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Old 01-29-2015, 11:53 AM   #1
BenG
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Cataract surgery and monovision

I had cataract surgery on my right eye Tuesday with the left eye scheduled for next Tuesday. Before then I have to decide if I want both eyes focused for distance vision or have one eye for distance and one for reading. If you've had to make that decision, I would like to hear your experiences.

Also people with contact lenses that are focused differently are welcome to chime in.
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Old 01-29-2015, 01:06 PM   #2
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Oh my! vision issues is one of my biggest fears. my eyes are slightly mismatched for close/reading, but still pretty okay at distance.

I'm feeling for you and wishing you the best of luck with it all!
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Old 01-29-2015, 01:29 PM   #3
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I'm paying extra for the toric lenses that correct for astigmatism. So hopefully my vision will be pretty good after everything is done. I did have a posterior subcapsule opacity in the right eye, which means the the membrane that holds the lens in place is cloudy. I'll have to get that fixed after the eye heals from the surgery. It can be done in the doctor's office in a couple of minutes and involves a laser punching a hole in back of the membrane where the light comes through.
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Old 01-29-2015, 01:31 PM   #4
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I recently (November) had cataract surgery in my right eye, I'm not eligible for the monovision technique as I lost central vision in my left eye several years ago from AMD, so I opted for a very expensive lens called Crystalens by Bausch and Lomb (they also have a version for astigmatism called TRULIGN). The Crystalens is referred to as being "accommodating" which means that it has a little hinge inside that changes the focal length based on the tension of my ciliary muscle to provide correction at near, intermediate and far distances.

That's all very good in theory, but in practice it works pretty well at far and intermediate distances, but not so much at near distance. I now need to use reading glasses but not distance or computer glasses. Don't get me wrong, from reading all the reviews and patient surveys that’s pretty much what I expected and is a vast improvement from being absolutely depended on spectacles for the past sixty years.
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Old 01-29-2015, 01:49 PM   #5
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Quote:
Originally Posted by BenG View Post
I had cataract surgery on my right eye Tuesday with the left eye scheduled for next Tuesday. Before then I have to decide if I want both eyes focused for distance vision or have one eye for distance and one for reading. If you've had to make that decision, I would like to hear your experiences.

Also people with contact lenses that are focused differently are welcome to chime in.
I don't need cataract surgery quite yet, but it's getting close. I'd be interested in hearing what you decide, Ben, and how it worked out.

Jim
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Old 01-29-2015, 03:24 PM   #6
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Having been nearsighted by nature and far sighted by Scientific/medical help, I gotta tell you, never Pick nearsighted even if it's only for one eye. Near sighted can kill you. Not so much the other way around
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Old 01-29-2015, 06:15 PM   #7
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Based on my experience with conventional glasses vs. progressive lenses, I'd go for far-sighted. I was used to wearing reading glasses for reading, so I just keep it up. I suspect the compromise is fine for many people, but if you do a lot of reading you'll know you're compromising.
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Old 01-29-2015, 06:49 PM   #8
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Monovision

"Monovision is the method of using one eye for distance vision and the other eye for near vision. Contact lenses, refractive surgery, and intraocular lenses are all methods used for monovision. When a patient chooses monovision, the dominant eye, or the one that would be used to focus on a camera, becomes the distance eye and the other eye is focused for close vision."

"The monovision method works because the brain learns to adapt to which eye sees at which distance. This method is also a form of a concept known as simultaneous vision. There is usually an adjustment period in adapting to this method of vision. Most patients find they are able to adjust. Because surgery is a permanent solution, doctors advise that patients try monovision contact lenses first."

"Disadvantages of monovision include a lack of visual sharpness. Persons who require very sharp vision due to a hobby or occupation may not be pleased with monovision results. Another drawback of monovision is that some patients experience decreased depth perception or blurred vision in the eye that focuses on near vision in certain situations."
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Old 01-29-2015, 07:23 PM   #9
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That would kill me. I will continue to shoot, in theory ski and many other things. it's not that much of a hassle to t
Take glasses off
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Old 01-29-2015, 07:27 PM   #10
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I have astigmatism in both eyes and slight cataract though not to the degree that I need the surgery yet. My mom had it done on both eyes (at different times) and hasn't had much trouble. Dry eyes now and then but she had that already I think. I had no idea they had lenses that could correct for astigmatism. Interesting. I'll have to remember that when I need to get it done. Hopefully it won't be any time soon. I'm only 44.
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Old 01-29-2015, 07:35 PM   #11
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Astigmatism makes you a perfect candidate for laser surgery
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Old 01-29-2015, 11:45 PM   #12
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I have astigmatism in both eyes and slight cataract though not to the degree that I need the surgery yet. My mom had it done on both eyes (at different times) and hasn't had much trouble. Dry eyes now and then but she had that already I think. I had no idea they had lenses that could correct for astigmatism. Interesting. I'll have to remember that when I need to get it done. Hopefully it won't be any time soon. I'm only 44.
Most insurance doesn't cover the toric lens for astigmatism since you can correct it with eyeglasses. I had to pay an extra $1250 per eye for it. But it will be worth it if I don't have to wear glasses except for reading.
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Old 01-30-2015, 02:39 AM   #13
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I had my big eye expense a few yrs back when my left eye was smouldering and I needed a laser treatment for that (due to my diabetes). So far I haven't had further trouble and I think it was probably even more than the surgery cost that you mention. Medicare took care of most of it though in my case (since it related to my diabetes). I doubt they would cover the lenses like you say though. I just got a new pair of glasses early this month with a co-pay of $2.00. I was told it was $3.00 but then I got a check from my clinic for $1.00 as I apparently overpaid the co-pay.
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Old 01-30-2015, 12:03 PM   #14
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Medicare and most insurance plans cover the surgery and what are referred to as "standard" lenses. Which means they have some degree of spherical correction (near sighted). They do not have any toric (astigmatism) correction nor any multifocal or accommodating (presbyopia) correction.

If you want astigmatism or presbyopia correction you have to get "premium" lenses that are designed to correct your particular problem, and the cost of those is out of pocket. They cost anywhere from a few hundred to about three thousand dollars US per eye.

Mine cost $2,600, but since my left eye doesn't work anyway I only had to buy one.
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Old 01-30-2015, 05:35 PM   #15
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I have natural monovision, so when the dread day comes (and my opthalmalogist is clearly itching to get his hands on my eyeballs), I'll obviously stick with it. It's what I've always known.

But I have to wonder about adjusting to the loss of depth perception. It's one thing never to have known binocular vision and to have highly compensated for it and another to adjust in one's golden years, so to speak. Even having always been this way, I find that everyday activities like parallel parking, walking downstairs and pouring require conscious thought if I'm not to come a cropper.
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