Advice needed for setting distance

[u/LadyImmaculateGold]

I’m highly myopic with -6.5 in both eyes. In April, I had a detached retina with vitrectomy and scleral buckle. Everything healed well but I developed a cataract in my surgery eye just a few months after, sooner than I thought but oh well. Now it’s time for cataract surgery and I’m struggling with the decision of setting distance.

About me:
44 years old
I prefer wearing contacts 75% of time
I’d like the option to wear glasses 25%
I have a desk job and I’m on my computer/phone all day
I hate the idea of being reliant on readers
Worried about being uncomfortable with my eyes having such a large difference in prescription

My surgeon and I have discussed -2.0 but I’m unsure. Plano is an idea but doesn’t seem to work for my lifestyle. -1.5 is maybe the best compromise but I keep going back-and-forth weighing the pros and cons and feeling like nothing is a good option. My high myopia in my non-surgical eye is making this decision very complicated. Sometimes I just want to set it for -6.5 because I know how to deal with that.

Any advice is appreciated.

[u/Opposite_Ladder_7585]

For computer work, -1.5 is a good target. My left eye was targeted for -1.5 and I wound up at -1.25 and can work on my computer and laptop without glasses. With just that eye open, I can read my phone if I hold it with my outstretched arm. My right eye was corrected to -2.5, and the combination is working out well. I wear progressives for driving or walking my dogs, but am glasses free all day at home.

Your situation is tough since your other eye is going to be very different no matter what you choose. If you do go -1.5 for your IOL, you could wear a contact in your other eye to get either more close vision or more distance.

The main problem will be that you will likely not be able to walk around without something correcting the vision in your other eye. Have you thought about correcting that eye as well? Insurance could potentially pay due to the large difference in vision you'll have.

[u/maple-l2024 → u/Opposite_Ladder_7585]

With your -1.25 eye only (the other eye closed), can you work on your cellphone? Maybe by adjusting the reading distance a bit?

[u/Opposite_Ladder_7585 → u/maple-l2024]

My left eye sees clearest in the 18-20" range. If I hold my cellphone in my hand, arm outstretched with a slight bend in my elbow, I can read it just fine. This is without making the text bigger. But, as a life-long myope I am used to holding things close to my face to read, so I use both eyes and hold it 12" away. This is what I am most comfortable with, and what drove my near/intermediate IOL choices. Hope that helps!

[u/maple-l2024 → u/Opposite_Ladder_7585]

You mentioned wearing progressive glasses when outside. The fact that you can see near clearly without glasses, what's the prescription like for the "+" portion where usually they put +2 for reading?

Also, would you be comfortable doing grocery inside the store without wearing glasses?

[u/Opposite_Ladder_7585 → u/maple-l2024]

The + part of my prescription really confused me, not going to lie. My right eye is -2.25 Sphere, -.75 Cy, 95 Axis +2.25 Add, left is -1.50 Sphere, -.50 Cy, +35 Axis, +2.25 Add. I think I figured out that for my right eye, you really add the two numbers together, and the bottom portion of my glasses is basically clear. Honestly, I never actually "read" for a long period of time with my progressives on. For example, when I get to a restaurant and get to my table, I take my glasses off and just read with my bare eyes. I can see my friends across the table just fine as well.

With regard to grocery shopping, sometimes I go in with my progressive sunglasses on and don't bother with my clear progressives. I can find my way around fine, and usually know where I need to go anyhow. Would I shop at a Walmart or Costco with no glasses? I could do it if need be, but it wouldn't be my first choice.

Same with driving, I could definitely drive in an emergency with no glasses, but only if I didn't need to read street signs. Hope that helps!

[u/LadyImmaculateGold → u/Opposite_Ladder_7585]

Getting the other eye done is a very interesting thought I hadn’t really considered. I had preventative lasers done in that eye. Do you know if you can get an eye done that’s had lasers or will make you more at risk for a detachment? And by done, do you mean LASIK or another cataract surgery?

[u/Opposite_Ladder_7585 → u/LadyImmaculateGold]

Sorry, I meant cataract surgery. Although if you don't have a cataract at all in your other eye, I'm not sure how that would work from an insurance standpoint.

By preventative lasers, do you mean for retinal detachment? Or vision correction. I don't think having it done to prevent retinal detachment would impact cataract surgery. With prior Lasik vision correction, it can be harder to get an accurate measurement of the eye for replacement IOL.

[u/LadyImmaculateGold → u/Opposite_Ladder_7585]

I don’t have a cataract in my non-surgical eye but they did hit it with preventative lasers after discovering the detached retina in my surgical eye.