Caterac surgery

[gjfine1]

I had a detached retina fixed in my left eye that changed my vision from a - 6 to a - 11. My right eye is -4.5. The surgery left my left eye with a catarac. Things appear much smaller and further away and smaller to my left eye. What can be done to make this more even. Objects overlap  and I use one eye for most things.

[Anomalychick]

I rescind my previous statement. You have a cataract in that eye, I missed that part. Cataract surgery is going to be necessary soon and therefore you should not have lasik or ICL done. When they do the cataract surgery they will select an implant that matches the new size of your eye, which will eliminate the additional refractive error.  You will need to choose whether you want both eyes to be -4.5, or if you want one eye to be -4.5 and the other to be -3.00 or so, Or you can choose to make the cataract eye plano with the plan of wearing a contact or having some kind of refractive surgery on the eye without a cataract.
   Sounds like your aniesekonia issue will be temporary, so don't worry too much about whether or not you can adjust to glasses.

[Anomalychick]

    Slab off lenses are used to balance the reading portion of bifocals. It doesn't apply to single vision. If you don't need bifocals they're not something you would need. Even with iseikonic lenses, they can only balance the image size in the direct optical center of the lense. If you looked up down right or left, one image would still be much smaller than the other. You would need to learn to see by moving your head and neck instead of your eyes. High index iseikonic lenses "might" make them close enough together where you could learn to tolerate it.
      My eyes were left 2 1/2 diopters apart after cataract surgery and I cannot tolerate glasses at all, iseikonic high index or otherwise. They cause double vision and vomiting if I wear them long enough.
   Some people are born with their eyes very far apart and don't seem to be bothered by it all. One of my boyfriends eyes is a +5.50 and the other a +2.00 and his glasses don't bother him. My optometrist had another patient who was 0.00 and -6.00 and had no trouble with glasses. In my case considering I lived 30 years with no prescription needed at all in either eye, I just can't deal with it. I insist on wearing contacts ALL THE TIME and the 5 minutes I spend in the morning before I put them in and at night after I take them out are torturous with how much the difference between my eyes bothers me. It makes me dizzy and nauseous and causes a very uncomfortable pulling sensation.  I also have dry eyes which make me severely contact lens intolerant and I am terrified of refractive surgery so I am pretty much miserable all the time. I spend my life trying to avoid all activities that require having my eyes open because of the pain my contacts cause. (Which is impossible.)
     Since your problems are also surgically induced, I would expect the same and would hope you can tolerate contacts. Given the other eye problems you have had, more surgery should be a last resort. Lasik or PRK would result in a large imbalance on the amount of correction done on each eye. The slight visual defects that lasik can cause might be noticeable for you. (Having night vision difficulty in one eye only for example.) Also one of your eyes is out of range for lasik or PRK, which means you could only use to make your eyes the same prescription, and not to get out of glasses.
     Having cataract surgery causes the portion of your eye that the lens is in to shrink, which puts pressure on the vitreous and the retina. Assuming you can still accomodate, you'd lose your near and some of your intermediate vision as well, and would need reading glasses.
      An ICL might be an option for you, but I don't know enough about it's possible interference with preexisting retinal issues to speak intelligently on the matter.  

[SoftwareDeveloper]

I  seem to recall that they can usually address up to around 6 diopters or so difference using specially made glasses, and they might leave a little it of difference between the eyes if they can't correct it all. Each person's tolerance varies in terms of how much difference they can adapt to. There might be newer techniques that can deal with  a larger difference, I didn't delve into it too much when I checked into it a couple of years ago (I had an even larger difference between my eyes due to cataract, but especially since it  kept changing  I decided to stick to contacts and risk not having  backup glasses that worked for both eyes).

The prior post mentions iseikonic lens. To provide more keywords to search for, or ask about, the difference in prescriptions in your eyes is "anisometropia", and the problem of  unequal size images each eye receives due to the difference in prescriptions is called  "aniseikonia". One technique they use to make glasses that address the difference difference in lens prescriptions is called "slab off". (I've seen these terms mentioned more than "iseikonic lnes").

re: "The surgery left my left eye with a catarac."

What the prior two posts didn't ask about is whether that cataract is causing reduced vision enough to risk operating on it to take it out. I gather that the risks of surgery are higher after a detached retina so its likely best to postpone that as long as possible, but eventually it will need to be taken out. When they take out your natural lens, they replace it with an artificial lens (IOL=IntraOcular Lens) and the power of the lens will be set to try to give you good vision. They might try to target the eye to have a 0 refraction, or perhaps target it to be slightly myopic so there is less difference between your two eyes so it is easier to wear glasses afterwards if needed. Before I had my cataract cause trouble, at times I  had a 3D or 3.5D difference between the two eyes and was able to wear regular glasses  that didn't try to account for the difference (though contacts were better).

[flossy93]

I agree with wanlien3.  You should definitely try contact lenses, as they would basically eliminate the image size difference you perceive now.  

It is possible for eyeglass lenses to be made which can adjust the image sizes presented to the eye to be approximately equal. These are called iseikonic lenses. However, they apparently are rarely used and from a quick read it appears they can only correct for up to 3 diopters of differential, while you have 6.5 diopters of difference.

If you are not a candidate for contact lenses due to some issue on the front of the cornea, there are two other options.  You could try refractive surgery, although at -11D with a prior retina problem, you and your refractive surgeon would have to evaluate whether this was possible and safe.  

Another option is implantable contact lenses or refractive lens exchange.  If you have a cataract in your left eye now, you may soon be ready for cataract surgery in which the replacement lens will be calibrated to compensate for your -11D of nearsightedness.  If your cataract isn't bad enough yet that you are ready for the surgery, contact lenses would be a good interim option.  

Surgical vision correction such as implantable contacts or refractive lens exchange (which is basically cataract surgery before a cataract develops) is never preferable from a safety standpoint to regular contact lenses, for patients in which contacts can be tolerated.  There's a wider variety than ever of contacts on the market, so if you tried some a while back and they didn't work for you it's worth another trip through the demo lens aisle to see what's new and if something else can work for you.  Good luck!  

[wanlien3]

You should try contact lenses.

Full strength glasses will probably cause dizziness as the brain will find it difficult to fuse one normal size image and another which is much smaller. However, contact lenses do not give you this problem since they sit on the surface of your eye.