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Can non-dominant eye be reversed from distance to near?

Last week I had cataract surgery on my left (non-dominant) eye. Right eye (dominant) is to be done soon.  I have always been near-sighted (astigmatism in both, but for most of my life I could see so-so without glasses), have worn progressive trifocals since middle age. I am an artist, heavy reader, heavy computer user. I made all that clear to the doc before surgery. Oops, now left eye is set for distance with Toric IOL. (Result of my not having enough knowledge to ask the right question at the right time.) I cannot read even a sentence in a newspaper (at any distance!) or the label on medicine bottle to know which eye drops I'm taking without the aid of my right (dominant) eye (without glasses). Left eye is a blur. When they said I might still need glasses following surgery, I had no idea it would be this bad in my left eye at reading. Cannot imagine being like this in both eyes.

Now I understand that the dominant eye (my right is VERY dominant), must be set for distance, if mini-monovision is desired. So by doing my non-dominant eye first and setting it for distance, my doc has foreclosed my options, right? Mini-monovision won't work? Or may be less optimal than it would have been if the dominant eye had been used for distance? If the answer is yes to both of those questions, then can the non-dominant eye be changed to near vision in some relatively easy way?

I would sure like to avoid having to pay for Toric lenses and still having to buy progressive glasses. Worst case scenario is needing a surgery to change the lens in the non-dominant eye so it can be set for near vision. I really don't have the money to have make mistakes like this & have to pay to fix them. (Assuming they can be fixed.)

BTW, the doc had told me after the surgery to take the left lens out of my old trifocals to see how my surgically altered eye works with my corrected right eye. Did not work! Felt nauseated at distance and intermediate, had double vision at reading distance. Put the left lens back in & discovered that I my distance vision was better using my old glasses over my new Toric IOL. I tested with an eye chart. I guess the correction in the right dominant eye with the glasses helps improve my distance vision. However, the good news is that I can drive and watch TV without any glasses, because the left eye is 20/30 for distance. Great. But  now I need glasses to find my glasses!

At this point I am ready to cancel the next surgery. However, I still do have issues with glare & color contrast, etc from the cataract in my right eye. But setting both eyes for distance and becoming blind in my near vision overnight seems unthinkable. Feeling stuck.

I will be seeing my doctor this week for a post-op visit.

Thanks for any insights!
17 Responses
711220 tn?1251894727
They were already functioning with the dominant eye set for near.

I have had other patient who developed a cataract first in the dominant eye and became non-dominant due to the cataract.  In these case I set the original dominant eye for distance.

Dr. O.
711220 tn?1251894727
Ask the doctor to exchange the IOL. I do not believe you change dominance easily, especially when very dominant in one eye.

I have seen patient that the dominant eye was set for near and I have not change them when they had cataract surgery.  

Dr. O.
Avatar universal
Thank you for your kind reply.

I'm a bit confused though about your second paragraph: "I have seen patient that the dominant eye was set for near and I have not change them when they had cataract surgery." If the lens can be changed from near to distant, and it's important for the dominant eye to be set for distant, is there a reason you would not change the lens on the dominant eye to distance?

Or perhaps I'm completely misunderstanding.
Avatar universal
Thank you again, Dr. O.

So getting my doc to exchange my Toric IOL set to distance in my non-dominant Left eye to one set for near is the ONLY fairly certain way for me to move forward to getting mini-monovision so I can see SOMETHING at reading distance?  Leaving the Left eye set for distance & getting my very dominant right eye set for near, MIGHT work, but it's a long-shot. Right?

What if did not get my astigmatism corrected in my right eye, but simply had the basic cataract surgery but no Toric lens in my right eye? My astigmatism in my right eye is helping me read without readers with only the left eye cataract fixed.


Avatar universal
I can answer your last question....if you don't get torics to correct your astigmatism, you are going to need glasses for everything...distance, midrange and close...
Avatar universal

Would it be possible to have a trial with a contact lens in your dominant eye to determine how you might adjust to closer vision with that dominant eye.

It might even be possible to  try several different distances to see which you prefer.

I am likely to have cataract surgery in the future and my optometrist said that I should have a trial with contact lenses first if I want monovision.

In addition, I have done a lot of online research, and have noticed that several eye surgeons have said that that they feel it is ok to make the dominant eye with closer vision for monovison.

With myopic shift from cataracts, I no longer need reading glasses for near and intermediate (computer) use. Would hate to have to go back to two sets of reading glasses all the time. Being able to drive without glasses is not important.

Avatar universal

Thanks. Yes, my optometrist suggested the trial contact. My opthamologist did not think it was really necessary because, as both noted, I appear to functioning with monovision already, since the cataract surgery on my left (non-dominant) eye removed my astigmatism. I had my one week exam. The left eye now has zero astigmatism and 20/25 distance. He didn't tell me my near vision, but it is beyond the range of fingertips without the help of right eye.

Avatar universal
How did you resolved your problem with non-dmonant eye set for distance?  What is the out come?   I have the same problem as you.  I also requested for mini monovision and my dr gave me near vision for my dominant eye.  I am very angry and confused.
Avatar universal
How did you resolved your problem with non-dmonant eye set for distance?  What is the out come?   I have the same problem as you.  I also requested for mini monovision and my dr gave me near vision for my dominant eye.  I am very angry and confused. (I resend my message because I made an error on your name and don't know if you would get the message. )
Have you resolved the problem - I have had the same issue. My non dominant eye was done first - I didn't ask the 'right' questions and the doctor didn't explain!! I now have my non distant eye set for distance...with it I can't even see the time on my watch...
Please read this:   http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You    ; Also there is an active post (this is from 2014) about this topic.  Don't rush to have the second eye done till the issue is resolved.  If you can post your post operative glasses refraction and the vision in each eye with that pair of glasses.  JCH MD
Avatar universal
I seem to suffer from the same exact problem as described by HapKP. I have been strongly myopic (approx minus 7 D in both eye) for last 30 years. Age 55 years. Left eye operated for cataract and set for distance vision with monofocal IOL. I am  software professional and now can not see computer and near distance without glasses. Want to be consider all options before right eye surgery. I have two questions:
1) I have been near sighted (myopic) for last 30 years. Is it a bad idea to have near vision correction in both eye during cataract surgery. I understand left eye already operated and set for far-distance vision and my options are limited, but why surgeons prefer to insert IOLs for distance vision by default, it there any merit in this that surgeons see in correcting for far-distance? Conversely, is there any demerit is correcting both eye for intermediate  or near distance. Your views, please.
2) Please suggest how to determine dominant eye.
Avatar universal
Re question 2;
Avatar universal
Thanks very much. It helps.
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