Experiment Advice

[NeLso]

Just  quick question to our board doctors.  (or to those who know)

I am trying to simulate what I might expect after surgery to get a better idea of what I can live with and what I can't.

One is to try out multi-focal CTL's a try to experience the glare and halo typical of multi-focal IOL's.
The other is to experience a complete loss of accomodation.  (mono-focal IOL).

Question:  If I wear negative diopter glasses set slightly too strong, does that mean
I must use my accomodation ability to focus on distant objects?  If this is true, would it also be
true that as the strength increases, there will be a point where I can no longer accomodate to see
in the distance?  This would be the point where I have no accomodation (ie. monofocal) and thus
I should be able to get a feel for just how blurry my near vision will be?  (after IOL correction to plano)
Aside from the headache, would this approximate my near vision after surgery?

Thanks in advance!  As you can tell, I am not sure if halos, glare and wax is a better alternative to
losing near vision.

[Harold14370]

I don't know how to simulate no accommodation, but I can tell you what it is like for me.

I have progressive lenses but they are nearly useless for working on a computer. There is one part of the lens where the screen is in focus, the rest is out of focus, so I can read about one line on the screen at a time.

I have found that a pair of 1.5 diopter reading glasses placed in front of the distance prescription of my progressives allows me to work on the computer. So I think next I will get a dedicated pair of computer glasses.

My reading prescription is ADD 2.25. This allows me to read a newspaper but isn't really strong enough to read any kind of fine print. However anything much stronger in a progressive lens, and I think it would be like a funhouse mirror effect. Too much distortion going from plano to the stronger reading prescription in one lens.

So, my plan will be to get the optometrist to prescribe a pair of computer/reading glasses with 1.5 or 1.75 diopters added in the top part of the lens, and about 3.5 in the bottom. Maybe this could be progressive, or maybe just bifocals. Not sure what will work best.

[Ray T Oyakawa, MD]

Unfortunately, most patients do not tolerate multifocal contacts.  There is no way to simulate accommodate.

Do not use the bifocal part of your glasses to get an idea of no near vision.  Or get contacts for distance and see how you like the loss of near vision.

Most patient who use only readers have many pairs all over the house.  Not being able to see near is a real pain.

Dr. O.