Recently Had Modified Monovision

[Craig10x]

Hi...

I'm new to the community...I had cataracts in both eyes (i am 61 yrs old) and just recently had Cataract Surgery..
The doctor used Alcon Acry-Sof Aspheric Toric monovision lenses and had told me about doing Modified Monovision (Dominant eye set for 20-20 vision and non dominant eye i believe was set at around 20-125 to cover mid range and close vision)...He explained that most of his patients get that and are very satisfied because it minimizes the need for reading glasses..

I just had the two eyes done within the last 2 weeks (dominant eye then non-dominant just several days later)...
I like that i can see mid range to close without reading glasses (which i realize wouldn't be so if i had gotten both eyes set to distance)...
  
What i have been noticing is that things seem a bit blurry...not only at distance but mid and close as well...
Even when watching TV, which is a 32" lcd tv that i am only about 6 to feet away from) it is pretty clear but has a slight blur to it (when looking through both eyes as compared to just the distance eye)...
  
My doctor at the follow ups says i am doing fine...no apparent problems...
  
My questions: will things likely get more crisp and sharp as time goes by?   If so, usually about how long?
Also, it seems like the brain blends both eyes together...the brain doesn't actually switch from one eye to the other,
So, if that is the case, how will it get sharper?
    
Thanks in advance for all feedback!  

[Craig10x]

Also, this article i read right here on Med Help:
It seems what i got is known as Mini-Monovison....and based on what i read here, if the doctor gets optimum distance in the dominant eye that is corrected as such, then distance vision should still be quite sharp in the blended vision of the two eyes...And my doctor did get me optimum in my distance eye...Along with a useful (but not perfect) amount of mid and close as well (which is what i am getting)...
So, this is why i thought that especially the distance should get sharper as time goes by (see excerpt below)...

Mini-Monovision is a very desirable result for many patients and usually provides excellent distance vision and some useful near vision for computer work, and light reading like price tags and menus.  It is my favorite technique.  For example, after determining the dominant, I would aim for 20/20 distance vision (as close as possible) in that eye and then aim for something like 20/50 in the non-dominant eye with about -1.25 of myopia or nearsightedness in that eye - just enough to support a small to medium amount of intermediate and near vision.  It is such a small difference between the eyes that a great many patients can adjust to it quite well. These patients already can see almost perfectly for distance with one eye so that the non-dominant eye is freed up somewhat to be a little less sharp for distance and a little better up close.  There is one caveat with this technique and that is that it is crucial to get the first or distance eye as clear as possible for distance.  It it is a little off for distance, then I am occasionally forced to make the second eye for distance as well since these patients usually have distance vision as the main priority.

[Craig10x]

Thank you all for your feedback....though my concern is whether my blended vision will improve more in terms of sharpness as i continue to recover from the surgery and my eyes heal...which i understand can take a month or even several months to reach the optimal vision...

This is what i have read in many articles...yet i seem to get the impression from the feedback here, that this is not usually the case and that basically what i saw within my first few days is as good as it gets..So now i am confused on what i might expect in the long run...

Take for example this small excerpt from a medical article i read:

After cataract surgery, it is common that there will be blurred vision, which may last for a number of days or some weeks, while the eye heals.  

[JodieJ]

I agree with the response above.  Your non-dominant eye is set for intermediate rather than near vision.  Most people need -2.0 or stronger for prolonged reading.  Your need for reading glasses depends a lot on your lifestyle.  If you don't enjoy reading or have hobbies that require good near vision, then you probably could do without glasses 95% of the time.  I'd suggest that you get some prescription progressive glasses.  In addition to reading, you could wear them when you wanted to give your distance vision a little boost (night driving, etc.)

[es98]

-1.25 is almost, but not quite, good enough for reading comfortably.  -1.5 to -2.0 would have been better.  I think you will have to accept what you have there.

[Craig10x]

Yes...JodiJ i think he meant -1.25D (sorry, didn't explain that part of it properly) in the left (non-dominant eye)....Things are fuzzy when i look only through that eye...and that is the eye that is enabling me to see mid to close which i wouldn't be able to see clearly without glasses had he corrected both eyes to distance...

I guess i thought that things would be a bit sharper (distance/mid/close) because i thought that the brain would automatically pull in the sharpest vision in whatever range you were viewing at the time (through combining the best of the two eyes together)...

After just two weeks, that doesn't appear to be quite the case....
I was told by the surgery coordinator at his place that my vision would improve even more as my eyes settled in and stabilized....that's why i thought it would get better as the eyes healed...are you saying i shouldn't expect any further improvements in the coming weeks?
And this is as good as it gets?

As far as seeing...i can see quite clearly in distance....also mid range like when doing the computer and as far as reading...at this point, as long as i keep the reading material about 12 inches away i can read whatever it is...

It's the slight lack of extra crispness/sharpness that i am concerned about...
They did tell me originally that i might need readers to read extremely fine print but otherwise should be able to do without glasses about 95% of the time...

[JodieJ]

After re-reading all the info you've posted, I'm a little confused.  You say that your vision in each eye is 20/25, and 20/20 using both eyes.  Yet the TV that is about 6-7 feet away (distance vision) is crisper with your right eye than with both eyes.

I think that your surgeon was targeting -1.25 D (not 20/125) in your non-dominant eye (i.e., good intermediate vision).  But if you ended up with 20/25 acuity in that eye, that's pretty far from -1.25 diopters.  I assume that your intermediate and near vision are not too good.

Mini-monovision involves distance vision in your dominant eye and intermediate vision in your non-dominant eye.  You will not have good uncorrected near vision with mini-monovision.  You'll probably be able to read most restaurant menus, but you'll need glasses for prolonged reading.  This is as good as mini-monovision gets, even with a LASIK touch-up.  By contrast, full monovision involves distance vision in the dominant eye and near vision in the non-dominant eye.  You might be able to lose the reading glasses with full monovision, but many people cannot adjust to this type of correction.