27 yo., considering cataract surgery in one eye, with chronic iritis

[himenges]

I'm 27 and have chronic uveitis in my left eye for years. They have found no underlying systemic cause--it's a mystery. Methotrexate didn't work for me. The thing I do respond to is Predforte, but it's giving me a cataract. My question has to do with having cataract surgery: my left eye is -4, and my right (good) eye is -6.75. I know that the lens implant can either be set for distance vision or near-sighted vision, but not both. I don't plan on having surgery in my good eye--why risk it?--so I am inclined to have my eye surgeon leave my left eye where it is now, ie, at -4, extremeley nearsighted. That way, I'll still have to wear contacts or glasses, but I'd have to do that anyways. And this way my eyes won't be so different as to give me double-vision. The idea of wearingn a contact in just one eye (my right, good eye) seems silly because I am so incredily myopic in that eye, I could never take it out. And I don't think they design glasses where each lens could be so radically different if I did have the left eye set for distance vision.

So: my optho. says this is a crazy idea to stay so near-sighted. I'm very confused about all of this. Any advice would be helpful, especially from folks who have been in the same situation with having two very myopic eyes, but only needing surgery in one.

[londonbridge]

I have one eye with an IOL corrected for mid distance and one "good" eye with a minor cataract, that I am leaving for now that is. -8.00.  I do need to wear my contact lens pretty much all of the time in order to see and I have not been able to wear glasses due to the discrepency in my eyes when my contact is out. I do have one pair of glasses with one lens blurred out for around the house, not great for driving. I do like the freedom from wearing glasses most of the time, except for reading. So it is a personal choice between staying nearsighted and having dependable glasses or the contact lens. It would be important to know if you can tolerate wearing contacts, if you go that route. I also think your plan makes sense and people should do what works best for them as long as the clinical judgement is sound, which based on the doctor above, it is.
Good luck.

[Michael J Kutryb, MD]

Please remember I am not your doctor and am not giving advice to you in particular. So always consult with your own surgeon.  I have been performing cataract surgery every week for the past 15 years and I have a deep interest in customizing the surgery for my patients and listen to them quite a bit.  In this situation, your intuition is quite good.  There are worse things in the world than being nearsighted.  The option of having to wear a contact in the other eye has its own risks and annoyances, so your chosen option is a very legitimate one.  Perhaps you should seek a second opinion.  I have no problem with your desire to remain nearsighted in order to retain your refractive balance.

MJK MD