Regarding Mini Monovision

[Craig10x]

Hi!  I am 63 yrs old...about 2 years ago, i had cataract surgery on both eyes...my doctor used the Acysof Toric Iol lenses because i had a lot of astigmatism...He suggested monovision, and my right eye (dominant) was corrected to plano (20/20) which is the way it worked out...for the left eye, he left me with -2.25 diopters....and hit that target too.

      I found full monovision to be too much of a compromise...distance and mid range was not as clear as i would have liked so he did a lasik touch up about a year ago for the left eye, which gave me Mini Monovision, and i ended up -1.00 diopters in the left eye....
       i find mini monovision to be a  LOT better...although for reading i have to hold things further away (about 12 to 14 inches depending on size of print) so it's fine for light reading (i have weak readers for extensive reading)...
      Computer distance vision is VERY GOOD....and distance is VERY GOOD....On the eye chart, i am 20/20 right eye and about 20/30 left eye....
      I am pretty glasses free (which i love) but there are certain situations where things could still be a bit crisper (TV and Movie Theatre for example) which i have with my 20/20 eye but not with my "blended mini monovision" (both eyes together)....
      Sometimes i wonder if i would have been better off going 20/20 in both eyes though....
1) Am i being to fussy about this? (lol)
2) Also, i was wondering, with mini monovision...is it more straining and fatiguing then both eyes having 20/20?
Sometimes i feel like i tire more easily, and my left eye feels a bit strained or fatigued...
3) Any tips or tricks to get the brain better trained to maximize the sharpest blended image?
    (there are certain situations where the blended vision could be a bit sharper so that does get a bit frustrating sometimes)...I know i can pop on glasses that correct my -1.0 diopters in the left eye (in fact i have a pair that does that) but like to be as glasses free as possible)...

[Timothy D McGarity, M.D.]

Your not being too fussy, you're being just like all of my patients. You want the best possible solution without any compromise. Unfortunately, there is no perfect solution. To start, toric IOLs are great. I recommend them without hesitation all the time for people with significant astigmatism and visually significant cataract. Furthermore, I employ mini-mono or blended vision with non-toric and toric IOLs.

For blended vision (just like you have, though you are calling it mini-mono), I find that most people have your complaints, though they typically don't verbalize it in such an eloquent fashion. Small print and night driving are the situations which may require some type of glasses. Rarely, t.v. too. If you correct your vision to 20/20...I believe what you mean is if you have your near eye corrected to 20/20 without glasses at distance objects...if you do this (which you can with additional lasik), then you will loose the uncorrected near vision instantaneously. Your eyes will constantly strain to see close and you will require readers much more frequently. Blended vision can be a strain at times, but this isn't injuring your eyes. I hope this helps,
Timothy D. McGarity, Medical Doctor

[Timothy D McGarity, M.D.]

Each person is different, so it's difficult to generalize. Either one is fine, but each has a compromise. Most patients who do blended vision stick with it.
Best wishes,
Timothy D. McGarity, Medical Doctor, Ophthalmologist

[Craig10x]

When you get a chance...if you could just follow up on this: (thanks)

would you say that in general, it is better to stay with the blended vision (using the glasses just occasionally to optimize driving/movies/tv....Or better with full 20/20 and be more dependent on readers...

Also, i was just curious...do most of your patients who do blended vision stick with it, or end up eventually going the full 20/20 route?

[TurtleJoe]

You may be more handsome now without glasses but a pair of glasses has one extra function, they protect the investment you made in your eyes from damage the same way they always did.

[Craig10x]

Yes it does...right...blended vision (i got in the habit of calling it min-mono but like you said...it is the same thing)...I'm glad to know it won't injure the eyes...
Yeah, sometimes i think i might be better off having the left fully corrected to 20.20 (through lasik touch up again as i had to bring it to blended vision) but then i do realize that everything close would be out of focus and readers would be needed for a lot more close tasks...right now, as long as i am willing to accept the slightly less the ideal distance and mid range, i am essentially glasses free which i do like...Guess it is not possible to have perfection with this...either way is a bit of a compromise..

I do have a pair of glasses that corrects my left eye to 20/20 and can use them in situations where i want to optimize that...

Just to follow up...would you say that in general, it is better to stay with the blended vision (using the glasses just occasionally to optimize driving/movies/tv....Or better with full 20/20 and be more dependent on readers...

Also, i was just curious...do most of your patients who do blended vision stick with it, or end up eventually going the full 20/20 route?

Thanks again by the way...i really do appreciate your very thoughtful answer for me...