choice of near or far vision after surgery?

I've been nearsighted since I was about 11 years old. Now at age 54 I
am having cataracts removed from both eyes. The doc says it's common
for people who have been nearsighted all their lives to want an implant
that leaves them a little nearsighted - they still need glasses to
drive - but able to read without glasses. I'm not sure I want that. I
think I want to see distances clearly and put on reading glasses. I am
very nearsighted - i can't see the line below the "E" on the eye chart.
Does that mean I really can't get an IOL that will give me good
distance vision and the doc doesn't want to say that?
What has been your experience? What did you choose and are you happy?

Dear JR,

I will probably need cataract surgery. I am also "nearsighed".

At "our age", you will get a choice -- clear distant vision (pass the
DMV),
or clear near vision -- as you state.

The operation aims at a refractive STATE of zero -- and can "err" on
either the plus of minus side. (Never perfect).

You have a choice. If it were me, I would choose to pass the
DMV (at 20/40 or better) and use a mild +1.5 to +2 for
reading.

But that is your choice.

Good luck,

Otis


JR wrote:
> I've been nearsighted since I was about 11 years old. Now at age 54 I
> am having cataracts removed from both eyes. The doc says it's common
> for people who have been nearsighted all their lives to want an implant
> that leaves them a little nearsighted - they still need glasses to
> drive - but able to read without glasses. I'm not sure I want that. I
> think I want to see distances clearly and put on reading glasses. I am
> very nearsighted - i can't see the line below the "E" on the eye chart.
> Does that mean I really can't get an IOL that will give me good
> distance vision and the doc doesn't want to say that?
> What has been your experience? What did you choose and are you happy?

JR wrote:
> I am
> very nearsighted - i can't see the line below the "E" on the eye chart.

thats really not very nearsighted. just moderately so.

> Does that mean I really can't get an IOL that will give me good
> distance vision and the doc doesn't want to say that?

not in the least. it would be easy to get you good distance vision
after cataract surgery with a much higher prescription than you
apparently have.

a caveat however is astigmatism-- that can gum things up a bit.
although it can be improved during surgery it is hard to completely
eliminate. how much of your refractive error is due to astigmatism?

sounds like the surgeon is telling you straight-up. you have a choice
at this time (i.e. before surgery) to choose the type of prescription
that you want them to aim for-- there's no guarantee that you'll get it
exactly but you can tell them now and they can include your request
into the formulation of the implant power and most decent surgeons can
get pretty close.

patients are happy both ways. i would say most of my patients are
happy at a refractive state of about zero in both eyes (=focused on
distance, not nearsighted or farsighted) but some enjoy being slightly
nearsighted (about -0.50 to -0.75 in both eyes). at that amount of
nearsightedness you can still see pretty good far away without glasses
(~20/30) and still see good enough to read briefly at near (newsprint,
etc.). prolonged nearwork would require readers.

another possibility is to get your dominant eye focused perfectly in
the distance and then get your non-dominant eye slightly undercorrected
(about -1.00D)-- that approach can allow you to "have your cake and eat
it too" although you would still need readers for prolonged reading and
for fine print.

> What has been your experience? What did you choose and are you happy?

i am an eye doctor (optometrist) and have not had cataract surgery.

I had cataract sugrery about 4 weeks ago. I've been highly nearsighted all
my life and chose to set my eye at 16 inches (-2.00D) because I didn't want
to rely on reading glasses. With distance glasses, my distance vision is
perfect for me. Actually, I can do most stuff without wearing distance
glasses.

I sometimes miss my old myopic vision, though. Before the surgery I could
see things up close in amzing detail at 4-5 inches and that was great for me
(e.g., seeing all those dots in a photo). But those days are gone. Probably,
I'll buy a pair of reading glasses to turn back time.

After all, the choice of the focal distance is totally up to you.

"JR" <(E-Mail Removed)> wrote in message
news:(E-Mail Removed) ups.com...
> I've been nearsighted since I was about 11 years old. Now at age 54 I
> am having cataracts removed from both eyes. The doc says it's common
> for people who have been nearsighted all their lives to want an implant
> that leaves them a little nearsighted - they still need glasses to
> drive - but able to read without glasses. I'm not sure I want that. I
> think I want to see distances clearly and put on reading glasses. I am
> very nearsighted - i can't see the line below the "E" on the eye chart.
> Does that mean I really can't get an IOL that will give me good
> distance vision and the doc doesn't want to say that?
> What has been your experience? What did you choose and are you happy?
>

JR wrote:

>I've been nearsighted since I was about 11 years old. Now at age 54 I
>am having cataracts removed from both eyes. The doc says it's common
>for people who have been nearsighted all their lives to want an implant
>that leaves them a little nearsighted - they still need glasses to
>drive - but able to read without glasses. I'm not sure I want that. I
>think I want to see distances clearly and put on reading glasses. I am
>very nearsighted - i can't see the line below the "E" on the eye chart.
>Does that mean I really can't get an IOL that will give me good
>distance vision and the doc doesn't want to say that?
>What has been your experience? What did you choose and are you happy?
>
>
I was nearsighted with astigmatism. In my first eye, we targeted -.50
knowing that there is about + or - .50 error. Ended up with -1.00 with
a little astigmatism. Just enough to read ordinary print. So we shot
for -.25 on the other eye and ended up plano. So I have mild monovision
and it's just fine. I still like glasses for various reasons, so wear
progressives most of the time, but I can function without them. I'm
happy and recommend this approach for anyone except those who might miss
being myopic (i.e. want clear uncorrected vision in both eyes up close,
and want to wear glasses for far vision only) and those who want to go
without glasses at far and don't mind being totally dependent on reading
glasses.

w.stacy, o.d.

My right eye is
-575 -175 x175
left is
-650 -125 x020
bifocal is
+225

Is it possible to correct that nearsightedness with the IOL?



(E-Mail Removed) wrote:
> JR wrote:
> > I am
> > very nearsighted - i can't see the line below the "E" on the eye chart.
>
> thats really not very nearsighted. just moderately so.
>
> > Does that mean I really can't get an IOL that will give me good
> > distance vision and the doc doesn't want to say that?
>
> not in the least. it would be easy to get you good distance vision
> after cataract surgery with a much higher prescription than you
> apparently have.
>
> a caveat however is astigmatism-- that can gum things up a bit.
> although it can be improved during surgery it is hard to completely
> eliminate. how much of your refractive error is due to astigmatism?
>
> sounds like the surgeon is telling you straight-up. you have a choice
> at this time (i.e. before surgery) to choose the type of prescription
> that you want them to aim for-- there's no guarantee that you'll get it
> exactly but you can tell them now and they can include your request
> into the formulation of the implant power and most decent surgeons can
> get pretty close.
>
> patients are happy both ways. i would say most of my patients are
> happy at a refractive state of about zero in both eyes (=focused on
> distance, not nearsighted or farsighted) but some enjoy being slightly
> nearsighted (about -0.50 to -0.75 in both eyes). at that amount of
> nearsightedness you can still see pretty good far away without glasses
> (~20/30) and still see good enough to read briefly at near (newsprint,
> etc.). prolonged nearwork would require readers.
>
> another possibility is to get your dominant eye focused perfectly in
> the distance and then get your non-dominant eye slightly undercorrected
> (about -1.00D)-- that approach can allow you to "have your cake and eat
> it too" although you would still need readers for prolonged reading and
> for fine print.
>
> > What has been your experience? What did you choose and are you happy?
>
> i am an eye doctor (optometrist) and have not had cataract surgery.

And, that only corrects my vision to 20/60 (Don't tell the DMV) This is
the best I can get until the cataracts come out.


(E-Mail Removed) wrote:

>
> i am an eye doctor (optometrist) and have not had cataract surgery.

I spend about half the day on the computer. Over the past couple years
I've had to pull the monitor a little closer every month. I don't do
any outdoor exercise, just a treadmill and weights while I watch TV.
I used to read without glasses until I needed bifocals. Now I have to
hold the book about 4 inches from my nose to see it.
I posted my scrip in anothere message. It changed about -75 in the
first number in both eyes over a period of 1 year.


Robert Martellaro wrote:
> On 6 Sep 2006 05:13:54 -0700, "JR" <(E-Mail Removed)> wrote:
>
> >I've been nearsighted since I was about 11 years old. Now at age 54 I
> >am having cataracts removed from both eyes. The doc says it's common
> >for people who have been nearsighted all their lives to want an implant
> >that leaves them a little nearsighted - they still need glasses to
> >drive - but able to read without glasses. I'm not sure I want that. I
> >think I want to see distances clearly and put on reading glasses. I am
> >very nearsighted - i can't see the line below the "E" on the eye chart.
> >Does that mean I really can't get an IOL that will give me good
> >distance vision and the doc doesn't want to say that?
> >What has been your experience? What did you choose and are you happy?
>
> JR,
>
> Most folks are not given a choice. Sounds like your surgeon is looking out for
> your best interests.
>
> Are you very active outdoors e.g. walking, running, sports etc.
>
> Do you perform frequent close tasks?
>
> Do you read without glasses?
>
> Do you take your glasses off to see fine print?
>
> What is your distance Rx presently and from about five years ago?
>
> Any other problems with your eyes?
>
>
>
> Robert Martellaro
> ~~~~~~~~~~~~~~~~~~
> Optician/Owner
> Roberts Optical
> ~~~~~~~~~~~~~~~~~~
> "If a million people believe a foolish thing, it is still a foolish thing."
> - Anatole France

JR wrote:
> My right eye is
> -575 -175 x175
> left is
> -650 -125 x020
> bifocal is
> +225
>
> Is it possible to correct that nearsightedness with the IOL?
>

Certainly. Your myopia should be fully eliminated if you choose to go
that route rather than leave yourself slightly myopic in 1 or both
eyes.

you have a significant amount of astigmatism. is the astigmatism due
to corneal surface irregularity? we could tell by seeing the
keratometry readings (look something like "OD: 45.25@100 45.75@10").
residual astigmatism after cataract surgery can be an aggrevating
source continued blur. ask your doctor about the source of your
astigmatism, and whether he anticipates he can largely eliminate it
during surgery.

Robert Martellaro wrote:

> For instance, I wear a -4.50 Rx, and will probably aim for a -4.00 when I have
> cat surgery. I can see extremely fine print without a magnifier and can read in
> bed without glasses.

That would certainly be true, but -4 is pretty strong blur at distance.
I would suggest in your case, shooting for maybe -2, so you could not
only see at a normal reading distance, but could see a computer monitor
clearly without shoving your face into it. To be sure, I miss the
ability to see a tiny temple screw without reaching for the readers, but
really, it's a pretty small part of my life. Being able to get up and
walk around the house in the mornings without putting on glasses is also
kinda nice. Anyway, go for what you want.

w.stacy, o.d.

>