Minimum focusing distance for monofocal IOL?

[Alan807]

I need to have cataracts in both eyes removed.  I'm nearsighted and have presbyopia requiring reading glasses. My health insurance (Aetna EPO Open Access) appears covers having the cataracts removed and the installation of a monofocal lens.  At the ophthalmologists office the doctor's discussion on my lens options was a bit one sided favoring multifocus premium lenses such as Crystalens HD, Restor Aspheric, and ReZoom which the insurance doesn't cover.  My question is if I went with the installation of  monofocal lenses to give me good distant vision, what's a realistic ballpark expectation of the minimum distance I will be able to see clearly with this type of lens?  I'm trying to figure out if I'd be able to clearly see things like the dashboard gauges while driving a car.

[Adriennemk]

This was quite a lot Ngd time ago, but I’m wondering what you ended up doing?

[MrPresley]

@Adriennemk I have a monofocal IOL in my left eye and my natural lens still in my right eye (with myopia in both) and can see small print clearly.  That’s with approximate parity (within 1.5 diopter) between both eyes I corrected.

[MrPresley]

^^^^^
Typo...make that “between both eyes uncorrected.”

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

=

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

If you chose moderate monovision -0.25 one eye and -1.25 in the other without glasses and in good light (assuming an otherwise healthy eye and a successful operation) the range of clear vision should be infinity (after 20 ft the light rays enter the eye parallel so how far one sees depends on the intrinsic strength of the eye and in the other eye clear up to about 22-24 inches.

JCH MD

[Occupant]

But to get back to your original question: if the monofocal lens puts your vision at 20/20 (like in my case) the minimum distance that you can clearly see is about 5ft  Everything else is blurry, but that doesn't mean, you can't  e.g. read the digit on the speedometer - the're just somewhat blurry.

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

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[Alan807]

At this point I'm looking for another doctor for a second opinion and possibly having them do the cataract surgery.  I've run into nothing but difficulty just trying to get information from the doctors office on which monofocal lenses does the doctor typically favor installing.  I know a doctor's office can get busy, but this feels like a situation where the office is mainly interested in the patients they can upsale to multifocal lenses which insurance doesn't cover.

[FredZq]

The monofocal is focused at one distance. Nearer or farther will be progressively out-of-focus. I had my left eye done a couple of months ago with a Tecnis aspheric acrylic monofocal. It is focused at 11" from the tip of my nose. That's OK for reading but not for distance. Car instruments would probably be marginal. I wear glasses all the time anyway, so doesn't bother me. When I have the other eye done, we'll shoot for intermediate distance focus. Good distance w/o glasses isn't important to me since I was nerasighted when I was young and it has progressed through plano to farsighted and I'm used to wearing glasses, and anyway I have astigmatism too.

You will likely have to wear specs for some activities. You just have to decide whether it will be driving, reading, computer or what.

After reading posts here about the problesm people have with restore/rezoom/crystalens, etc. I completely rejected those as possibilities. Also Doc H here recommends the monofocal type and thats good enought for me. My Doc didn't push the multifocals. he said the tecnis would be the best bet.

After what you have related about the one-sided discussion about lenses, I would not go back there. Period. I'd find another. Not to knock Docs in any way, but there are huge differences in competence and perhaps even ethics. Humans, you know..After some experiences, if I'm not comfortable in any way, I seek another opinion.

[2ndsight]

there have been several discussions on this board from people who have gotten two distance IOLS and needed glasses for all kinds of close-up activities including the car dashboard, reading labels on store shelves, using the mirror (shaving) and so forth. The blended vision Jodie describes is a kind of modified monovision, and you might wind up needing glasses to pass a driver's license test or otherwise see well at distance.

[JodieJ]

Monofocal IOLs can be set for "blended vision," leaving one eye a little nearsighted.  With this type of correction, you would not need glasses for distance or intermediate vision tasks (e.g., computer).  You'd probably only need readers for seeing small print.  Seeing the dashboard gauges wouldn't be a problem at all.

Of the three "premium" lenses, my first choice would definitely be the Crystalens HD.  I'd avoid the ReStor and ReZoom because of the problems with halos, glare, ghosting, waxy vision, and very long (up to a year) adaptation time.