toric IOL: choose near or distance vision

Discussion in 'Eye-Care' started by silvere2, Oct 22, 2008.

  1. silvere2

    silvere2 Guest

    I'm facing cataract surgery and my trusted experienced
    opthalmologist asked if I wanted near or far vision as the outcome.
    This is an agonizing choice and I'd like your opinion.
    All my life I've been nearsighted (with bad astigmatism doc says
    won't be eliminated completely by IOL).
    I can see pretty well unaided at a distance of about 6 inches and
    am afraid to lose this vision. But everyone says life after surgery
    will be better overall.
    Should I pick near vision so I can read, apply makeup, see
    computer? Or should I pick distance vision to drive, see TV, watch
    people across the street? I realize glasses (or cheap readers) will
    be needed to get the opposite vision of whichever I pick, and no
    outcome is 100% predictable.
    For those of you who've actually picked one or the other, what
    were the surprises afterward? For you with medical expertise, what
    was the general choice of most folks and what are their regrets
    afterward?

    Details: I'm mid fifties, retired computer person, cataracts for about
    8 years, now using toric contacts for monovision (not fond of mono).
    Will get toric IOL with LRI. Not worried about surgery, just the
    choice of outcome.

    last glasses RX was
    R= -8.00 sph, +2.75 cyl, 85 axis
    L= -7.5 sph, +1.50 cyl, 80 axis
     
    silvere2, Oct 22, 2008
    #1
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  2. silvere2

    otisbrown Guest

    Dear Silviaelli,

    Subject: No one can tell you what you should do.

    I had cataract surgery. The man was excellent, and the results good.

    I chose "far" vision, since I did not have clear distant vision since
    I was eight years old.

    The result is that I have 20/20 vision in each eye. I check this
    myself.

    Further, using my own trial-lens kit, I have a refractive STATE of
    +1/2 diopter.

    In "normal" words -- this is a perect result -- exactly as I wished
    it to be.

    Further, I am typing this into my coputer (and reading it) with no
    lens
    on my face. (Measured distance is 25 inches.)

    But, as a matter of choice, and scientific interest, I am wearing
    a +2.75 diopter lens for all work less than 25 inches.

    This is far better than wearing a minus lens 16 hours a day
    seven days a week.

    If I do no "close work", then no glasses at all.

    Further, I play tennis, and it is great not to have those
    negative lenses on my face.

    So that was MY choice -- and I was lucky about the result.

    Good luck to you,

    Otis
     
    otisbrown, Oct 22, 2008
    #2
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  3. silvere2

    jack Guest

    Geez, I would take either one! As my farsightedness progresses, I can
    barely see to run without glasses.

    Personally I would go with good distance vision. Seems easier to have
    reading glasses than driving glasses.

    Is splitting it an option? My son has terrible vision in both eyes, but one
    is far and the other near; until he had them tested he didn't know he had a
    problem.
     
    jack, Oct 23, 2008
    #3
  4. silvere2

    Dan Abel Guest

    I was nearsighted almost all my life. I chose distance vision when I
    had cataract surgery in both eyes. I have been very happy with it. I
    can get out of bed and see.

    It depends some on your lifestyle. If you like being outdoors, there
    are problems with fogging and mist with glasses. If you need glasses
    indoors, fogging and misting shouldn't be a problem.

    Once in a blue moon I miss the extreme close vision, but I just keep a
    variety of reading glasses around. One pair lets me see pretty closely.
    Once in a while I find myself somewhere away from home and unable to
    easily read because I didn't bring glasses. Doesn't happen often, and I
    keep spare reading glasses in my vehicles.
    Don't wear makeup, but wearing glasses sounds like a problem.
    You will lose all of your focusing ability when the cataract is removed.
    This means that you will probably need different glasses for computer
    use than reading. This isn't true for everyone, but you should expect
    it.
    Maybe it's not a big deal for you, but distance glasses are *always*
    prescription, and reading glasses in your case will normally be OTC.
    You can afford to have multiple reading glasses. If you choose near
    vision suitable for reading, you may need both computer and driving
    glasses (or bifocals, which most people find work poorly for computer
    use).
    Not a big surprise, but the loss in color and sharpness came upon me
    gradually, whereas after the surgery, it was all of a sudden back. That
    was very pleasing. I had forgotten what grass and trees looked like.
    That's a good thing to know in advance. Some people on this group have
    said that they want monovision with their cataract surgery. If you
    don't like that, you can choose not to do that.
    Be aware that if you don't have both eyes done at once, there will be
    vision problems when wearing glasses. Contacts will be fine, so if you
    get one eye done, just wear your regular contact in the other eye.
    Frankly, I wouldn't want both eyes done at once, but that's just me.
     
    Dan Abel, Oct 23, 2008
    #4
  5. silvere2

    The Real Bev Guest

    With all due respect, could you explain this comment? When I wear my
    contacts (distance) I use cheap (99-Cent-Store, some with those nice
    spring hinges) readers in various diopters depending on what I want to
    do -- for hours at a time. It's easy enough to hold them up to straight
    lines and see if an individual lens is wavy -- and I've never found one
    that was, although cheap sunglasses used to be (decades ago) problematical.

    --
    Cheers, Bev
    +++++++++++++++++++++++++++++++++++++++++++++++
    "Genius may have its limitations, but stupidity
    is not thus handicapped."
    -- Elbert Hubbard, American author
     
    The Real Bev, Oct 24, 2008
    #5
  6. silvere2

    Dan Abel Guest

    Some years back, during a routine exam, I asked my OD whether I should
    get prescription readers. He did a few minutes of testing, and
    recommended +2 OTC readers. He said that if I had any problems, to come
    back and he would do more tests and prescribe glasses if he thought they
    would be better. These were to wear over my contacts, -10D in the left
    eye, and plano torics in the right, with 1.75D for astigmatism. He said
    that my actual reading prescription was +1.75D and 2.25D, but didn't
    think that would help much. I wasn't so sure, but with all I've read on
    this group, about monovision without correction after cataract surgery,
    perhaps he had a point (I had had cataract surgery in the right eye,
    which is where the "plano" came from).

    [Note: My OD wore OTC readers]
     
    Dan Abel, Oct 24, 2008
    #6
  7. silvere2

    The Real Bev Guest

    I've always had LOTS of residual astigmatism with my prescriptions
    glasses and contact lenses no matter who has prescribed/made them.
    It seems like a person ought to be able to tell just by trying. It's
    not like it costs a bundle, unlike prescription lenses.
    It turns out I have a pair of bifocals like that, and they make nice
    computer glasses. I don't want to drive with them, though.

    My prescription glasses -- over the last 30 years -- have ALWAYS had a
    2D difference between left and right lenses, and the distance in focus
    has always been different. I now regard my left eye as pretty useless
    at any distance for anything but providing 3D information because of
    residual astigmatism and a foveomacular vitelliform dystrophy, which is
    REALLY annoying. To even things out, I have floaters in my right eye :-(

    --
    Cheers, Bev
    =============================================================
    "On the other hand, I live in California so I'd be willing to
    squeeze schoolchildren to death if I thought some oil would
    come out." -- Scott Adams
     
    The Real Bev, Oct 26, 2008
    #7
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