Confused!

[Bosibos]

I had cataract surgery on my Right (dominant) eye a week ago.  An Acrysof Toric iol 14.5D 3.00 cyl 6.0mm was used.since I had severe astigmatism.  I am scheduled for surgery on my Left (non-dominant) eye in 1 month, which does not have as much astigmatism as my right.  I have been wearing glasses for distance since age 13 and then went to a progressive lens a few years ago.  I have never gotten used to reading with the progressive lens and always take them off to read.  I have been told by my opthamologist that I will be unable to read or use my computer without reading glasses after my next surgery.  I am quite concerned about this since I can see better close up without glasses as opposed to wearing them.

Since my surgery, I can see distance with my right eye but not intermediate or close up.  I am considering an intermediate lens for the surgery on my left eye.  My opthamologist feels that my eyes will not work very well together unless I use the same lens.  I would like your opinion.

Thank you,

[JodieJ]

It sounds like you have dry eyes.  Try some drops/ointment for dry eyes available without prescription.  There is a lot of information about treating dry eyes available online.

You might need progressive glasses for your best vision.

If you would like feedback from one of the forum doctors, start a new thread.

[Bosibos]

Well, I had my left eye done two weeks ago.  As you predicted, Jodi,  I am very unhappy with the results.  I wish I had never had it done.  My left eye feels like there is sand in it although I've tried every drop and gel on the market.  It seems like I'm looking out of a film which is blurring my vision.  Since my left eye was my best, visually,  that is very disheartening.  Dr. claims it is floaters and will either be absorbed or my brain will compensate.  It has not improved at all in the past two weeks.  He said he cannot find anything wrong and he has "no problem" sending me to someone else.  My vision is 20/40 in right eye and 20/30 in left which is not as good as he had predicted it would be.  My eyes really hurt when I wake up in the morning and feel as though I have ill fitting contacts in.  I'm sure two weeks post surgery that should not be.  Not sure how to proceed at this point.

Thanks for listening.
Donna

[JodieJ]

Your vision is currently unbalanced.  After you have your second eye done (or get a contact lens for your left eye), your magnifying mirror should work just fine.

If you want to make yourself feel better, read some of the recent multifocal IOL horror stories posted on this site.  In view of your high astigmatism, it's very unlikely that the Restor or the Crystalens would have given you good results.  Your second opinion doc's first two options make no sense.  Be glad that he wasn't your surgeon!

A toric lens for your left eye does make sense.  The question is whether to go for distance or intermediate vision in that eye.  Getting a third opinion might be a good idea.  And experimenting with different powers of disposable contacts would provide you with good information about what your vision would be like with distance/intermediate vs. distance/distance.

[Bosibos]

Well,  I got my second opinion yesterday and was very unhappy with what he had to say about my "options" now that I've had the Toric implant in my right eye.  He advised my options were:  1} Have an explant and since he could not use Crystalens (which he has had the most success with)  use ReStor implants. 2) Leave left eye as it is and see relatively good for distance, intermediate and near.  This option is ridiculous since everything is out of focus, blurry and I have no depth perception. 3) Go with the Toric in my left eye and use glasses for intermediate and near vision.  

I have decided my only real option at this point is to have the same Toric lense implanted in my left eye.  I am so disappointed with my opthamologist for not giving me the information and options that were available to me before I had my right eye done. I am also beating myself up for not doing more research before I had such a huge and life changing surgery done.  I have literally felt ill since I saw the second surgeon.

Even after reading almost every post on this site,  I am still so CONFUSED!  Jodie, I bought a 7x magnifying mirror with a light today and could not see well enough that I would be able to apply makeup.  

I have a post-op appointment tomorrow and will be discussing all of my new "knowledge" with him.  I am very curious to see what he will say!  I do have to tell you that my" 2nd opinion Dr." did say my surgeon did a very good job on my cataract surgery and my eye looked good, lol.  

If any one has any other options they can come up with for the surgery on my left eye please please let me know.  I feel kind of....desperate!  

Thanks for your help,
Donna

[JodieJ]

Wearing a contact lens in your unoperated eye would (hopefully) eliminate your current sense of having unbalanced vision.  (A contact lens works very well for most people who have not yet had cataract surgery on their second eye.)

Your best correction probably depends on the extent to which your vision in your right eye is impaired by being "lazy."  The benefit of having both eyes set for the same distance is that your "good" eye can compensate for problems involving your "bad" eye, keeping visual problems outside your conscious awareness.

Both of my eyes are set for distance vision, making everything within arm's length at least slightly blurry.  I was very nearsighted before cataract surgery and always wore glasses/contacts, so I was used to having crisp vision at all distances. The blurriness at near/intermediate distances does bother me, so I usually wear progressive glasses.  On the other hand, people I know who never needed glasses until they gradually developed presbyopia in their 40's seem to have become accustomed to the blurriness.  They wear glasses for reading but not to see what they're eating (like I do.)

Getting a second opinion is a very good idea.  If you do decide to get distance vision in both eyes, you can experiment with different versions of (mini) monovision using disposable contact lenses.  

[Bosibos]

I do have a large magnified mirror,  but still too out of focus to see well enough for makeup.  I have also noticed that just using my right (surgery) eye that what I am eating is very blurry and out of focus.  I am really freaking out!  

I am having such a hard time since my surgery 1 week ago because my eyes are just not working together and I am off balance and depth perception is nil. I have been nauseated and overall felt awful. I have not even been able to return to work.  My opthamologist had no openings for surgery on my left eye until 12/8.  I do not know how I can wait that long and still am not sure how to proceed.  Hopefully,  when I get my second opinion today it will shed some light.  

Any more suggestions would be appreciated.

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

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[JodieJ]

Don't despair--of course you'll be able to put on makeup!  Stores like Bed, Bath & Beyond, Ulta, Target, and Walmart sell relatively inexpensive mirrors which magnify x10 to x15.  Some even light up.  Invest in one.

In your place, I'd probably go for distance vision in my left eye to get the best vision possible.  If you're unhappy with your range of focus, then try wearing a contact lens in your right eye only.  You could try out contacts in various powers to get whatever works best for you.  (The 1-day Acuvue Moist contact is especially comfortable.)  That magnifying mirror will come in handy; it's harder to insert contacts when you're not nearsighted.  

[Bosibos]

I think I've made a big mistake!  After reading your posts and doing some more thinking about my surgery,  I've come to the conclusion I probably should have used my left eye for distance and right eye for intermediate.  I say this because my left eye has my best vision correction.  My right eye not only had most of the astigmatism but also (as I recently found out) has lazy eye.  

So,  in retrospect,  I wish I had done more research prior to the cataract surgery and toric implant in my right eye.  I certainly would have gotten a second opinion and not have gone with what my opthamologist decided should be done.  I realized this morning,  that if I went with the same lens in my left eye,  I would never be able to put on makeup again :-)  Since I cannot go back I now must try to make the best possible informed decision as I move on the my the next surgery for my left eye.  I have already made an appointment for a second opinion for tomorrow.  Wish me luck!

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

Yes do get a second and if necessary a third opinion so you understand your options. Even people thathave never had monovision with contacts can adjust to differences of about a diopter to a diopter and a half. Leaving your second eye set for "intermediate" perhaps -1.00 or -1.25 is generally adjusted to well. With that RX you can usually see good for computer and shopping and in good light with good printing even read some. Be prepared to wear progressive bifocals for extened reading and when you want your best possible vision in both eyes

JCH MD

[JodieJ]

I predict that you will be very unhappy if you proceed with your surgeon's plan to set your left eye for distance vision.  Everything within arm's length will be blurry, and this is not what you're used to.  I would get a second opinion from another experienced, board-certified surgeon.  (Your plan makes a lot of sense to me.)