Cataract Dilemma

Due to what I have found out was a misunderstanding, I was given a short sighted IOL after my cataract surgery on my left eye which resulted in me having anisometropia.

The surgeon who did the operation has since left so there's no chance of discussing this with him as to why he did this when I clearly asked for distance vision.

I've been getting by using a contact lens in my right eye and thus having Monovision. I can tolerate the monovision quite well and have been able to drive etc. but I don't want to be dependant on a contact lens  - I don't tolerate it very well and my eye gets dry, blurred and uncomfortable if i wear it too long.  I also get very depressed with being partially sighted when I have to remove it.  Anyway I'm 65 now and can't see me fiddling with contact lenses when I'm older.

I've been given choices by my consultant but he says I have to make the decision as he can't do it for me but I'm so confused as to what to do.

1. I can have the left eye operated on again and a new distance lens put in and hopefully get the other one done at some stage so I won't need glasses except for reading
2. I can have my right eye made short sighted too and only wear specs for driving and distance
3. I could have a distance lens put in my right eye and live with monovision

I'm worried about option 1 because I had problems with patchy vision in that eye and it's still not 100% so not sure I'd get a good result.?
Option 2 means I'm stuck with having to wear specs outdoors which is a pain, especially as it's always raining here in the UK.
Option 3 worries me in case I don't get a maximum vision result in that eye (I have Glaucoma) and I would still be anisometropic if I needed spectacle correction after.

I'm having sleepless nights worrying about what decision to make so could anyone help me to decide please.

[Sandra M Brown, MD]

Since you are tolerating the monovision situation, it is very reasonable to consider having the right eye operated on for distance vision.  The difference in focus between the two eyes should not be more than 3 diopters (don't worry about that diopter means, your doc knows).  Probably 2.5 diopters is safer for most people.  To stay within this range, you may have to be slightly undercorrected in your right eye (very slight leftover nearsightedness).  This will likely not bother you unless you need to drive frequently at night.  The best way to ensure your happiness would be to try a contact lens in your right eye that would be equivalent to what the doctor would create surgically.  Maybe you are already wearing the correct power of contact lens.

[MandaCope]

Thankyou very much for your reply.   It does make sense to try that first I think because while it's recovering I will still have the now short sighted eye for the computer at least.  Also if I can't get on with monovision for any reason I would still have the option to have the first eye redone maybe which should give less disparity between them and thus no more anisometropia.  It would seem more sensible to do it in that order rather than redo the short sighted eye first because then I would never know if I could have got away with permanent monovision.  

I do envy most of the members of this forum who live in the USA as they all seem to be given much more information and are much more clued up about their vision.

I was looking at my before op test result (two years before) which was:

R - Sph +3.75  Cyl -0.75 Axis 10  (near add +1.50)
L -  Sph +3.75  Cyl -0.80 Axis  5  (near add +1.50)

After the op:

R - the same as before except near + 2.50
L - Sph -2.00  Cyl -0.50 Axis 90.0 (near +2.50)

The contact lens I am wearing on my right eye just says +4.25   8.6  CT 0.171 DIA 13.8

I don't know if this would help you to know if I might get a good result with monovision?  I really would like to be armed with all the facts when I next speak to the consultant and tell him what I've decided.  Thankyou.