I am 62 year old with a denser cataract in the right eye and less in the left eye. I have posted another tread with a question on whether I should get Symfony lens or not. I have decided to go with mono focal lens in both eyes. The input from everyone on this forum has helped me a lot in deciding. I have right eye cataract surgery scheduled for Friday, October 12th, 2018. My left eye surgery is on November 2nd, 2018.
I went to my doctor's office for pre ops and also met him to discuss the right eye lens details. From what I had told him initially he had planned to do mini monovision for me. I asked him in terms of distance at which I will need to keep my cell phone to read clearly. He said it would need to be 18 inches from my face. He said I may need reading glasses for fine print. When I asked him how about making cell phone text readable at 14 inches. He said he agrees with me and he can do that but I will need to keep my computer closer than 26 inches.
My current prescription details are as follows: OD: Sphere: -2.50 Cylinder: -0.75 Axis: 172 Add: +2.75 and OS: Sphere: -1.0 Cylinder: -0.75 Axis: 017 Add: +2.75.
He said if we do cell phone reading at 14 inches it is mono vision and computer has to be moved closer. If we do cell phone reading at 18 inches it will be mini monovision. The computer can stay at 26 inches. I will need readers for fine prints.
Based on my prescription and no other eye problems, can anyone suggest which way I would be better off? I am unable to decide whether to go with monovision or mini monovision. Any help would be greatly appreciated. Thanks again for all your input so far.
Everyone is different in terms of how much monovision their brain will adapt to. The less you do, the better the probability that you'll adjust. You also might find that you can read at 14" and use the computer with Symfony set for distance (some people do).
If your left eye is still decent, you can do the surgery on your right eye (set for dsitance) and then try contacts in the left eye to simulate the different degrees of monovision to see how your brain adjusts. Contacts will work much better for glasses for this test as you won't have any issues with the image sizes being different.
Thank you derek40125. I have already decided not to go with Symfony lens as I know the possibility of halos and other side effects is more with multi-focal lens.
I already have mono vision (right eye is near sighted and left eye is far sighted). Lately I am noticing both my eyes are becoming more and more near sighted. Therefore, I am wondering if I should go with mini monovision (18 inches for clear cell phone reading). So I have to decide between 14 inches and 18 inches cell phone distance for right eye. The left eye is going to be set for distance and will have mono focal. Thank you, again.
Any you mention you already have monovision- is this with contact lenses? And if so what is the diopter difference between left and right eye. As Derek mentions it would be very difficult for anyone to tell you how much monovision a person’s brain can adjust too. My cataracts when diagnosed were bad enough that I could not simulate monovision with contact lenses so I decided against it. Not to throw a wrench in your plans but perhaps a Symfony lens set for intermediate would give you both that computer vision and 14 inch reading vision (likely closer as I can read at 11 inches and my surgeon targeted it for plano). If the Symfony lens is targeted for intermediate the less likely you would see the concentric circles.
If going with monofocals I personally would target intermediate and hope for best I could read. There is always that possibility target won’t be achieved by .25 either way due to IOLs coming in increments of .50 diopters and settling of IOL. surgeon can always make adjust with 2nd eye target when it comes time for that surgery.
If you had to choose which is more important to you reading distance or computer? And I realize that can change too with time. I do a lot of computer work with my job so that yo me was an important criteria when choosing a lens.
18" isn't that far for smartphone reading unless your arms are very short?
Mini monovision is easier to adapt to than full monovision, thats what I plan for whenever I need my left eye done - either that or a Symfony toric in that eye to get even better range.
anu1942, I am in a situation that is similar to yours. I have a bad cataract in my right eye and a mild one in my left eye. I will be scheduling surgery in the next day or two for my right. My left eye is 20/25, so I hope it will be a long time before I need surgery. for that one. I have decided against Symphony Lens, because I don't want to deal with night vision issues. For the past few years, I've been using my right eye for reading and my left eye for distance. Prior to that time, I used monovision contact lens, which I have always happy with. Frankly, I did not realize there were 3 ranges of vision until I started reading on this forum (distance, intermediate and reading). Initially, I was going to go with my right eye for reading and my left eye for distance. With that said, If I eventually had to have cataract surgery on my left eye, I would have no intermediate vision. With that in mind, I chose to go with mini-monovision, because I spend far more time on the computer than I do reading up close. Also, I want to be able read the dashboard on my car without using glasses. I realize that with this decision, I will need glasses for reading.
Thanks Sue.An. I have always had natural monovision. I never wore glasses or contacts for any activity. I have always used my right eye for near and left eye for distance. Therefore, I assume it would not be a problem to adopt the same with similar mono focal IOLs replacements. I know natural lens has more adaptability and I cannot expect the same functionality with a IOL once I get surgery done. I have decided against Symfony due to a higher chances of halos and other side effects. Your reply is helping me decide better. My job is to be on the computer throughout the day. However, I also using my phone for nearly the same amount of time every day. I think the responses on this post are helping with making a choice more easily. I am thankful for that.
Thank you Night-Hawk. My arms are long. So from what you are saying, I think 18" for my right eye should work. During my first appointment, my surgeon asked me whether I hold my phone close or far. I promptly replied 'far'. Since I had told him I want mini monovision he noted 18" for right eye on his chart. As you also say mini monovision is easier to adapt I think it would work great for me. Once I get my right eye done I will see how things go and decide on whether to get the left eye done immediately or wait for some time 
Greg98553. I agree. We both have almost the same type of vision. I don't know how much astigmatism you have. My surgeon has said that I have slight astigmatism (cylinder - .75) in both eyes. Since he will be using ORA technology during surgery to calculate the power of my IOL, this will be addressed. I am praying for your surgery to be a great success. Thanks for sharing your info. I am also leaning towards mini monovision. Hope it goes well.
For me, I went with two mono focal lens for distance and set the second eye 1/2 diopter in for slightly better near vision so I have mini mono vision. Both of my eyes see around 20/20 distance and I see the computer with no problem at all and my near vision is very good also. At my last check up a while back I was around 20/25 near and it is at least that good or better today. I had to learn to hold the phone slightly further than before surgery. Before surgery I was very near sighted so I had to hold the phone no more than 5" from my eyes now I hold it 12-14"
With that said, there are a lot of "tricks" I learned so as to almost never need reading glasses at all. I don't mind wearing them but I usually just don't need them. Over time it has gotten even better and I can now read the small print on a medicine bottle (with adequate lighting). I've learned that it's a lot easier to read things in day light or if I "swipe up" on my phone to turn on the flash light when the lighting is dim. For me it was about reprogramming my brain to find that new "sweet spot" when reading small print.
I decided against full mono vision for many reasons. First, it affects one's depth perception. Next, I was very concerned that over time especially because my eyes would not be working together that they might become compromised and I might not see well at either near or distance. I find that with my eyes working together, I see better at all ranges. Last, I remember reading studies that show because depth perception is affected, chances of slip and falls are greater as one enters their senior years in life.
Also, I found that test contact lens (before surgery) might give you an idea of what kind of mono vision you can tolerate but they didn't give me any idea as to how well I would see. In other words, I see better at all ranges with -0.5 IOL than I did with a -2 test contact. I attribute that to the fact that the cataract was gone and I didn't see as well with the test contact due to the cataract I had.
Finally, I've read studies that vision is not as "clear/crisp" with multi focal lens and/or symfony as it would be with a mono focal lens and contrast is also not as good. I don't know if this is for some or many but I think if my vision and contrast were not as sharp, I would not be able to see as well at all ranges with a mono focal only. I've never had any night vision issues halos, glare or anything else. So, for me it worked out great. Good luck with what you decide.
I do not have any astigmatism. By the way, my cataract surgery on my right eye was scheduled yesterday for December and I'll go in for measurements in November. My left eye is now 20/25 and the cataract is not bad right now. My left eye is dominant, so I've decided to continue using it for distance and have my right eye set for intermediate vision with a monofocal lens. My ophthalmologist plans to set the IOL in my right eye for -1.25D. I hope things turn out as planned.
Hi michael74313. I am glad all worked out good for you. When you say “set the second eye 1/2 diopter in for slightly better near vision" what do you mean in terms of inches for the nearest good vision. I am impressed that even with both eye set for distance you are still able to hold your cell phone at 12 -14 inches. The doctors are not able to guarantee that in my case. So I am specifying 18" and mini monovision and hoping that I will still see closer than that because of my good eyesight now. I am afraid that if I go with both eyes for distance and my near vision is not good after surgery I will be stuck with glasses for ever. I rather have to wear glasses for driving and occasionally for reading fine print. Is the likelihood of achieving that with my plan possible? You mentioned the problem with depth perception. Is that problem less with mini monovision. If so, I shouldn't be worrying about that, I am guessing. I have my surgery this Friday for the right eye which is being set for near vision. No astigmatism correction as the doctor will use ORA technology during surgery to calculate my power without natural lens. Hopefully, the results will be close to what we expect. I will go for the left eye surgery two weeks later. Thank you for sharing your experience.
I honestly think it varies from person to person. You can google to get an approximation for diopters and inches. I know for me, after my doctor did my right (non-dominant) eye and set it to distance I just couldn't see well up close at all. But, I could see my computer just fine. So, he then set my second (dominant) eye 1/2 diopter in slightly. Now, both eyes working together see better at all ranges. My doctor also did not even say I would see the computer without glasses. I think doctors do this so as to stay as conservative as possible. Compromised depth perception should not be a problem with mini monovision. Most people can tolerate a 1D difference. Mine are set to -1/2D difference. Just keep in mind that there is also an error factor so if you do target for 1D difference you could wind up with even 1.5D difference which would be too much for me. I tested with contacts before surgery on the second eye to see what I could tolerate. With my doctor's advice, I chose -0.5D and my eyes "work together" at all ranges to see better than I would with one eye alone if that makes sense. I'm not sure what your current plan is at this time. I thought about symfony and multilens but in the end, I'm glad (with my doctor's help and advice) that I chose a mono focal lens.
Yes doctors tend to be conservative when taking about expected outcomes. As you say there ate variables outside their control which can make you slightly more near sighted or far sighted than target. Old sales pitch holds true to under promise and over deliver.
better that than some who promise the moon and downplay side affects.
Thank you, michael74313. I agree. Each person has a different need. I have told my doctor what my needs are. I trust his judgment on deciding what the difference is diopter between the two eyes should be. May be once I get my right eye done tomorrow and I know what power has been used I will have the opportunity to decide how much difference we should keep when getting the lens for the left eye which is my dominant eye and would be set for distance. Or maybe I won't have that opportunity after having fixed the right eye at 18" for near vision. Anyway, since I have conveyed to my doctor that I need mini monovision and he has noted that on his chart I have stopped thinking much on this. My surgery is tomorrow. I will continue to post the outcome and plan so more people can benefit from my experience. My doctor says that after the right eye is set for near and if you try to get Symfony lens for the left eye you will risk some confusion in your brain. In other words he is not for mix and match in my case. Not sure why.
Thanks, Sue.An. I agree. Most doctors would do that. Under promise and over deliver. Hope my doctor is doing this too. That will make me very very happy :)
Good luck tomorrow anu1942. Wishing you a successful outcome.
Thank you Sue.An. And thank you all others for your well wishes. Thankfully, the recovery from surgery is quick. No inflammation or discomfort whatsoever. It's been 48 hrs. since I got my right eye done for near vision using 22.0D AcrySoft mono focal lens. The eye is still adjusting. However, I am not having a good feeling about my outcome. May be this is common with all patients on the 2nd or 3rd day. Actually, I am able to read on my cell phone at 16-18 inches. I am not able to see clearly on my 49" TV at about 12 feet away. My left eye is week in both near and distance. So it is not helping.
During recovery I had halos around can lights in the house and that resolved on the 2nd day. But I developed another issue. I started experiencing flickers on the right side of my operative eye at irregular intervals. Especially when I am looking at my cell phone, iPad, or Computer screen with bright white background. It's hard to explain what these visual disturbances are. No flashes of light similar to retina problem. Just feels like something being closed and then opened again half way from side. I got a little concerned at first because I was really shaking my legs during surgery. With anesthesia I was totally asleep (which was not supposed to be the case). I was supposed to respond to doctors instructions. Also, I seem to have restless leg syndrome. I started shaking my legs intermittently and they were trying real hard to talk to me and tell me not to do that. Finally they held my legs and doctor continued to perform surgery. Not sure that caused any type of injury to the eye or displaced the lens. How do I find out? When I saw the doctor’s assistant the next morning of surgery everything looked good to her. She said still much dilated.
Are my symptoms of flickers common? I called the doctor on call and he said to wait if I am not having any other problem with vision. Hopefully, these will resolve.
all these symptoms could very well be normal any. Results from eye being dilated, drops and healing. some recover quicker than others. your brain too is adjusting to processing new vision. flickering can occur from light hotting side if IOL. That could disappear with time. Write your concerns and questions down for your next appointment with surgeon. do you have a other scheduled appointment?
Thank you. I hope so. It's day four. Everything else looks fine. Eye is healing well and reading on cell phone and computer is more crisp. However, the issue with flicker on the right edge of the eye is still bothering me. Now I can reproduce this effect by looking at tip of a pen or my finger pointed at me at about 6-8 inches away from my face. When I look at a small object at this distance I get a half circle closing in on the vision only from the right side. It's like looking through a pipe/ring but it is only on the right side. Sometimes this comes and goes like a flicker even when I am not looking close. Usually when there are bright lights around me. All this started on the second day. So I am wondering if this is going to be permanent problem. Should something be done quickly or should I wait and see how things settle. What is a safe period for intervention if needed.