I have been myopic since 8 years old. Having wonderful near vision is a real gift. Cataracts came along, and I ended up choosing the LAL because the doc was very confident he could get me “functional” near vision, such as using my phone, reading a menu, reading labels…but that I would need reading glasses for novels or tiny print. Of course with a disclaimer that it comes with no guarantee, but his confidence and enthusiasm were convincing. My directive to him was that I wanted to ditch transitions glasses if possible, but that I absolutely did not want to give up functional near vision. I emphasized that it would be a huge adjustment with even functional vision, and I did not want to swap near vision for distance clarity.
If you opt for LALs, be SURE your doc actually listens to you about your wishes, and is willing to take the time to discuss/demonstrate your choices.
It was a tough lesson for me, story not quite done. Eyes were blurry after the surgery as expected. At the followup, I was told I had a “decision” to make at the next appointment, whether to choose close or distant vision. I came to the next appointment with a list of visual goals, and a few questions, expecting he could provide some guidance for the decision. I was told “We don’t have time for that”. RXSight advertises as a patient you will have the chance to “try” visual options to take the anxiety out of the decision. My “trial” was having my eye test adjusted for clear distance vision on the screen. (20/15, the doc was over the top!) I had no opportunity to see what my vision would be like if I chose the “near” adjustment, although I tried to get clarification. I wasn’t given any opportunity to try functional tasks with each option. The doc basically told me to either choose between seeing well up to your arm’s length vs seeing the rest of the world out there (basically his words), with the important assurance that there would be up to 2 additional adjustments if needed.
I opted for the distance…but the adjustment did not provide functional near vision. Everything was blurry until at least 8" beyond arm length. Had to grab for cheaters for all reading except headlines, fumble for cheaters to use phone, read a menu, do food prep, check price labels when shopping, put on makeup, etc. My food was blurry without cheaters. It was pretty traumatic to feel so handicapped. Even with cheaters, I had difficulty doing many near tasks. Sick of grabbing for them with every ring of my cell, I discovered wearing them on my nose so they were handy made me dizzy walking in my house.
At the next adjustment appointment, I requested to have a small portion of that near vision restored, since the doc said he would “tweak” my vision with additional adjustments. I wanted simply to regain clarity for near vision to a functional level. “You can’t go back,” he said. But instead, he said he could offer blended/monovision with just a slight loss of depth perception. I was stunned. Should I stop now, or have them adjusted again? I had questions about this step, because when I came out of the surgery and the first adjustment, I had better distance vision in my non-dominant eye. Plus I wanted to know what my quality of distance vision would be with less depth perception. His “trust me, let me do my work” approach was not as reassuring as the first time. I balked enough that he gave me a contact lens to try in each eye for a couple days, to see what monovision was like, and to decide which eye I wanted adjusted for reading. At this point, I haven’t been able to trial yet, so perhaps my concerns are premature. My doc and I apparently are not a good match, and he is now refusing to answer my questions. His last comment to me was, “All I want to hear from you next time is which eye you want for near vision.” (If you’re wondering, let me assure you that I am not an obnoxious patient. I just like enough information to make an informed decision.)
At this point, I would welcome suggestions for who might be able to answer my questions, since my doctor and I are at an impasse. Now I must choose +1.5 in one eye for monovision, or cut my losses with fantastic distance and no functional near vision. He says monovision can be reversed, but what are the downsides? I would like to know if I go ahead with monovision and don’t like it, can transition glasses or bifocal contacts recover my depth perception? Then I would have options if I didn’t like the monovision adjustment. Otherwise I’m stuck with terrible close vision and back to glasses, which IMO is worse off than when I was nearsighted.
Takeaways and LAL experiences:
- The LAL needs more light for finer indoor vision, compared to my pre-cataract vision.
- Be sure your doc is willing to counsel you while making a decision, and answer reasonable questions with clear explanations. Be aware that he might overpromise.
- Find out what your doctor does to let you “test” your visual options before adjustments.
- Ask your doctor if the upcharge for the lens includes time for questions and collaborative decision making about your future permanent vision, or if it only covers the adjustments.
- Be aware that “adjustable” is not an all encompassing term, since I apparently cannot recover any amount of near vision with an adjustment. Only next option is some degree of monovision to recapture near vision, which has drawbacks too.