How can you tell if monovision is working...while you have a cataract?

[Arlene55]

I am 55 years old, and have a cataract surgery scheduled for early May.  I am trying to decide what type of lense to get.  I would love to stop wearing glasses after so many years, so I am looking for an option that involves the least use of glasses.  So far I am considering multifocal lenses or monovision.  I am currently testing monovision with a contact lense for distance on my dominant right eye.  The only problem is that eye has the cataract!  The doctor seems to think that even with poor vision, we should be able to tell whether my brain will accept the monovision.  What signs do I look for?  How can I tell?  I'm guessing that with the contact in I am seeing 20/50 in my right eye, and probaby not much better in my left eye, as it is uncorrected so that I can use it for reading (I am near-sighted, with great up close vision).  I don't seem to be having any problem so far, although everything seems a little flat (depth perception?), but then again, that might be because of the poor vision in general.  Any thoughts?  I probably have to make a decision on lense type this week.  Scary!!

[dori76]

I'm also in my 50s and have standard non-toric monofocals in both eyes for distance (not monovision). I only need to wear reading glasses for extremely small print or if I want to read an entire book or magazine. I don't need glasses for my laptop, TV, cooking, applying makeup, driving (including seeing dashboard instruments), etc.

[John C Hagan III, MD, FACS, FAAO]

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[MrPresley]

I'm the opposite, I have a monofocal IOL in one eye and my natural lens still in the other and use contacts/glasses for distance correction. Most patients don't do it that way but I may very well never need surgery on my non-operative eye so we went with an IOL that left me myopic but within parity between both eyes. I of course informed my cataract surgeon on my initial visit that I was perfectly willing to continue needing correction for distance, as I've worn contacts for decades and am used to doing so.

[John C Hagan III, MD, FACS, FAAO]

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[MrPresley]

I tried monovision with contacts and did not like it, so when I needed cataract surgery a year ago I went with a monofocal IOL set at approximate parity (though slightly better) with my non-operative eye.

[John C Hagan III, MD, FACS, FAAO]

The world will be even flatter after surgery if you choose monovision especially full monovision not mini-monovision. 3-D depth perception requires clear vision in both eyes at the same time. With monovision one is always out of focus so you lose true depth perception.

[Arlene55]

I think my opthomologist had mini-monovision in mind.  Would the depth perception be as bad and would I still need glasses for reading?  I know from earlier posts that you are not a fan of multi -focal lenses, so are you only comfortable with mono-focals?  I am hoping to be mostly glasses free...

[John C Hagan III, MD, FACS, FAAO]

My wife had cataract surgery within the last 6 months. She chose monofocal IOLs and has done fabulous.  She has some astigmatism and does not mind wearing glasses. She wanted best optics, least chance of complication and was happy to wear glasses.    Another close friend didn't mind reading glasses but wanted to be able to drive without glasses. He had 1.5 diopter astigmatism so we used toric monofocals and he is very happy. 20/20 at distance (20 ft and >) and just wears reading glasses. I had another long time friend. Hates glasses. Did not mind extra expense of multifocal and that night vision would be "glare'y" and that he might need glasses for some things.  He is happy also.  So its not that I have anything against multifocal IOLs.  I have a consulting practice so I see lots of people that paid $5000+ per eye believing they would not need glasses for anything and still need progressive bifocals for a lot of things and are very uncomfortable or unable to drive at night and rue the day they reached into their savings  and respond to the 'upselling' used in some cataract/IOL offices.