glasses after cataract surgery

[yatriwalli]

it is now three months after my first surgery and two months after the second. my vision decreased somewhat since the operation and i will be needing glasses. i am still taking eye drops for the swelling in one eye but i feel both are slightly swollen-as far as i know it would be the cornea? i doubt at this point it will impact my sight.

the implants are tecnis zm900. my right eye is one diopter more than the left i would say-i am getting conflicting results on eye tests. but it looks that way to me. my question is, what kind of prescription should i use in order to get the best clarity? the doctor does not know-what he prescribed for me was about a 2.5 in one eye and 3.5 in the other and added 2.5 for reading, and then sent me back to test how that worked out and i couldnt see a thing, so he said then dont use any glasses.

i found that a 2+ means i can read anything, though it looks like it is a bit musty. a +1 works well enough and i am  trying to use them instead. but when i tried added another number to the weaker eye i couldnt see as well.

in addition, however i see with only the left eye or with only the right eye is not as good as how i see with both eyes open. isnt that a bit odd? i am now using glasses for both computer and reading, sewing, cooking. but i can walk outside well without them. i dont know if i can see good in the distance or not because i dont know what is there so how would i know. but i dont trip any more when i walk like i used to and i dont have to look at my feet, so something has definitely happened.

so should i try to use the lowest prescription possible?
should i add another number to the right eye even though it feels better to use the same lens?
what will wearing glasses do to any advantage i have with the tecnis as far as contrast sensitivity and depth perception? they are more useful to me than acuity or clarity actually, it is very difficult getting along without them.

i am not wording my concerns properly, sorry. i m worried about putting a monocular glass over my supposedly multifocal lenses-will they become monocular then? i dont know if they have or not, dont know how to tell.

good luck anyone answering this, please do your best to understand.

[John C Hagan III, MD, FACS, FAAO]

Wear what you see best with and do not worry about weakening the eye.

JCHMD

[yatriwalli]

i have read that many people need reading glasses or computer glasses or distance glasses, but generally not for all distances, even after surgery and multifocal IOL. i dont mind that, it is a far cry from the 7+ i wore for a distance of 6 feet and the 9+ i wore for reading which even then was not adequate, plus i had no distance vision, no depth perception, no contrast sensitivity, no night vision, no figure ground perception, every other difficulty you can imagine. so i am not really complaining, just not sure what to do.

i already know another person who didnt have surgery and my doctor prescribed some glasses for him that were totally wrong. i can only hope the man is a good surgeon and a poor optometrist.

the bottom line is i am able to find my own proper prescription but i am not sure yet whether things will continue to change and what might make my chances better for getting the optimum out of the IOL i have. i had a good deal of trauma to the left eye and can only guess that is why the swelling is not yet contained. . i have also read that it can take up to a year for all the neurological adjustment to be complete.

if i dont wear any glasses i will have to stop reading except in bright sunlight. the computer can be adjusted for most tasks. but i dont think eyestrain is helping the swelling any either.

sorry, i should pin this down better. what the doctor prescribed was 2.5 in the left eye and 3.5  in the right eye for distance, but added another 2.5 to each eye for distance. he was going to give me a bifocal to wear over a multifocal IOL, which sounds a bit odd to me, but i assume only as a temporary help until the swelling is under control.  no matter what his reasoning was it was the wrong prescription altogether. perhaps he wanted me to do without wearing glasses until things have stabilized.

it seems to me that if i am using an IOL that is multifocal and one eye is 1 diopter better than the other they will learn to work together and there would be no need for correction at any distance in either eye by making one lens stronger than the other. i think they (lenses in any glasses i wear) should remain equal, otherwise how am i going to be able to switch from using reading glasses that make the correction to account for the difference in the two eyes and then look in the distance when i am not wearing glasses without that correction being there?

is it safe to just use what i know i can see best with and live with? should i err on the side of using less strength for the time being?

i may seek a second opinion in delhi or in america, i am going to be there from january 15 until march 3. at least to satisfy myself as to whether the surgery was performed properly. only i am not sure i would know who i can believe so it would only be money down the drain. it is a small problem compared to what other people have to worry about, i guess.

[John C Hagan III, MD, FACS, FAAO]

I agree with Jodie J. Plus wearing glasses over monofocal or multifocal IOLs will weaken or damage the IOL or the eye.

JCHMD

[JodieJ]

Yes, your post is very confusing.  If your doctor prescribed a +2.5 add for reading and a distance correction, too, then you probably don't have good acuity at any distance.  In other words, you paid good money for "premium" implants (Tecnis multifocal IOLs), and you're definitely not getting your money's worth from them.  Based on the information you posted, I suspect that your doctor doesn't know what to do to improve your vision.  SEE ANOTHER DOCTOR WHO IS EXPERIENCED WITH MULTIFOCALS FOR A SECOND OPINION.  (You might even need to a third opinion about what to do to improve your vision.)