I’ve just returned from a Thanksgiving dinner with friends. When I mentioned monovision they just stared at me. I said, it sounds terrible doesn’t it. There was silence.
I’ve been home a lot since my surgery 2 months ago and realized when moving around my friend’s house that I was reaching out to steady myself with one hand on the counter. I’m also thinking now I don’t understand how near/intermediate mini monovision works!
I ask myself why I chose near in the first place. It was when completing the form which asks would you like to wear glasses for near or distance. I answered distance. What I didn’t understand until it was too late that by choosing near I’ll have to wear glasses to see across the room not just for outside activities.
This text is relevant but was not directed to me. I’ve bolded the text that applies to me.
(1) You may want to target both eyes for near instead of trying for mini-monovision as you would get best near and intermediate if your eyes could work together to improve visual acuity in those ranges (you lose most of that benefit at mini-monovision ranges for the benefit of better total DoF), or you might be able to target near at -2.5D or nearly whatever your actual reading offset is (hard to precisely test if you still have any accommodation in your natural lens as you lose that with the LAL and most other IOLs) for near and up to 1.5D towards distance relative to that for your distant eye (not necessarily plano). I think a good ophthalmologist or optometrist can give you a numbing eye drop which immobilized accommodation to do a more accurate preoperative test assuming your cataracts aren’t so bad as to substantially interfere with the refraction. (2) **I have no idea if this type of mini-monovision can work OK as that is not normal for mini-monovision (always plano target for distance eye as far as I know). It is possible that the brain can only pick the best distance image if it is close to plano, so that option would require more research. **
I’d very much appreciate any thoughts about passage 1 or 2 above.
Many thanks.
I'm sorry but I really cannot make any sense of the 1 & 2 above. I hope it was not me that said it! Your struggles remind me of the Aesop's Fables, The Man, The Boy, and the Donkey. Sometimes, too much advice is not a good thing!
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That said, when you find out on Monday when you get your refraction done for the first eye to see where it really landed, I will give you my advice! No point of getting the cart ahead of the donkey!
I've just returned from a Thanksgiving dinner with friends. When I mentioned monovision they just stared at me. I said, it sounds terrible doesn't it. There was silence.
"Blended vision" is the term that does not sound terrible, but means the same thing.
@Bookwoman likes her near/intermediate vision, and she says she uses glasses to watch television and see across a room. I don't recall her saying she needed to steady herself. You certainly did your due diligence in considering all the options. Sometimes, though, a person can overthink their options. I have that tendency myself. But I think eventually you will be satisfied with your vision.
Thanks Lynda. The unsteady feeling is unusual but caused I'm sure from one eye being at -2.0 D and the other cataract not yet replaced. What has me thrown for a loop is realizing that what I had thought of as reverse mini-monovision may very likely not work well for my particular situation in which I was holding out for a second lens substantially more myopic than plano (-1.0 D) to pair with my current -2.0 D IOL. I'm so grateful to someone in the group cautioning me that:
I have no idea if this type of mini-monovision can work OK as that is not normal for mini-monovision (always plano target for distance eye as far as I know). It is possible that the brain can only pick the best distance image if it is close to plano, so that option would require more research.
Now I understand why my surgeon gave me a choice of either plano or another -2.0 D IOL. This now makes perfect sense. With my current understanding, I'm leaning toward the option of another -2.0 D IOL rather than plano. As expressed by the same group member although not directed to me:
You may want to target both eyes for near instead of trying for mini-monovision as you would get best near and intermediate if your eyes could work together to improve visual acuity in those ranges.
So glad I have an appointment with my optometrist on Monday for clarification.
Yes, @bookwoman does very well with -2.5 in one eye and -2.0 in the other eye. I believe she does not wear glasses when she is in the house and she doesn't have any problems seeing her feet when she goes up and down steps. But she uses progressive lenses when she drives and I am guessing when she watches TV. I am hoping that she will post something to judith93585.
My situation is very similar. I am wondering how mini monovision would be tolerated with -2.5 in one eye & -1.5 in the other eye (1.0D difference). Hopefully there is a contributor that is using this type of Blended vision. The light adjustable lens appears to be a solution because you can change your prescription up to three times. However, it seems you would have to have a lot of confidence in the refractionist as well as the ophthalmologist who is doing the adjusting.
I don't think one would have any trouble adjusting to -2.5 and -1.5 D. That is only a 1.0 D difference. What I would question is the value of doing it. It would give good binocular vision in the -2.0 D distance of 20" or so. But, one does not need 3D for reading. Perhaps useful if doing some fine needlework or knitting, or some crafts that require very good 3D vision. My wife knits with only one eye (no vision in the other) set for distance (about -0.25 D) and refuses to even wear readers, or her progressives to do it! She watches TV while knitting, so that is probably why she is not using readers. But, not an excuse to not use progressives, which she has.... I guess she is just anti-glasses. She uses her tablet without glasses too, and just increases the font size. I can read it from across the room!
I don't need to reply, as you've stated my situation exactly. :-)
You may want to add a small bit of distance vision for the second eye. Personally, I believe people should target distance with some intermediate for both eyes and use over the counter glasses for reading.
As I recall you did not go into this difference between the eyes as a plan. You had a bit of a miss on the first eye and adjusted the second eye some to compensate? That makes a lot of sense.
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The OP is in a different situation and I believe was attempting mini-monovision with a plan of -1.50 D in the near eye, and there was potentially a miss landing at -2.0 D. Her need as I interpret it is to gain some distance vision not near vision.
Nope - my first eye came out at -2.0, as planned. It was the second eye that shifted to -2.5. A happy accident in my case, but yes, Judith might want to go the other way.
My situation is different, but maybe my experience would still be useful for you.
I currently have "triple-monovision" - that is, ~plano in one eye and extremely nearsighted (-6 to -8 D) in the other. For the moment, both of my lenses are natural, but at age 64 my presbyopia must be pretty far advanced. I have very little stereo vision - everything I see is largely seen with one eye.
Yet all of the issues you describe are alien to me. I have no trouble seeing steps or feet, no unsteadiness, nothing like that. Perhaps that's because I've had more time to get used to the monovision, or perhaps I will experience similar issues when I get older or after my natural lenses are gone.
The moral of the story, if there is one: maybe with more time you can become comfortable with full monovision. Is there some visual therapy that could help? If there isn't, maybe there should be...
Good luck with your decision.
However, it seems you would have to have a lot of confidence in the refractionist as well as the ophthalmologist who is doing the adjusting.
Yes, our situations are very similar and I too hesitate with regard to LALs for the same reasons you mention. I also have some concern about this being a new technology and wonder about any possible problems yet to be discovered. Without a strong recommendation to a particular LAL practice, I'm not inclined to go in that direction. If I find out anything interesting or helpful, I'll be sure to let you know!
LAL is not that new a technology. I looked it up, because I am considering the same lens. It has been used commercially since May 2008 in Europe, and late 2017 in the US. So, over 15 years' real experience, and so far no big problems reported with the tech.
I certainly agree that I would want an experienced doctor and technician.
With reading books the priority, that miss was probably a good thing.
Be sure to think in advance the questions you want to ask for "clarification." Most medical providers seem to be in a rush, so make sure your optometrist clearly answers all your questions to your satisfaction.
Be sure to think in advance the questions you want to ask for "clarification."
Having the questions printed out is better.
Thanks Lynda. Yes, I'm compiling a list.
I've forgotten, do you have a slight offset between your eyes? Maybe one eye is set for -2 and the other -2.5? If yes, are you aware at all of the difference? I'd be interested to know what the naturally occuring offset is among the general population, not including those who have had cataract surgery or lasik. I understand that's not the kind of statistic most people have immediately at hand!
Once again, something I did not think about! 3D vision. It never occurred to me that there would be no value in mini monovision for near and intermediate vision. Is there a way for the optometrist to test you to find out if you can tolerate mini monovision? Even with advanced cataracts?
I sent you a private message about where I live and the doctor I have seen who does the light adjustable lens.