I require prism correction, as well as correction for myopia, astigmatism, and presbyopia. I currently wear progressives. History; early in life I was able to clearly focus on objects within 3" of my eye with little to no effort. I offer this as some indicator of the scope of my myopia. I do not have my current prescription, but will report back with it tomorrow, if that would help with any advice. I have worn glasses for 56 of my 66 years. Therefore my goal is not to eliminate them. I have resigned myself to wearing them till I die.
Given the level of my myopia, I also have been able most of my life to get by without wearing glasses for close in to intermediate range work. Which I would define as from 6 inches to 4 feet. And which I greatly prefer now, when working from 18" to 4'.
My surgeon has told me most people choose distance correction in their IOLs as opposed to near. He also has told me that my prism problem will require wearing glasses for correction even after my cataracts are removed and new IOLs are inserted. Because I am bothered more with wearing my progressives for near work now, (feels like I'm in a tunnel) and have little to no complaints about their functionality for distance vision, I'm considering having the close or intermediate IOLs implanted. As I age further I anticipate less distance requirement and more close to intermediate for computer, hobbies, and and reading work.
My question is, if I choose close or intermediate IOLs WITHOUT astigmatism correction, and accept wearing 'reader' single vision glasses for astigmatism and prism (if needed) for close and intermediate, with a SEPARATE pair of single vision glasses to correct for astigmatism, prism, and distance, will I be creating a condition which will be difficult for an optometrist to correct for? OR will choosing Toric IOLs dramatically reduce the complexity of creating glasses? I should add the cost for the Toric IOLs is considerable, but if creating glasses with prism, distance and astigmatism correction is going to be very difficult, it may be worth it.