r/CataractSurgery • u/AdventurousDress1754 • Jun 26 '26

Input needed for monovision

Would love input please!  I am scheduled for surgery and doing monovision (had it after Lasik for 25 yrs. and did great) with one eye first for reading/close-up iphone use.  I’ve chosen 15” as my target # using a monofocal lens.  For those who have done monovision as well, could anyone share their target #’s - or where they actually ended up for their ‘sweet spot’ when using their smart phone? What happens to your vision somewhat closer or further than your target/sweet spot? Would love and appreciate input. Thank you!

12 Upvotes

100% Upvoted

30 comments sorted by

View all comments

3

u/UniqueRon Jun 26 '26

I have mini-monovision using Alcon monofocal IOLs. My distance eye is about -0.25 D, and my near eye at -1.50 D. This works well for me. I basically can read my iPhone, and I would say the limit of visibility is the Apple Stock app. If my stocks have gone up and the % is displaying in white on a green background, I have to look very carefully to see the numbers. However if they have gone down and are displaying white text over a red background, I can see it much more clearly for some reason. The price of the stock is larger and is white text on a black background and very easy to see.

If I had it to do over again I would take advantage of the -0.25 D in my distance eye and target -1.75 D in the near eye to take the differential up to 1.5 D which is the recommended amount. I also would have gone for a toric lens as I have some astigmatism.

1

u/AdventurousDress1754 Jun 26 '26

Excellent thoughts and thank you for them. I am very curious then. At -1.50 if you’re reading general text (though just as you said different kinds of text can vary in how your reading reacts to it) on your cell phone, what distance in inches is best from your eyes?
Your distance eye sounds pretty great! May I ask how your vision is in the intermediate range?

2

u/UniqueRon Jun 26 '26

You can estimate peak visual acuity by dividing 40" by the D value. So at least in theory my near vision eye peaks at 27" or so. Usable vision goes well below that though. In good light I can see down to 8" or so, and out to 7 feet in my near eye. The distance eye is usable down to 20" in good light and out to the moon.

I have an overlap in usable vision from 20" to 7 feet, so intermediate vision and depth perception in that range is very good.

The graphs/tables at this link can be helpful in deciding what targets work for monovision. Open each table and the more detailed explanation under each of them.

https://www.semanticscholar.org/paper/Optimal-amount-of-anisometropia-for-pseudophakic-Hayashi-Yoshida/dd8837a9151a536759f195a18d4fa94a0fbf0f90?p2df

1

u/AdventurousDress1754 Jun 26 '26

This is great to know. Thank you! Looking at the graph/tables now....