, check into "mini monovision" for a better range of vision. My eyes are only about 1/2 diopter different.
I had my first eye done 7 weeks ago and second eye done a week ago with monofocal IOLs set for distance. I can read my laptop at a foot away with a regular size font, see my cell phone at normal size (but that can be made larger if need be), see my car dashboard perfectly, see the TV, see the food I'm eating, drive my car, etc. without glasses (I thought about asking for minimonovision on the 2nd eye to try to make it even easier to read small print without glasses, but decided against it since I had lasik a long time ago and calculating the correct power for cataract surgery can be harder for them to do after someone had lasik). I only need reading glasses to read the smallest print or if I'm doing extended reading. I posted a study on here done by Abbott where they found only 5% of people couldn't see at intermediate distances of 2 to 5 feet without glasses after cataract surgery with monofocal IOLs set for distance (therefore don't believe what your doctor tells you about that, but be prepared for possibly being one of the 5 people out of 100 who need glasses to see at intermediate distances after cataract surgery with monofocals set for distance).
Sounds like you got an email xcellent result Nina. And there has been a number of people asking about that intermediate distance. I recall my doctor telling me I would likely need glasses for computer distance too and it did play into my decision to opt for Symfony lenses. Had I have known perhaps I would have investigated monofocals more or if I were retired and didn’t need to be on a computer or reading spreadsheets so much. In the end although I paid $1,800 for Symfony lenses I too ended up with a really good result.
Hi nina234, Great result! Do you happen to know if your vision ended up at 0D, or a slight + or - number?
For those who chose NEAR IOL what is the power of the glasses you use for distance -#.##??
Do you see spider webs at night Sue.An?
I am younger for cataract too at 41. I may have gotten it early due to steroidal cream I used for an eczema infection on cheek.
But then again my mother got it when she was 41 in 1987. She says that with whatever IOL she got back then gave her both clear near and distance vision.
Hi Sims - at first few weeks with Symfony didn’t see spider webs but did see strong glare/glare from lights. Those have subsided substantially (and when I ask my husband or others what they see I don’t think the glare around noon or other light sources is any different than they see - and they don’t have cataracts).
But yes do see the spider webs around certain types of light sources at dusk and night. These are much lighter than the glare and I do not find them overly bothersome (still wish they weren’t there but accept them). Mostly see them around brake lights and amber turning signal lights or porch lights that are LED.
Everyone has to compromise on something as perfect lens doesn’t exist. I am younger too and active. Like to run walk bike racket sports and work full time and raising a daughter. For me Symfony allows me to do all those things without glasses for first time (nearsighted since a teen).
My surgeon told me at 6 week check up he knew it was a hard decision and he said younger patients who have good near vision like me find the decision and compromise the worst to make.
I am though pleased with the outcome and as days go by think less and less about the negatives.
I wish you the best as I think you are in my position trying to decide between night visuals or losing near vision. I too have eczema so wondered if creams affected me. Also had to go on prednisone when I was in my 30’s. No one in my family has early cataracts and my parents are in their 70’s and still aren’t impacted with them.
nina, your results with monofocal (Abbott?) IOLs set for distance are excellent if you also have good intermediate (2feet) and decent reading vision for smartphone, etc!
I too am starting with my right (dominant) eye first for cataract surgery with Abott Tecnics toric monofocal IOL set for distance, surgery later this month.
After that right eye heals and then evaluate if I get good intermediate distance vision with that eye. That will determine my plan for the left eye in the future, whether I will need to make it a little nearsighted for mini-monovision with another monofocal or consider a Symfony in that eye to expand the focus range.
But your result with monofocal IOLs set for distance gives us others hope to get a wider focus range than expected!
soks, my 2-week post op Rx is -1.0D for the Right cataract eye (0 astigmatism) and -1.5D (slight, .25 astigmatism) for the oLeft. Still some halos R but diminishing; similar to halos Left from small cataract. MD says they are likely from inflammation an may go away. (Likely would be worse with multifocal per MD.) I can see very fine print (e.g. print on the eyedrops bottle) with R eye alone, as long as I move it out a bit. Near-vision is much better than expected, so may not have to use readers much. Middle distances are excellent (computer, sheet music, cooking, walking around the house, grocery shopping, etc.). A little blurry for far distance, but have no objection to using glasses for driving, biking, movies, conferences, "star-gazing?," etc. Very happy overall choosing to be a little myopic, especially with some mini-monovision (left eye .5D poorer than Right) to extend the range. Hope this helps!
Wow - you can read the fine print on an eyedrop bottle with only the -1D right eye which has a monofocal IOL?
Thats incredible - how far away are you reading it OK, 24" or so?
My arms are pretty long so I can hold something to read to almost 30" away from the eyes.
Night-Hawk -- Testing it out here again ... I swear it was much better this morning in bright daylight (ha ha) it's very late and my eyes are tired but here goes in so-so lighting (Left eye closed; Right @ 24" straining; Front of bottle: "PHARMA Rx only PREDNISOLONE ACETATE ophthalmic suspension USP 1% 5 mL. So far so good . . .back is way harder! Only the bolder print is legible: "CONTAINS: Active . . .blah blah blah. . .USUAL DOSAGE . . .blah blah blah. . .shake well before using . . blah blah blah. OK, forget it. Opened Left eye; only a little better, but still straining. Put on +1D readers: All letters and numbers are legible without too much strain at 14" distance. So there you have it! No, can't read all the fine print but nevertheless shocked that so much is even legible at this point. Did not expect that at all.