Lifelong monuclar vision to binocular vision after cataract surgery?

[Farls]

I am hoping you will kind enough to answer a question for me in regards monocular vision and cataract surgery.  I was diagnosed with Amblyopia at the age of 11 and after lasix surgery at the age of 28 on the degenerated eye was told it is not Amblyopia but monocular vision because the vision was corrected to 20/15 nearsighted.  I feel the lasix surgery gave me monovision as I was able to read using the corrected eye alone.  I see 20/20 at distance in the good eye and do not wear glasses. I still cannot see 3D movies.  Now at 40 I have developed a cataract in the previously corrected eye which has me back to monocular vision.  My eye doctor is recommending a Crystal Lens and while he makes no promises he claims I may be able to 20/20 both near and far with this eye.  My question is:  Will I be able to obtain binocular vision?  I'm a little concerned that my brain won't be able to adjust. What is the best that can happen? What is the worst?  I would appreciate any thoughts you may have on this.

[prasenjit1970]

I was detected to have PSCC in both eyes in the year 2002 when I was merely 32 years old, the doc said it was a dot cataract. From the year 2008, I began to see halos around the light, a vague cloudiness during the night, poor depth perception during the night, being troubled by the glare of incoming headlights and a fall of visual acuity. I had been myopic all my life, with -8.5 power distance and about -7 power reading vision with correctional glasses. I had got my right eye operated on January 13, 2012. The doc said my distance vision in the right operated eye was 0 and reading vision will require a +2 correction. Since I want to be sure about the visual outcome in the operated eye, I asked the doctor to bring parity in two eyes and he prescribed me to wear a -7.5 contact lens in the left unoperated eye (its visual acuity with glasses was 20/40). Should I get the left eye operated sooner rather than later? I have somehow a feeling that I chose to get my right eye operated sooner, and going by the progress of the cataract could wait for at least another five years. Now with contact lens in one eye and with one operated eye the visual outcome is not satisfactory. I am just 42 with demanding visual needs. I need a sharp and pure reading vision. An aspheric toric monofocal lens has been put in my right eye. I don't have diabetes, no other eye condition apart from the fact that my myopia was quasi-degenerative in nature, never had steroids as medicne. I am a smoker and used to long hours of reading and computer exposure. Please suggest, one, should I get my left eye operated any soon? With two eyes operated just at the age of 42, would there be any lifelong restriction/inhibition put on me, as I am intensely active as a biker, teacher, reviewer and as a traveller requiring to carry luggage.  

Regards and thanks,

Prasenjit Chowdhury
India

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

What I have said does not indicate your choice of monovision or mini monovision or both eyes for distance, midrange or near.

Like many people with strabismus or amblyopia you have reduced depth perception due to suppression of macular vision from the weaker eye under binocular conditions. (you don't fuse perfectly). Your perhipheral vision however does fuse normally.

At your age, indeed in many people from birth this is not curable, instead we try for 1. good vision in both eyes  2. cosmetically "straight" eyes.

JCH MD

[Farls]

ok, I got it.  If I am wired for monocular vision it doesn't matter what lens I get I will never achieve binocular vision then I should definatly get the short sight monolens.  I did have EXCELLENT pheripherial vision after lasix .  Is this any kind of indicator as to what I am genetically wired for?

[Farls]

Huh! That is interesting.  the first symptom I noticed of degeneration of sight when driving.  The poor eye is my left one and I noticed I had to turn my head all the way around to make lane changes so my right eye could see.  Post lasix I was able to use the left eye.  Then when I started to do the self one eye checkup I realized I wasn't using the left eye to see anymore.  Tested 20/400.  Post lasix I definatley had peripheral vision, used to strong eye for distance, weak eye for reading.  What does this mean as far as being wired congentially for binocular vision.  Can I ever obtain it?  I'm leaning towards a short sight monolens with hopes that the IOL will be improved upon in the next 20 yrs. I'ved 40 years with mono/monocular vision, another 20 years won't kill me but I would like to know one day how other people see. What DO other people see like anyway. Thanks so much for the responses.

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

Ask the consultant to confirm that you are not wired congentially for binocular vision. Likely you are a monofixator which means when you have both eyes open your brains uses peripheral vision from both eyes but only uses macular vision from one eye at a time.

JCHMD

[Farls]

Thank you Dr. Hagen, I read the blogs and some posts.  I am going to go for a second opinion. I wonder if a regular lens that will just restore me to monovision is not the way to go.  I'm not impressed with the number of complaints about the Crystal Lens.  Buyer Beware!

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

Your "good" eye will become presbyopic and within a couple of years will no longer be able to read without reading glasses. It quite likely that down the road it will develop a cataract also.

You could be a "mini-monofocal" without the expense of a Crystlanes and without the trouble some people have by putting in a high quality, aspheric monofocal IOL with a targeted refraction post surgery of about -1.25

Use the search feature and archives to read about the problems with Crystalens. More expensive, more prone to complications, glasses still often necessary, night vision often not good.

JCH MD