Cataract in One Eye and Near-sighted

[rizzobr]

I am 55 years old.  I am very near-sighted (about a -5.00) and I wear glasses.  I have a cataract in the right eye only.  I need to have cataract surgery on the right eye.  I am planning to get a mono focal lense.  Since I am only having surgery in one eye, I have to make a choice.  If the surgeon inserts a lens set for distance in the right eye, then the difference between the two eyes is quite different.  I would have to wear a contact in the left eye.  And then still wear glasses for reading.

The other alternative is for the surgeon to insert a lens that makes me somewhat near sighted in the right eye so that the difference between the two eyes is not too significant and then I can just wear glasses like normal.    

What can you tell me about the pros and cons of each alternative.  What should I do?

[John C Hagan III, MD, FACS]

If you eye is set for relative good reading post surgery say -2.50 you will still have 2.5 diopters of unequal refractive error and may still need to wear a contact on the unoperatied eye.

You should ask yourself if it would make you reallly happy to be able to drive and see far away without glasses. If the answer is year then go for good distance correction.

You likely will develop a cataract in the other eye someday (usually not too far down the road). Or you can always have lasik on the unoperated eye to balance them if the contact does'nt work out.

JCH MD

[JodieJ]

I was in a situation similar to yours when I developed a cataract in one eye following retinal surgery.  If you go to three different doctors, you might get three very different opinions.  Here's mine:

I think that targeting a power which would make your right eye moderately nearsighted would be a BIG mistake.  You would be passing up a chance to have good uncorrected vision.  As Dr. Hagan states, your options for your left eye would be a contact lens, LASIK, or a lens exchange (i.e., cataract surgery).  At age 55, you already have at least the beginnings of a cataract in that eye.  Perhaps your surgeon would be willing to do your left eye sooner rather than later.  My vision with aspheric monofocal IOLs is at least as good (probably better) than it was with my natural lenses.  

[2ndsight]

there is a discussion going on now on the Eye Care Community board about having one IOL and one contact lens. Most of us seem to do fine with this, there could be a little adjustment phase for you since you are used to glasses, but this way you might only need glasses for reading and other close up tasks.

[John C Hagan III, MD, FACS]

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[indi1664]

Hi,
     You have to think into future....at moment you have one cataract...fine...there is good likelihood at some latter stge you will develop cataract in LE....
Therefore you have few chioces...like Jodie J and doctors I would opt for monofocal blended vision...this usually has the highest safe outcome...as dr Hagan has pointed out in other posts ...if your surgeon can acheive...-0.25 and -1.25 ...you will be very very happy...almost not needing glasses atall ...acccept ..possibly for  reading tiny writing...and possibly for driving...

I really would say target for this rather than balancing you current prescription and wearing glasses....

Also please read mine and other  posts with regard to wearing contact lens on non operated eye as i have had surgery on both my Eyes and I was -20 (both eyes)...

This topic will also help..

http://www.medhelp.org/posts/show/566325?post_id=post_3143337

Good Luck

[John C Hagan III, MD, FACS]

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[rizzobr]

Thank-you Dr. Hagan for your response.  And thanks to all the others who have responded.  Your responses are helping me to arrive at a decision.  I had visited an opthamologist who was an expert at cataracts.  After my appointment with him, my initial plan had been to go for the good distance correction in the right eye and wear the contact in the left.  However, when I talked to my optometrist about getting a contact lens for the left eye, he tried to talk me out of it.  He didn't think that I should "frog around" with the contact in the left eye.  He sent me to another opthamologist who recommended the near sighted solution too.  Just like JodieJ said "If you go to three different doctors, you might get three very different opinions."

[John C Hagan III, MD, FACS]

No the saying is "if you go to three different doctors, you'll likely get four different opinions"

JCH MD

[2ndsight]

I apologize in advance for bringing this up but isn't your optometrist the one you BUY your glasses from ($$$) - ?

[John C Hagan III, MD, FACS]

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