Question: I'm now contemplating cataract surgery and have decided that I want mini-Monovision, rather than multifocal lens implants. I would also not like to have a big correction disparity between each eye - e.g., maximum 1.25 D. My goal is to attain very good vision for the following kinds of "near-intermediate" activities: Sitting at a table playing cards, shaving, seeing the dashboard of my car, searching through drawers, looking at my cell phone, reading a menu, walking down the aisle of a market, and reading the labels on cans (at least the larger type). As a trade-off for very good "near-intermediate" vision, I would be willing to sacrifice some sharpness in distance vision - perhaps 20/40? Here's my thinking: It seems that if I was corrected for very good "near-intermediate," I could probably go without glasses about 90% of the time --needing them only for really sharp distance (e.g., driving, tennis), and readers for the fine print. My questions are: Is it possible to get the type of good near-intermediate vision I'm seeking, and still be 20/40 for distance? If so, what would your target correction be (with a maximum of 1.25 D difference between the eyes)?
Answer: First, you are asking the right questions to help you identify the most acceptable choices and compromises for your vision correction after Cataract Surgery. Monovision Cataract Surgery requires careful measurement of the near and intermediate working distances your desire clarity for as well as identifying the specific tasks. While you have identified the tasks, the actual working distances of those tasks can vary greatly by your personal physical stature and size. For example if you are 5'4'' tall with medium length arms you will require different working distances than someone 6'2" tall with long arms. Next, the achievement of the results you are requesting could also depend on several other factors including but not limited to the type of Lens Implant to be used and whether it is a spherical or aspheric design, your pupil size as this contributes to your ultimate depth of focus, the amount and type of spherical aberration in your eye as well as your overall tolerance and threshold to "defocus." Now, in order to consider these factors, if you have not already done so, it would be wise to be sure that you had a complete refractive Monovision evaluation as part of your Cataract consultation at which time detailed measurements could be taken and analyzed AND it might be possible to provide you with trial contacts to demonstrate the defocus and working distances that could be achieved. This kind of trial will really depend on the degree of cataract formation you presently have. In general, the scenario you describe is achievable but does require careful measurement and testing in order to select a proper target correction-AND may require specialized testing for the actual Lens Implant selection. To obtain this level of testing and precision we would suggest you choose an eye surgeon who is both a Cataract Surgeon and a Refractive Surgeon and thus fully equipped to deal with the precision of the measurements and the testing required to achieve your personal goals here.
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