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Mini Mono Vision infomration Required for Cataract surgery decision
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Mini Mono Vision infomration Required for Cataract surgery decision

Hello Everyone,

I am 46 yr. old, have astigmatism in both eye and have already done cataract
surgery in right eye, Toric IOL set to distance in my right eye and thinking of doing
left eye with mini monovision using Toric IOL, I have a surgery next week
for Toric, Distance, I am thinking of getting mini Mono Vision -1.25 done in my left eye, so based
on my reading in the forum, I have few questions, so I would like some answer
so that I can make informed decision to go with Mini Monovision

1>What I am expecting from Mini Monovision is that I should be able to have better
intermediate/distance vision, which will ALLOW me to read computer, dash board in car
and so on, is this realistic expectation ?

2>I am thinking I should not expect to read from Near distance when it is set for intermediate
in left and distance in right ? I will need to have reader for reading near

3>I spend 10-12 hrs. on computers and using one eye for intermediate for that long
will make my eye tired ? if that is the case, can I use progressive glasses over mini
mono vision to work on computers ? which will allow me to read intermediate without
glasses during temporary activities and for prolonged I can use glasses

4>Will few days is good enough test to check whether your brain will accept mini mono vision  ?

5>When I called Dr. office they told me since I have astigmatism, getting test contact lens to simulate
mini mono vision might not be readily available, it will take some time and it won't
be covered by insurance, what are my options to test my adaptability with mini mono vision ?


5>Is difference between two eye should be -1.25 to get mini monovision,which will
allows you to get intermediate range in one eye(non-dominant) and distance in other
eye(dominant), is this correct ?

5>Are there possible to have Glare/Halo using Toric IOL just due to
using Mini Mini Mono vision ?

6>Are there any downside of using mini mono vision over long term ?

7>If at some point, if brain do not like mini Mono vision, can I use progressive glasses
over mini mono vision for all distance ?

8>Because of mini Monovision, do I loose crisp vision in distance ?

9>I can use progressive glasses over mini mono vision to get crisp vision for all the distances, is this
correct ? if I need crisp vision for certain activities and having mini mono vision would not
prevent me from using progressive glasses for better vision, is this correct ?


I will really appreciate your response in this regard, so that I can make educated decision
for mini mono vision and also can set my expectation accordingly.

Thanks for taking time.

-Regards,


Tags: Mini Mono Vision Cataract
31 Comments Post a Comment
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Avatar_m_tn
I had toric lenses done for both eyes also....my doctor made me 20/20 in dominant eye (right eye) and -2.25 diopters in my non dominant (left eye).
I got use to it, but after a year we did an experiment and he tried moving me up to -1.50 in the left eye...he tried it with contact lens and then i had some glasses made up to try it at home for a month or two...

I decided i liked it better and he did a lasik touchup to bring it up to -1.50 and i have been much happier this way...

With the fuller monovison i had, i found that though i could read quite close, it wasn't very sharp and also my mid range and distance was compromised a bit too much....computer was clear but not sharp and tv was a bit difficult (viewing my 32 inch flat screen) and in movie theatres, the titles look blurred...

Since the change to closer to mini-monovision, my distance is sharper for driving AND movies (no more blurry titles) TV viewing is FAR BETTER, computer is not only clear but sharp as well.

the only slight sacrifice is that to read without glasses, i have to hold things about 4 inchs or so further away, but i see the page SHARPER then i use to...so, i still get by like 95% of the time without readers...i find i only need them for extended reading periods...not for brief reading...

-1.25 as the doctor here suggests sounds good...not sure why my doctor preferred making it -1.50 (perhaps because i am older then you, 63 years old and my presbyobia is probably more then what you have...by my age you have essentially gotten as much of that as you are going to get and mine is like probably the maximum one can get...LOL)...

So, yes, overall i am very happy with it....it DOES take time to adjust to though, you have to have patience, but the rewards are you get more freedom from glasses that way...

If, after 6 months to a year, you decide you would rather have the eye corrected to 20/20 and would be willing to use readers a lot, then you could always get that done...

Hope that helps...and i also hope the doctor here will comment to you and any others who have had mini-monovision will tell of their experience as well...
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Avatar_m_tn
Hello All,

Can you all share your experience with Mini-Mono vision and also answer few of my above questions ?

-Regards
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Craig10X answered many of your questions. The other questions have been discussed in detail and you can aaccess those discussions on Mini-monofocal vision  with distance bias using the search feature and archives.

JCH MD
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Avatar_m_tn
And keep in mind that if you go 20/20 in both eyes, you will be very dependent on readers since anything with, say 2 to 3 ft of you will be blurry..so that includes reading and computer of course...that shouldn't be the case if you go mini-monovision...

If, after 6 months to a year, you decide you would rather be 20/20 in that eye and are willing to put up with using readers a lot, then a lasik touch up should do it for you...

I think generally most eye surgeons prefer that route (lasik touchup) instead of removing and exchanging the iol lens because it is far less invasive way to go...

Either way you go there usually is some compromise, you can't obtain perfection with this but you can make things work pretty good...only you can make the final decision...just decide which way sounds better overall to you...
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Avatar_m_tn
Hello Craig10x,

Thanks for all the information

Today I had discussion with my Dr and I have ordered contact lens to try it out, which means for now, I have cancelled my surgery, to try mini mono vision with contact lens and based on that I will decide to do the same with Toric IOL. Ofcourse this will add additional expense, but I think that is the best way to do it

I was told right eye is still heaing but my right dominant eye has 20/30 vision, so based on my experience with Contact, I may end up with -1.25 to -1.75.

For now, I would prefer that I can have Near/Intermediate/Distance Vision and if necessary, I can always put progressive to make it more Crisp. Doctor told me I may get intermediate Vision with Mini-Mono vision but might not be Near ?


Why would someone who can see Near/Intermediate/Distance may go with 20/20 with both eye ?

I will keep you posted, seems like I am pretty much in the same boat, as you were few years back

-Regards,


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Avatar_m_tn
You are very welcome...yeah, i pretty much have gone through what you are now...As far as some people preferring 20/20 in both with the sacrifice of the mid and near, i think it is usually those who need very precise and super sharp distance vision...say like a pilot or a golfer as examples....

But with my new (closer to mini monovision) set-up, i find i am able to do drive, go to movies, do computer and even light reading....all without any glasses at all...with perhaps only a tad less distance sharpness then i would have the other way....i prefer the versatility as you do....

Keep us posted...i'd love to hear how you are doing with it....
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Avatar_m_tn
Hi Craig10x,

By the way, how long did it took you before Glare went away after the surgery ? and also how long did u waited after the First surgery for going in for the 2nd surgery ?

Do you still have any Glare/Halo after the surgery ?

-Regards,

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Avatar_m_tn
I had the dominant eye (right) done first and non dominant (left) done 4 days later...My cataract was pretty much along in the right eye at the time of surgery and left eye was also coming along, so we couldn't really do the "test" in advance...

My doctor made the left eye at -2.25 diopters (which is more like full monovision) to maximize reading capability...some people find that to be fine but for me it took away a bit too much from mid and distance...

It's much easier to do the "test" after both eyes are done of course, and i got a very accurate picture of how it would be like after the "lasik touch up" to slant it more toward the "mini monovision"...

I do get starbursts at night around street lights and traffic lights and that seems to be a permanent thing for me, but it doesn't really bother me that much...in fact, in looks kind of pretty at night (lol)....I had that even after the iol surgeries, it wasn't brought on by the "lasik touch up"...

Glare i only get a bit of when watching my lcd tv screen, but it has only been about 3 months since i got the lasik touch up so that may improve over the next few months...I don't have any glare in any other situation then watching the tv...not even in the movie theatre...
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Avatar_m_tn
Hi Craig10x,

Thanks for the reply.

So you did not had Glare prior to lasik ? I meant after Cataract ?

Also with full mono vision, after the surgery, how long did it took you for reading/intermediate vision capability ? and after lasik touch-up, how long did it took you for getting better reading/intermediate vision ?

-Regards,
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Avatar_m_tn
Actually, i had glare in the same situation (watching my flat screen tv) and only with that (both after cataract surgery with full monovision and after the lasik touch up change to mini-monovision)....

But the glare was worse before the touch up change and the picture on the tv was not as clear...it was hard to watch for me where as now it is not...

Also, the computer screen was clear but not sharp before the touch up, after the touch up, very sharp!

I do have to read further away then i did before (several inches) that was the only sacrifice i made going from full monovision to mini, but i feel it was worth it to get the extra sharpness in mid and distance...

I have a 32 inch tv but when i went to a friend;s house that has a bigger set (50") i didn't notice any glare on the tv...

I'll probably have to experiment with lighting in my apt to see if perhaps turning certain ones off reduce the screen glare...but the glare may be improving on it's own, at least it seems that way to me...

To answer the other questions:  After the cataract surgery, my reading/intermediate vision capability was mostly there after just the first few days...though i think it improved a bit after i was able to stop use the medication eye drops...

And after the lasik touch up, the differences i noted when just a day or two i would say, but after lasik it seems to continue to improve as time goes along...depending on how your eye(s) heal after lasik, it could take up to a few months before you reach the maximum vision i think but for the most part, you notice the difference in just a day or two...



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Avatar_m_tn
Thanks for the info

One more thing, since using mono-vision we are using one eye for intermediate/nar vision and one eye for distance, so when we are focusing on distance and when we are focusing on intermediate/near, is it normal for eye to see things from the start or do u have to develop habit to look accordingly ? What I meant is will there be any habit/training we need to develop to look accordingly ? since both eye is looking at same object, where one eye can see clearly and other can not based on the distance from the object, but will combined image is good enough for brain to interpret and see image from the start ?

-Thanks
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Avatar_m_tn
No problem....It's automatic...the brain fuses the two images together...some have the impression that with monovision and mini monovision you are seeing out of one eye or the other (depending on the distance)  that is not really the case...both eyes are working together and the brain sorts out the best image from the two...

But it does take a while to get use to it...also try not to do a/b comparisons closing one eye or the other...i was doing that for awhile but realized that i would adopt faster if i didn't do that (lol)!

The less the amount of monovision of course, the quicker it is to adapt to it...in the case of mini, it shouldn't take long at all...

Let us know how you make out...
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Avatar_m_tn
Thanks
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Avatar_m_tn
Hello,

So today I got test contact lens to create mini monovision, with difference of  -1.50 in my left eye compare to the power of  that eye. My left eye has
Power of -5.5, instead we got trial contact lens of -4.0, to create mini mono vision for -1.5. We can still adjust power of contact lens in order to come get best mini mono vision I would like and then we will use that power to test min monovisin for few months.

So it seems to be working fine, except that some of the characters in some text looks mixed up(meaning, not much space between them) when viewed with the both eyes, but when I look via left eye only, it seems fine,
so I am assuming it will get better over time to get the same vision with both eye opened as I am getting it with only left eye opened ( left eye has mini mono vision), is this true ?

-Thanks,
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Avatar_m_tn
Hello Craig10x,

I have few questions, during trial period of mini mono vision with my contact lens in my left eye set with -1.5D since past 5 days

1>I am not getting clear reading vision, it seems fuzzy after reading for more than 5 minutes, If I use readers, I can read clearly for long time so if I increase from -1.5D to -1.75D will I get better reading vision ?

2>Will this increase to -1.75D will decrease my intermediate range, so I may need glasses for computer work, based on the ditance from computers ?

3>Should I expect more clear vision in reading after few more days with -1.5D or this is pretty much I should expect for reading

Have a Great Holidays!

-Regards
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Avatar_m_tn
Hi again!  So you are in your experiment phase now (like i did with the glasses) lol...

Well, if you increase to -1.75 it might improve the reading slightly but it will also take a bit away from distance/midrange....

Remember, i started with -2.25 and though i could read close, it wasn't super sharp even then, and i was sacrificing too much in the midrange and distance, i found...

When i went to -1.50 i do see the page sharper to read, but then i have to hold it further back now (several inches) but my distance and mid range (which includes computer) is much better now...

Keep in mind, mini-monovision is slanted toward better distance and midrange and really for reading, it is really for brief reading, like seeing menus in restaurants, groceries on your supermarket shelf, signing credit card slips, reading your mail, you know...LIGHT READING....

It allows you to escape your glasses likfe for 90% of your activities...for extended reading, even I would need to pop on my (weak) readers (i use +1.25 for that)...

Think about it....90% of your activity is done in distance and mid range....Reading is generally the smallest activity of what most people do all day and night...

Personally, i wouldn't recommend going for more then -1.50 diopters for your non-dominant eye...

Also, it takes some time to adjust to monovision (even mini) but don't expect to be able to read a novel without any reading glasses...ain't going to happen!
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Avatar_m_tn
By the way, i noticed you asked the doctor in your other post about crystalens...i don't believe you can get them in toric...also, it isn't such a great idea to mix lenses anyway (one monofocal and one multifocal) and if you look through the theads you will see many who have had problems with multifocals and also the crystalens as well and ended up having them exchanged for monofocals...

You may not get the results you are seeking with that lens...sounds like you are trying to achieve perfection, which is not possible with this technology...

Also, keep in mind that even though the cataract isn't fully developed in your non dominate eye as of yet, it could be detracting from what you are seeing with your "experiment contact lens"....

Again, the choice really comes down to either having both eyes set to 20/20 and end up wearing readers around your neck (or carrying in your pocket) all the time to see anything that is closer then arm's length or
doing mini-monovision and get very good distance and mid range (which includes computer viewing) and light reading without the readers...

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Avatar_m_tn
Hello Craig10x,

Thanks for replying based on my reply to the Dr

Since Dr was suggesting crystalens, I thought it might be a good idea to matche with Toric to get more reading/intermediate range without sacrifying sharpness using crystalens in my left eye  ?

I know Toric crystalens is not available, so was wandering if that is something in the future developement, so may be I can wait as I do not have much cataract developed in my left eye, provided this match works out good

I did not understand your comment - Also, keep in mind that even though the cataract isn't fully developed in your non dominate eye as of yet, it could be detracting from what you are seeing with your "experiment contact lens"....

What you meant by that ? Can you please explain. Using contact lens for mini mono vision, I am able to works on computer and can also read menus and so on, which I can't do without contact lens. But I am not able to read iphone mail msg for longer than 5 minute, but I can do that, when I read some documents.

I am happy with my current intermediate/reading range but if possible would love to get little shapness and better reading range, and so I thought of using Toric crystalens when available ?

Also even if my cataract is not fully developed (very little), I can still go-with removing it and replace with IOL, isn't that correct ?

Again thanks for your concern and I really appericiate it

-Regards
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Avatar_m_tn
No problem, you are quite welcome...i can understand what you are going through since i have already been through it...

Well, i just meant that it isn't possible to get everything perfect...if you maximize reading (by going to higher diopters) then you sacrifice too much from distance and midrange...so there is ALWAYS going to be some "trade-off"...

And since you have somewhat of a cataract already in the eye you are trying the contact with, it could be taking away a bit from what it will REALLY be like after the lens is replaced and the cataract is completely gone...In other words: it may be even BETTER then what you see right now...

For most people, distance and midrange are the priority, so that is why mini monovision is usually the best compromise....it still allows reading of mail, menus in restaurant, looking at your shopping list, reading labels on grocery items, etc, pretty well...I get tired if i tried to do extended reading also...so, when i do, i put on the weak "readers" and that solves the problem!

I wouldn't wait, if i were you....my other eye didn't have a fully developed cataract yet, either, but in fact i had my done just 4 days later...I wanted to get my eyes "in synch" as it were...and YES you do NOT have to wait until the cataract is fully developed to have the iol replacement for it...

Better to have your eyes "match" with the same type of lens that you have now, then wait for possible future technology developments...Things might get thrown "off balance" if you mix as you are suggesting...that would be my advice, based on my own personal experience...It's best to try to avoid potential problems...

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Avatar_m_tn
Hello Craig10x,

Happy New Year!

I am been using contact lens in my left eye with -1.5, it seems -1.5 is working out better than -1.25. So with mini mono vision is working out for me.

However, what I have noticed that when I am using -1.5, when looking through both eyes, Yes, I can read, but not as clear/sharp as I can see with only left eye(one with contact lens) open, is this normal ? are you suppose to see image clear/sharp with one eye or both eye to the same degree ? or do we loose some sharpness due to mini mono vision ?

your response will be appericiated.

-Regards,

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Avatar_m_tn
Hi! Welcome back and Happy New Year to you too...

Yeah, you do lose some sharpness due to mini-monovision (when using both eyes) when it comes to reading...you will probably find that if you hold the page a bit further back it gets sharper, as opposed to closer where you may get a slight blur...that sounds pretty normal to me...

I find that it works very well and frees me from glasses about 95% of the time...If you have both eyes corrected to 20/20 you would be carrying around readers with you all the time and using them a LOT...with mini-monovision, you avoid that...

I find it (mini monovision) works out well for light reading, but if i was going to do heavy reading (say, reading a book or a couple of magazine articles) i'd want to pop on my light readers for that...i use the weakest ones for reading, which are about +1.25)...you may want to do the same...

Computer i can do for hours with no problem at all...and no readers...
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Avatar_m_tn
By the way, by light reading, i mean like the routine stuff you do throughout the day (both inside and outside) such as writing notes, reading the mail, signing a credit card receipt, looking at your tv's remote control, looking at a restaurant menu, etc etc etc...

With mini monovision you can do all that without readers, with full 20/20 correction in both eyes, you would need to pop on the readers for all those types of things...which is a real pain in the you know what...

Actually, i am not a heavy reader these days...i do most of my reading on the computer screen and those various light reading activities as i outlined above, so it is fairly rare that i actually wear my (light) readers...

But if you like to do a lot of book and magazine reading, you may will find that the light readers will make it more comfortable and less straining...
Still, you won't have to lug around reading glasses every place you go!
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Avatar_m_tn
Unfortunately, I had my dominant right eye under corrected for mini monovision and it has taken me a long time to adjust. I wear glasses nearly all the time for crisp vision--whether distance or reading. I wonder if I would have better results if my dominat right eye was corrected for distance my left eye undercorrected. I could have lasik to bring both eyes to 20/20, but then I would need reading glasses all the time even for the light reading mentioned above. I am not sure what I am going to do---any suggestions? Thanks!
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Avatar_m_tn
It might help if they can do a lasik touchup to get your dominant eye to 20/20.
What is your non-dominant eye corrected to?

My doctor hit the target of 20/20 in my dominant eye, and originally my non dominant was -2.25 (full monovision) which i really did not like so had lasik touch up which brought it up to -1.0 diopters...

It is much better now but any mini monovision will not be perfect in all ranges...I see very good in distance but it isn't always razor sharp unless i would put on my glasses that correct me to 20/20 in that eye...
Same goes for TV and Movie Watching...

My reading is pretty sharp but i do have to hold the page about 12 inches away...and it is fine for light reading but for long reading i need to put on my readers as it does get tiring after a while...Computer distance is very good i find...

So, the only way to get razor sharp type of distance is 20/20 in both eyes and then of course, you need readers for anything close...

As you can see, it's always some kind of compromise no matter which way you go...i know it's a bit frustrating as we would like to have it all but that doesn't seem possible with the current technology, unfortunately...
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Avatar_f_tn
Hi Craig! I just have a question for you regarding your up close vision with the "mini mono distance bias" you have. When you look at something near you - lets say you are in your bed and you have a nightstand right next to you (I.e- close to you)... Are the items on that nightstand blurry or just not very "sharp"? I'm trying to figure out what to go with because I am only 30 and will need cataract surgery sometime in the future (I'm praying they don't progress quickly but since diagnosis almost 2 months ago my RX has doubled already) so.. I am just wondering how your "close" up close Vision is. I am afraid to do distance because I think it will be weird to look at something right near me and have it be very blurry... But having distance vision is nice too. Lol I can stand it if the items near you are just a bit fuzzy but not full on blurry and look like just shapes. Thanks for any help or advice!!
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Avatar_m_tn
Hi Sara! Doing an a/b comparison of how it would be if i were 20/20 in both eyes (as opposed to 20/20 in dominant and -1.0 diopters nearsighted in non dominant as i am) which i can do by putting on the distance corrective glasses, i can tell you that close stuff is much better with the mini monovision...i can get fairly close to something before it gets completely blurry...not so with full correction...

There is no question, it's easier to do close activities with "mini" then with 20/20 in both eyes...things are sharp down to about 1 foot...where as the other way the same items would have to be at least 2 feet away or more...

Even say, cutting my fingernails i can do without readers (though i have to hold my hands a bit further away then normal....I can get close to my nightstand's digital clock to about 6 inches before it starts to get real blurry (lol)....I can look down at the food on my plate and it's pretty darn clear...not so with 20/20 in both eyes...

Again, the sacrifice on the other end (distance) is things often could use a tad more sharpness...oh, it's very clear, just not always "razor sharp" depending on the distance...

But as far as compromises go, i think "mini" is FAR BETTER then FULL MONOVISION because that sacrifices too much from distance and mid range...i prefer the Mini even though it requires me holding things further away then i did before...

But i digress...lol  To answer you main question, with "mini" when i am in bed and looking at the night stand everything on it is VERY SHARP...
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Avatar_f_tn
Oh thank you so much for your reply!! I appreciate it. You're so helpful! These are such big decisions and it's so hard to finally say, ok make my vision "this"... Especially if you didnt have vision problems prior to this and never had to worry about glasses or contacts. I hate to wake up and feel like I NEED to put my glasses or contacts in before I can even check the clock.
     I'm considering doing the mini mono with a "near" bias. I'm hoping someone with that set up posts at some point. I'm curious to know how bad the distance vision is with that option. It seems like what you have is pretty great since you can see food on your plate, the clock til about 6 inches before it blurs out, etc. that would be ok for me I think.. I'm just worried I wouldn't have such a fantastic outcome like you've had!
     Again, I thank you for your response! :) I'm happy that you've got such a great result and it gives hope to us who are about to go through it!
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Avatar_m_tn
You are very welcome, Sara...i am glad to be of help...my general feeling (based on my experience) is that the best way to go is mini monovision with dominant eye corrected to 20/20 and with non dominant eye at -1.0 diopters (not more then about -1.25 diopters)...other then that, i would say 20/20 in both eyes and reading glasses for close...

The way i am, it keeps you out of glasses about 90% of the time...
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Avatar_m_tn
Hi Craig,

I have all your excellent comments and advice in the thread. I had cataract surgery in Jan 14 in my left eye which is non-dominant eye. Surgeon has set this left eye for 20/20 vision and I am getting very good distance vision, except that I get "diagonal light streak" when I look at car head light or bulb.

Since my non-dominant eye is already set for 20/20, I wish to go for mini mono vision in right eye (dominant) when I decide to go for surgery in near future.

Is it alright to go for mini mono vision in dominant eye from the point of view of how long my eye / brain will take to adjust with incorrect combination (mini mono vision in dominant and 20/20 in non-dominant). I am strongly myopic - minus 7.5 since the age of 15 - and am now 55 years of age. and I wish to go for mini mono vision to avoid being almost blind for near without glasses. Most of my time in office is at computer being in IT industry.

Thanks in advance for your thoughts ..
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