Thoughts on Monovision after cataract surgery?

[chilkat]

I am scheduled for cataract surgery in the near future.  I am nearsighted and currently wear OD -2.75/-1.25/124/+2.75,   OS -4.25/-1.00/121/+2.75 .   My right cataract is the worst and night vision is horrible. I have already seen the surgeon but am still struggling with lens choice.  Right eye only correctable to 20/40 now.

I am 63, been wearing progressive bifocals for almost 15 years.  I am an avid motorcyclist, active in shooting sports, horse back rider, have an embroidery shop in my home.  So I have multiple needs for both distance and near vision.  

Through my research I have ruled out the premium lens offerings because it sounds like there are more potential complications. Plus I want the best night vision possible and do not want halos.  My biggest dilemma is whether to go for both eyes close (one intermediate and one close), both eyes distance, or monovision (distance and intermediate).  I have worn glasses since 7th grade and although it would be nice to be free of them I know that is not going to happen.

I am right eye dominant.  It is my shooting eye (also right handed) but depending on what type of shooting I am doing I may wear a shooting lens to see the front sight clearly.  I am considering monovision with monofocal IOL lenses but am not sure which correction to do in my right (dominant) eye.  Many articles I have read say to correct for distance in the dominant eye.  But I have considered going for intermediate in my dominant eye because it will actually be closer to my shooting lens correction.  Plus, my left eye has always been more stable as far as my astigmatism correction.  Historically my right eye axis has shifted frequently requiring a new RX for the right eye almost yearly.  My thinking is the left eye is more suited for distance than the right.

I would appreciate your thoughts and opinions about the pros and cons of monovision, how to choose which eye for distance and intermediate.

Thank you.

[JohnHaganMD]

Best of luck.  JCH MD

[chilkat]

Agreed.  Thanks for your thoughts. When I shoot open sight rifles I use some glasses made by Bob Jones. There are numerous other systems as well. I guess my biggest concern is being able to see enough of the front sight if I ever need to defend myself.  Even now with my progressive  bifocals the sight is blurred.  Just was thinking I might be able to still see it better if my dominant eye was the intermediate one. You've been very helpful. Thanks again.

[JohnHaganMD]

I would suggest you Google articles by shooters who have tried that.  If your type of competition allows glasses, aperture attachments like the Merit system https://www.meritcorporation.com/  or best of all optical sights that is generally the best choice by far.  Even for middle age shooters without cataracts maintaining a good sight picture becomes more difficult after 40 and eventually impossible without some help in the form of glasses, peep sights, optical sights.  It will be difficult to pick and IOL that would leave your eye in focus, without glasses at exactly the distance you hold your handgun.
JCH MD

[chilkat]

Dr. Hagan,   thank you for pointing to the posting.  I have read it it and think I understand all the pros and cons.  Searching the postings produced a post I believe you made in which you mentioned being a shooter like I am.  Any thoughts on making my dominant eye the near vision and non dominant eye for distance?  I want to able to shoot in handgun competitions, preferably without worrying about corrective lens so I can see the front sight.   Thanks again.

[JohnHaganMD]

ChilKat  read this carefully:  http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You  ; JCH MD

[Garrry]

Best of luck then

[Garrry]

I have Symfony lenses in both of my eye Which gives me excellent near and far vision I doo a lot of night driving so it was imperative that I had good night vision No Halos
I had both my eyes done on the same day so there was very little adjustment period

[chilkat]

Thanks for your report. As I understand it right now these are not approved yet in the USA.