each monofocal IOL set for different range

[WilmaM]

Can anyone share their experiences with me about how they were able to adjust (if at all) to one IOL set at -1.25 for computer reading, and the other IOL at zero for distance.  So far I've only had the IOL in the left eye, which is at -1.25, & I'm very dizzy b/c of the difference between eyes, & waiting for a new pair of glasses that will hopefully help.  
In the future, should I have the right eye set at -1.25 as well, to avoid any other off-balance sensation associated with monovision?
Or should I have just gone with the Multifocal lenses?
My Doc would always talk me out of the multifocals, saying "they're not perfected yet".  But being that I'm relatively young, 39, I was looking for a solution to see at different distances with minimal dependance on glasses.  Any experiences with multifocals, good or bad, are appreciated as well.  Thanks.  

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

I think the possibilities have been outlined. If you're comfortable going without glasses then do that. Hold off on the second eye and as JodieJ say use contacts to experiment with what makes you happiest.

JCH MD

[JodieJ]

Modified monovision aka "blended vision" involves correcting one eye for distance vision (close to plano) and the other for intermediate vision (around -1.25).  My friend was immediately comfortable with modified monovision (although he's not sure about his prescription).

I don't know why you're not comfortable with glasses correcting to plano and -1.25.  That is not enough of a difference between the eyes to make most people uncomfortable, but everybody's tolerance is different.  Try a contact lens in your right eye that corrects you to plano; if you can't adjust after a reasonable time, you could try substituting a contact that corrects to -.5 D.  Any contact lens would work for this purpose, although I've found the 1-day disposable contacts (like 1-day Acuvue moist) to be the most comfortable.  In your place, I'd postpone my second surgery until I found a solution with a contact that gave me comfortable vision using both eyes.  Your surgeon might have to adjust your IOL power calculations.  Perhaps Dr. Hagan has other suggestions for you.

[2ndsight]

Dr Hagan has stated in some previous posts to other patients that there is a big optical difference between the way an IOL corrects your vision and glasses. Think about it, the IOL is behind your eye and the glasses lens is in front of your eye and they have two entirely different ways of processing the light onto your retina. This is why cataract patients who wear glasses usually get both eyes done, or have the IOL set  to nearsightedness so both eyes can then be corrected with glasses.

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

-

[WilmaM]

Jodie,
Also the strange thing is, is that I'm LESS dizzy if I where no glasses & the right eye is at -3.5D and Left at -1.25.  When I where my old pair of glasses with a "plain" lens in the left side (-1.25 from IOL) and the right eye at Zero (with corrective lens), I'm even more dizzy. I don't understand this. I would think it would be the opposite b/c there's less of a descrepancy with the glasses on, isn't there??   What do you think?  
Thanks a bunch!
Wilma

[WilmaM]

Thanks for the info Jodie, you seem very well informed.  After my visit on Wed. I found out that my right eye is actually -3.5D, even worse than I remembered.  The contact lens is a great Idea, I wish one of my doctors told me that before.  Anyway, can you explaine to me what "modified" monovision is?  & what type of contact lens is used?
Also, How long did it take your friend to adjust?  Was he dizzy at first?
Thank you.
Wilma

[JodieJ]

Thanks for the additional info, 2nd sight.  So right now, WilmaM, you are -2.75 (right eye) and -1.25 (left eye).  This would be great for near and intermediate vision, but not very good for distance vision.  In fact, your blurred (uncorrected) distance vision might be sufficient to be the cause of your dizziness.  Your vision can be comfortably corrected with glasses, but then how do you know that you won't have a problem if you were to set your right implant to plano vision?  I think that 2nd sight's suggest of wearing a contact lens in your right eye (corrected to plano) is an excellent one.  You should know in a week or two whether it works for you.

There is a big difference between full monovision and the modified monovision correction that your surgeon is suggesting to you.  After (unsuccessfully) attempting full monovision for a week with contact lenses, I returned to my optometrist to demand two distance contact lenses.  Instead, he exchanged my left contact for a lens that gave me modified monovision, and (amazingly!) my vision with both eyes immediately became comfortable.  (I later gradually adapted to full monovision.)  I think it's very likely that you can adapt to plano and -1.25, which is a great combination for many people.  My friend who has this correction only needs weak readers for seeing fine print or for prolonged reading, and his distance vision is excellent.

Plan B (just in case you hate your vision with the plano contact lens):  Per 2nd sight's suggestion, try a contact in your right eye to correct your vision to -.5 D.    

  

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

-

[2ndsight]

I think you stated in a previous post that your right eye is currently
-2.75 which means you have a refractive difference of -1.50 (I think, Jodie will correct this if I am wrong) so at present you are more nearsighted in your right eye and should have some kind of correction for distance.

I would try the glasses which you are being fitted for first, to see what kind of result this brings, and maybe also a contact lens in your right eye to try out  different vision combinations. Also remember that monovision can take several weeks to adjust to, and many doctors recommend trying it with contact lenses first.

[JodieJ]

You stated that your surgical target is plano for your right eye, and your vision with an implant in your left eye is -1.25 D.  What is your current (pre-surgery) vision in your right eye?  Is it plano, or something very different?  Most people don't have a problem adjusting to a difference between their eyes of 1.25 D.  On the other hand, just about everybody would have a major problem with a 3+ diopter difference, and glasses might not help.