Recently Had Modified Monovision

[Craig10x]

Hi...

I'm new to the community...I had cataracts in both eyes (i am 61 yrs old) and just recently had Cataract Surgery..
The doctor used Alcon Acry-Sof Aspheric Toric monovision lenses and had told me about doing Modified Monovision (Dominant eye set for 20-20 vision and non dominant eye i believe was set at around 20-125 to cover mid range and close vision)...He explained that most of his patients get that and are very satisfied because it minimizes the need for reading glasses..

I just had the two eyes done within the last 2 weeks (dominant eye then non-dominant just several days later)...
I like that i can see mid range to close without reading glasses (which i realize wouldn't be so if i had gotten both eyes set to distance)...
  
What i have been noticing is that things seem a bit blurry...not only at distance but mid and close as well...
Even when watching TV, which is a 32" lcd tv that i am only about 6 to feet away from) it is pretty clear but has a slight blur to it (when looking through both eyes as compared to just the distance eye)...
  
My doctor at the follow ups says i am doing fine...no apparent problems...
  
My questions: will things likely get more crisp and sharp as time goes by?   If so, usually about how long?
Also, it seems like the brain blends both eyes together...the brain doesn't actually switch from one eye to the other,
So, if that is the case, how will it get sharper?
    
Thanks in advance for all feedback!  

[JodieJ]

The truth is that (mini) monovision involves compromise.  With only one eye set for best distance vision, distance vision is NEVER quite as it would be if both eyes were set for best distance vision.  For most people, the slight loss of acuity is more than compensated for by the wider range of focus.  If you can read the 20/20 line with both eyes, that's an excellent result.

[Craig10x]

Hi again JodieJ and everyone again...I had been to the eye doctor's office yesterday...

His opthmologist that examined me told me that i was healing very nicely...
I did ask what the left eye had been corrected to, and she told me it was actually 20/100 (right eye to 20/20 of course)...

My combined vision is 20/20 and for the reading test, with the chart held at a distance that was comfortable for me (about 1 foot at this point) i could read all lines on it without difficulty...

I did ask her about my concern that using the combined vision it wasn't quite a sharp as it is just looking through the right eye (particularly at distance) and she essentially confirmed what it said in that article
excerpt i posted in my last post...

She said, everyone heals differently and she said it will probably take some more time and also that the brain needs time to make the full adjustment to obtain the "optimal vision"....

It is really only a very small difference at this point (in the combined) but hopefully eventually i will see that "tad" extra sharpness within the next few weeks or so...i guess i needed to be more patient...

But please don't discourage people who post as i do (with the modified monovision) if they post similar concerns...it is not necessarily true that what you see within a day or two of the operations is what you will always see...

it can and actually should continue to get better as time goes by and that process can take anywhere from two weeks to perhaps as much as even a month or two depending on the individual, his healing and brain adjustment rate...

So i am still hopeful yet...and by the way, i will follow up here on my progress...

[Craig10x]

Thank you JodieJ...i will definitely do that...I should have some interesting questions now to ask him at our follow up this coming week...

Overall, it is actually working pretty well for all purposes (distance/mid/close) it is just the bit of blurriness (or lack of sharpness) in certain instances that i was hoping would improve as time goes on...

Until i get back here with an update, i thought you (and everyone here) might find the excerpt from a medical article i read yesterday online about what to expect after cataract surgery when having either monovision or min-monovision done. (reading articles like this gave me encouragement that i might yet see a further improvement that will leave me even more satisfied)....here it is:

After a week of taking it easy, your doctor will probably tell you to do as much as possible to challenge your eyes and brain to work together at all distances with your new lens. You will be adjusting for a while and may feel a little frustrated at times. This is normal.
Two weeks after surgery, if you are like most who have lens replacement surgery, you will be delighted at the great improvement in your vision. However, when any part of the eye undergoes a change, the brain needs to adjust to help us obtain our optimal vision.
After two months, your brain and eyes will have largely learned how to work together, and between two to four months after surgery, your vision should be nearly optimal.
During the first few months, continue to challenge your vision. Check with your doctor if you have any questions about whether what you are experiencing is normal.

[JodieJ]

There is one additional point that might help you understand why you are having the vision problems you describe.  IOL power predictions are based on formulas derived from averages, and the results aren't always consistent with the predictions.  Although your doctor targeted plano (20/20) for your right eye and -1.25 for your left eye, your post-surgery acuity might end up off-target.  Even the most skilled surgeon doesn't always hit the target.  Please re-read the quote you posted above from Dr. Kutryb's blog about mini-monovision. ("There is one caveat with this technique and that is that it is crucial to get the first or distance eye as clear as possible for distance.  If it is a little off for distance, then I am occasionally forced to make the second eye for distance as well since these patients usually have distance vision as a main priority.")

I strongly suspect that your right eye is a little off target.  If this were the case, you could either wear progressive glasses or consider having a LASIK touch-up (either to achieve a good mini-monovision result or to correct your left eye for distance.)  Possibly an IOL exchange would also be an option.  

Keep us posted.

[Craig10x]

JodieJ....The opthomologist in his office that does the follow up eye exam for him (which he reviews and does some checking himself right after it with me) told me that last time...I was supposed to do my 1 week follow up last week but was unable to... however i will be seeing them this coming tuesday, and hope to get clarification on that as well as my overall view on the results so far...

I will post back here after i see him with a hopefully better "picture" of the situation...

By the way, i really appreciate your feedback as well as the others here...

[JodieJ]

Craig, in a previous post you stated that your acuity in your right (dominant) eye is 20/25.  Is this really the case?  If so, then your doctor did NOT get optimal vision in your dominant eye.  (I suspect that this is the real basis for your dissatisfaction.  Possibly your right eye is a little farsighted.)

You also stated that your acuity with both eyes is 20/20.  This is what excellent mini-monovision results should be, but it does not seem to the case for you based on your complaints.  What is your acuity with both eyes?  20/25?  20/30?

Keep in mind that with mini-monovision, neither eye is set for good near vision.