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Long story for a young person
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Long story for a young person

I'm a 25 year old male who had a ruptured cerebral aneurysm  nearing 3 years ago, causing Terson's. One Retina guy wanted to do a vitrectomy. Second opinion more experienced vitreoretinal surgeon told me to hold off, saying it would clear on it's own. At this point, the vitreous is fairly clear, with a rare floater. A small retinal detachment was corrected by laser, after vitreous was clear enough to be seen through and it was found.
Now, I'm told I have a cataract. I'm told causes include the hemorrhage  intrusion from Terson's as well as the laser used to repair the tear.  All of this mess in in my right eye. My left eye sees 20/15 with a -2 correction. The right eye was at -3.75 prior, both eyes have about -1 Cyl. (astigmatism?) I will be attending medical school in Fall 2014, continuing physical therapy until then.
I have been doing kind of ok even with the cataract in place. I know the left eye was already dominant before, but am concerned that if I don't get the right one in shape soon, the brain might turn it off altogether.
My college education is in biomedical engineering, so the whole IOL business is kind of fascinating to me.
I'd like to not be 25 with bifocals, so I was considering some kind of multifocal. Seems like Crystalens is the only multifocal without light halos o a long time to get used to it (per official literature). However, I've read horror stories of Posterior capsule opacification and the YAG that follows (concerning since I've already had one retinal tear).
I think I was told my cataract is a Posterior subcapsular cataract, if memory serves.
I'd like some information on choices, and especially what the doctors would do, if in my place. I'd like to know what to ask  before making the official consult (only picked up info packet from surgeon's office so far)

Tags: cataract, Terson's, Stroke
As an adult, you do not have to worry about the cataract in the right eye causing a lazy eye.  This only happens in young children.  The cataract may be removed when it is troublesome to your functioning, like reading or driving. A posterior subcapsular cataract can really interfere with reading, and seeing in bright light situations.  My strong preference is for a monofocal implant lens in your case; the best results with multifocal or crystalens are when the lenses are in both eyes.  Clearly, your left eye will not need cataract surgery for decades.  You could place a monofocal implant in the right eye, aiming for -2.00 correction to balance the left eye.  You would be able to read without glasses, and need them for driving or movies.  
I have noticed that in dimly lit rooms, I can see much better with the right eye than in bright places (even without glasses)
if a monofocal is done as you suggest, while wearing distance glasses (as I'm accustomed to doing), would things focus up close? Or would I have to do the middle-aged thing of reading at arm's length? I've gotten used to having distance glasses on for even computer work (24-48ish inches away) as at that distance the left eye isn't as clear as I would like uncorrected for small print.
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This Forum's Experts
John C Hagan III, MD, FACS, FAAOBlank
Discover Vision Centers of Kansas City
Kansas City, MO
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