Second Cataract Options

[Mtaitlyado]

Hi, I’ve dipped into the forum many times over the past several months… first time poster now I’ve had the procedure.

A month ago my prescription was R eye -4.5 and L eye -4.0.
Have worn glasses and contacts since I was about 17.

Now aged 56 and first cataract done one month ago – and R eye is now Plano.
(Still slightly mourning the loss of my near vision but swings and roundabouts).

I’ve tried -2.75 contact in the L eye – great overall vision and can use the computer and read, although use a pair of 1.5 readers for sharp computer and for most reading…
-2.50 contact - not much notable difference for distance with the -2.75 but computer an improvement
-2.25 I’ve found computer is sharp unaided and readers only needed for small print, but some noticeable loss of vision of course.

So I’m tending to think -2.50 might be my best option – and presumed (possibly wrongly!) that if the consultant could achieve 1.5 in the L eye, this would be very similar to what I’m seeing now with the -2.5 contact.

However, he seems to think that aiming for 2.0 in the left eye will be a good option and has suggested I get some -2 contacts to trial… as he says my near vision will deteriorate over the next several years so best to have more reading vision longer term at the expense of distance.

I’m struggling to understand this and concerned that a post-op prescription of R 0 and L -2 will be difficult to cope with… and would mean wearing glasses is more difficult.

Any advice gratefully received! Thank you.

[JohnHaganMD]

These computations don't really work as far as simulating vision post cataract surgery. 1. You are looking through a cataract in your LE after surgery it will be gone  2. Even at your age the eye is doing some focusing, after surgery the eye cannot focus the normal way. Also after the cataract is removed the eye stops losing focus power (except for multifocal/accommodating IOLs)  so with monofocal IOL  or toric IOL focus ability not decline with age.   Read this link again  http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

Even taking the contact lens in non-op eye you are choosing full monofocal  RE 0.00 and LE -2.00 That will make glasses difficult to adjust to, mid range distances like TV at 10 feet will be hard to see.  Eye can usually adjust to 1 to 1.5 diopters between the two eyes. e.g. mini-monofocal distance bias 0.00 RE    -1.50 or -1.25  LE

[Mtaitlyado]

Thank you Dr Hagen, your link has been very helpful.
Now I am thinking of asking my consultant to aim for -1.25 in the left eye and hope that will give me good distance and intermediate vision and I will be able to wear glasses for reading, and another pair for driving at night.

[JohnHaganMD]

that is a combo that works really well for most people.