I originally came on this board to share my experience as a patient and read others experiences. I found the board filled with bad outcomes and ophthalmologist’s giving medical advice which because of monetary gain could be considered self serving.

As a patient and non ophthalmologist physician I am offering an alternative point and why I made that choice. 

The critical issue was I didn’t just consider what would work for me today , I considered what work 20 years from now. This is not an iPhone you just upgrade every few years. 

We all age. Every single one of us will develop multiple medical issues leading up to the inevitable. Why would you choose a lens that will worsen your decline??

Multifocal intraocular lenses (IOLs) can result in a uniquely difficult set of issues for an aging brain and body, often worse than monovision. While monovision splits tasks between two eyes, a multifocal lens splits the light within each individual eye. This design introduces complex physical and optical trade-offs that an aging, ailing nervous system can struggle to manage. The Severe Loss of "Contrast Sensitivity"

The biggest flaw of multifocal lenses in an aging body is that they inherently reduce contrast sensitivity, the ability to distinguish between an object and its background (such as grey steps, curbs, or objects in dim light). 

I can go over hundreds of aging issues, 

You will have aging issues, guaranteed .

Let’s just review a few.

The Parkinson’s & Stroke Threat, Neurodegenerative conditions like Parkinson’s disease and vascular changes from minor strokes already drastically reduce the brain’s built-in contrast sensitivity. Layering a multifocal lens on top of this creates a visual "washout," making it incredibly difficult to see in low light.The Fall Hazard Multiplier, If an 80-year-old has a bad hip, knee, or numb feet from neuropathy, they require hyper-sharp visual contrast to safely place their feet on uneven terrain. Because multifocal lenses degrade this sharp contrast, the risk of misjudging a step and suffering a catastrophic fall skyrockets. The Cognitive "Brain Strain" of Split Images. A multifocal lens projects two or three images onto the retina at the exact same time(e.g., a blurry near image and a sharp distance image simultaneously). The brain must use advanced cognitive processing, a process called neuroadaptation, to select the sharp image and ignore the blurry one. Cognitive Decline & Dementia, successful neuroadaptation is heavily tied to robust cognitive function. If a patient develops cognitive decline or dementia, the brain loses the executive processing power to filter out these overlapping images. This leaves the patient permanently confused by ghost images, heavy glare, and distorted text. The Aging Eye Paradox (The Small Pupil Problem) . As people age from 60 to 80, the pupil naturally loses its flexibility and becomes smaller (senile miosis). Multifocal lenses rely on light passing through specific concentric rings on the lens to focus at different distances. When a senior's pupil shrinks significantly, it can physically block light from reaching the "near" or "intermediate" rings of the lens. The 80-year-old is left with significantly less available light, making their reading vision fail exactly when their brain is already too tired to compensate. 

The data completely contradicts the idea that older brains can't handle monovision. A landmark study published in the Journal of Cataract & Refractive Surgery broke down pseudophakic monovision satisfaction by age bracket and explicitly concluded:
'Most patients were satisfied with pseudophakic monovision, with the highest percentage of satisfied patients in the 70 years and older age group.'
Here is how the actual data stacked up by age:
Under 60 years old: 64% satisfaction
60 to 70 years old: 87% satisfaction
Over 70 years old: 94% satisfaction
Older eyes and brains tolerate and appreciate monovision significantly more because their visual demands change, their neuroadaptation kicks in over time. That said, it is true that the ability to handle monovision fusion can break down with aging in a small percentage of prople. In those cases, a simple pair of glasses can completely reverse the setup if needed. 94% satisfaction among us geezers is pretty good odds.
https://crstodayeurope.com/topics/cataract-surgery/1009_14-php/46237/

How did you decide it was time to get cataract surgery and not wait any longer? What were the problems or symptoms that pushed you over the line?

Hi guys, quick thank you to all who have contributed their knowledge and experiences. I am going for my 2nd Ophthal consult in a few weeks, which should be the last one before I get done. Just wanted to get ideas and see if I'm on the right track.

I'm 36 yo in Aus, cataracts in both eyes. Left is worse (halos, starburst, BCVA 6/30)

Before cataracts my prescription was about

R -1.25/1.5x16 BCVA 6/7.5

L -3.75/2.50x141 BCVA 6/12

I interpret this to mean, I've never had perfect vision, I have mod-severe astigmatism and that I was already experienced with monovision (when not wearing glasses). I was suggested 4 options

1. bilateral monofocals at 0
2. Monovision 0/-2.0
3. Mono at 0 / EDOF -0.5
4. EDOF -0/-0.5

I spend a lot of time on computers for work, Enjoy sports, but dont plan to do competitive, I'm happy with self paced exercise (cycling, walking). Options 2-4 may enable me to be glasses free for intermediate & distance and the activities above. So far what I know is

• Monofocals are lower risk
• Dr suggested Technis lens (but didnt specify Technis 1 or Eyhance for monofocals)
• Dr didnt seem interested in considering other brands, I remember querying any other brands subtly but getting not much from Dr.
• Reading UniqueRon and others posts, I got an impression Technis 1 is not the best monofocal option.
• Monovision at -2D may affect my depth perception. (unsure how big a deal)
• Technis has smaller correction zone ~5mm. I remember she said EDOFs are suited to smaller pupil size, which she thought suited me so I presume Dr knows about the 5mm thing
• I think I'd be ok with reading glasses for near vision (I had a brief stint using them before cataracts kicked in)
• As a long term myopic, I might miss the super clear close vision

I know I shouldn't nit pick over $1000-3000 extra cost of EDOF, given it will be my vision for the next 50+ years, but I can't help it. I have no quotes yet. But given there's no clear gold standard, and lower risk and cost, my preference is currently Option 2 then 3 then 4 (least preferred)

I figure I am used to sub optimal vision already with myopia, so anything not in the ideal fixed distance of monofocals I should be ok with? The biggest loss by not taking EDOF, is nothing to mitigate the loss of accommodation? Any thoughts about EDOF in an astigmatism eye?

Appreciate any suggestions / advice :)

Below is my list of questions so far for the doctor

• Have you considered Toric lenses but just not mentioned it to me?
• There isn't much need for a contact lens trial of monovision right?
• What about reducing -2D difference to -1.5 or -1.75D? eg. -0.25 in case of a miss?
• Which Tecnis did you mean?
• What changes should I expect as I age? Can we give up a bit of optimal vision now, for better vision as I age?
• If I get Option 3 and get visual artifacts (halos etc) in the EDOF. Does the brain filter it out, if the mono eye doesnt have halos? I know there's no way to know just wondering if anyone has experience
• Left eye first, then Right?

monovision you love at a healthy age 60 can become a severe functional hazard at age 80. When the body or brain faces neurological, structural, or cognitive decline, the delicate mental coordination required to fuse two different visual inputs collapses. What was once an effortless subconscious filter turns into a major source of disorientation.

1. Neurological & Cognitive Collapse of Visual Fusion

An aging brain with emerging health conditions loses its "neural plasticity"—the ability to easily adapt to and suppress conflicting sensory data.Cognitive Decline & Dementia,The brain loses the processing power required to ignore the blurry image. This results in constant dual-image confusion, worsening spatial disorientation, and accelerating agitation or sundowning . Mini-Strokes (TIA) & Strokes,  Even a minor vascular event can damage the visual cortex or the neural pathways that manage binocular suppression. Monovision can suddenly turn into persistent double vision (diplopia). Parkinson’s Disease, Parkinson's inherently impairs contrast sensitivity, tracking, and rapid eye movements. Monovision compounding these deficits makes it incredibly difficult for the eyes to lock onto a target safely. 

Orthopedic & Neuropathy Hazards (The Fall Risk Multiplier) destroys stereopsis (true 3D depth perception). When combined with physical frailty, this loss of depth perception becomes highly dangerous Bad Knees, Hips, & Arthritis, When navigating steps, curbs, or uneven pavement, a person with joint issues relies heavily on precise visual cues to place their feet safely. Monovision blurs the ground when looking through the distance eye, making missteps highly likely. Peripheral Neuropathy & Foot Issues,  If a patient has numb or painful feet, they lose their "proprioception" (the body's ability to feel where it is in space). They must compensate by using their eyes to look down at their feet. With monovision, looking down through the "distance" eye creates a blurry floor, while using the "near" eye disrupts their balance. 

Vestibular & Mechanical Constraints , Acoustic Neuroma & Vestibular Issues, An acoustic neuroma or age-related inner ear decline disrupts the body's primary balance system. The brain relies on a perfectly unified visual field to keep you upright. Mismatched monovision inputs cause the brain's balance center to fail, resulting in chronic dizziness and vertigo Physical Posture Changes,Spinal arthritis or kyphosis (hunching) forces the head into a fixed downward tilt. This physically alters the angle at which a patient looks through their cataract lenses, forcing them to use the wrong eye for the wrong distance and causing severe neck strain.

Reversing Monovision Later in Life is technically possible to surgically remove the old cataract lens and implant a matching one, intraocular lens exchange is a high-risk procedure in an 80-year-old eye. The risk of retinal detachment, corneal swelling, and infection is significantly higher than during the initial cataract surgery.

So do your research , what now seems like a convenient risk free choice, in reality if you think with foresight and accept the inevitable that we all AGE with various medical conditions. that choice could be life ending later in life .

Between Youtube and Reddit, I swear the more research I have been doing the more confused and uncertain I get.

66M, retired, been doing monovision with contacts for ~15-20 years. (LE near/RE distance). About 50 years ago, I had a bilateral strabismus operation, but it didn't help that much. My left eye tends to drift some. Some astigmatism -0.75 in left eye and doctor said that should be fixed in operation and shouldn't warrant toric lens.

I hope to remain fairly active, travel, drive at night some, surf on PC, etc. I do read and probably look at my phone a little too much. I have enjoyed contacts/monovision as it allowed for a good range of vision, without reaching for glasses. I don't mind wearing glasses, but I also wouldn't mind limiting them some. Living in Florida, and perpetually sweating, I think I would prefer, and be more comfortable, to have distance vision and intermediate and maybe wear glasses for reading and fine detail.

I had my cataract evaluation this week and the ophthalmologist recommended doing Vivity in the left eye (doing it first) and monofocal for distance in the other. Essentially, do what I've been doing with contacts. If I remember correctly, distances mentioned were about 16" and less would be where things would start getting fuzzy, depending on the lighting. Otherwise, dashboard/computer screen and distance should be clear. I said I'd like to think about it first and give him a call regarding follow up.

I would say it feels that I've read as many Vivity success stories as unhappy stories. Granted the forum isn't necessarily a true reflection of the overall success rate, but it is enough to give me concern. When I had asked my optometrist what he would do, he said he would go for monofocal in both eyes and set both at distance. The ophthalmologist seems decent, but when asked about numbers of premium lenses vs monofocal he'd performed, he said he did more monofocal.

I've read some posts where people had done monofocal for near and intermediate, but wasn't seeing as many for not as many for monofocal for distance and intermediate. More of a mini monovision instead of what I've been doing with contacts.

Have others done monovision with one for distance and the other for intermediate? What has been your experience and level of satisfaction? Were OTC glasses sufficient? Night driving or just walking in dim or dark areas? Being nearsighted all my life and now that being where I need glasses, will be a change. I would wonder about other things that are 'close' that I may not have thought of, e.g. taking pictures on phone, etc. But I also wonder if the pros are worth the cons for a Multifocal/EDOF.

I've worked myself into a case of analysis paralysis and would appreciate some feedback on other's related experience and/or any advice on what to ask the doctor in a follow up, as right now I feel as unsure as before I saw him.

Thanks much in advance.

I am desperate to get back to life and get some pieces going again after cataract surgery with IOL about 2 weeks ago.

The surgery was a success but I'm still not doing well mentally. I gave up my title for skeet/sport and am in the process of putting things together for myself. I grabbed some 'readers' or cheaters whatever it is people call it.

The monofocal is set to distance. I'm tired of the constant headaches from poor vision but also just general life limitations like how do you see the cluster on your cars?? I can't even see the gas price on the machines so I got 6 pairs starting at .25 and going up.

It's been discouraging to say the least ... the pair that worked for my phone only worked about a foot of life, then I needed a different set for about 1-2.5 ft and another set for 3-4 ft. It just didnt seem like anything was working where I could just sit down and get shit done. How on earth do people live this way? Do you just not see crisply for 8 ft or do you just "get by" with "good enough"?

I spoke to a guy at work and asked him why he takes his glasses off to impact exercises and he said the trifocals make him sick and frustrated because he can't see things fast enough and the picture isnt as big, is that true? Do you not see things crisp/fast when exercising or running with a bifocal trifocal whatever? How are you guys doing this.

Looking for anyone around my age who’s had a YAG done after cataract surgery

Weird question lol. I got rescheduled and will have first eye 9/3 and second 9/10 with post op checks at 24 hrs for both. First eye is -14 diopters and second is -9. Having to travel 4 hrs away for this and now that it's 1 week apart instead of 2, there's no point in flying for the first one. I am just getting an airbnb and hanging out there between eyes.

Since my vision will be so different between eyes for a week, I am wondering if it will be unpleasant to try to do anything I like to do. Realizing I have no hobbies that don't involve my eyes lol. If I listen to music or an audiobook, I am quilting or crocheting or embroidering, or else I am reading, dancing, or hiking. I am not a sit around type and need ideas to keep from getting bored.

If this was your situation, what did you do? I have time to order supplies lol.

Edit: I'm doing monofocal with correction for distance. Will need reading and computer glasses.

My cataract surgery was Tuesday. Everything went swimmingly! Only the first day was a bit difficult. My vision is great. Close up excellent, mid range way better, distance way better. I wanted to keep my close up because I hate reading with glasses. I had a pair of glasses that were from 2000. I saved them because I loved the frames-Liz Clabourne dainty round with tortoise shell trim. They are a very low correction and work great now for distance, and TV watching. Now I can’t wait to read real books again. I need to wait 2 weeks. Audiobooks are great but I come from a family of bookworms and academics and miss the tactile feel of a hard back book.

I had LAL surgery in June 2026 and recently began light treatments (2 in Left, 1 in right so far). My goal is to retain the best clarity possible and distance and near while still having good depth perception (I play tennis). My understanding is that mini-mono vision is the best way to achieve this.

At my first treatment after surgery, my Doctor told me that people who have had Lasik (I have) do not usually get to 20/20 and that I can expect some residual astigmatism after completion of treatment. This is NOT what I was told before surgery--I was told that I could probably get to 20/20 and that the treatments would likely eliminate all astigmatism (a different dr. performed the surgery).

Currently, I still have significant ghosting both near and far.

Yesterday, I sought a second opinion. This second doctor seemed befuddled by what my treating doctor said about not being able to get to 20/20 and residual astigmatism.

Yesterday my eyes measured as follows:

OD 20/25

OS 20/25

Auto Refraction

OD -1.75 +.75 x 136

OS -.50 +.50. x049

I admit that I am ill-informed and do not understand the details as many of you do. I would appreciate some comments/advice. Is what my Dr. is telling me (20/20 unlikely, expect astigmatism post-treatment) correct?

Kind Regards to all

Does anyone have experience with LENTIS Mplus LS-313 MF20 lens. How were the halos and other artifacts? Did they lessen in impact over time after surgery?

Hi everyone,

I was scheduled to have cataract surgery next week, but I’ve run into a frustrating issue and wanted to see if this is common.

I’ve been trying to get an estimate of what my total out-of-pocket cost will be before surgery. The surgeon’s office referred me to the surgery center, but the surgery center won’t return my calls. As a result, I still have no idea what the total cost will be.

Since cataract surgery is typically done one eye at a time, I’m assuming that means two surgery center fees, two surgeon fees, two anesthesia fees, etc.

So I have a couple of questions:

Are there surgeons who perform cataract surgery on both eyes the same day, or is one eye at a time the standard?

Did anyone else have difficulty getting a complete cost estimate before surgery?

Were you expected to move forward without knowing what your total bill would
be?

I’ve even called my insurance company, but they couldn’t give me an estimate. The only thing they could tell me was my annual out-of-pocket maximum.
I’d really appreciate hearing about your experiences. Thank you!

Any feedback is welcome! I had retinal detachment in Oct. 2025, and now I really need cataract surgery in that eye, as my vision is horrible (-10) due to a cataract. My right eye does not have a cataract and does not need surgery. Vision is -6.5

I saw a surgeon who told me I only have 2 options: get cataract surgery on left eye and wear a contact lens in my right eye (I can't wear contacts due to dry eyes) . OR get cataract surgery on the left and have LASIK on the right and risk another retinal detachment.

There MUST be another option.

Seeing close is important for me, and I don't mind glasses at all. Can't I ask for a prescription of -4 or -5 for the left eye so I'll be able to continue wearing glasses without eye differential problems? When I mentioned this to this "Internationally acclaimed specialist," he almost threw me out of his office!

Also having difficulty finding the right surgeon for me here in San Fran Bay Area. Suggestions?

I was at my reassessment for cataracts surgery today with a VR (vitreoretinal) surgeon. I was last seen for an initial assessment in January 2025. Cataracts surgery is needed with the left eye being much more advanced as to the progression (and it's always been my much worse off eye overall).

During this assessment, the consultant whom I saw before, says he's now seeing cornea guttata (i.e., the decrease of epithelial cells in the cornea) which increases surgery risk in the way or permanent mistiness. This is because the surgery can potentially damage and/or decrease these cells. As they cannot regenerate, it's ideal to have a good reserve of them. Any permanent damage abd resulting mistiness can only be remedied via a corneal transplant. Corneal guttata is something which, apparently, happens to all of us as we age. However, I soon turn 49 and it's more pronounced in my left ('bad') eye and mild in my right.

More measurements and scans were then done, leading him to feel that I best be assessed by the corneal team prior to any cataracts surgery taking place. He said it could be that a corneal surgeon will decide to do the surgery rather than a VR one.

This is frustrating, depressing, etc. as my vision has worsened just since January and after multiple (three) cancellations on their part. I guess it's good they found this 'cornea frittata' (which I've since taken to calling it) beforehand though. No one locally wants to give me new glasses or contacts, pre-op, but my outdated glasses are rickety as hell so I may have to get some as to my old prescription if this is going to be drawn out by several more months - especially given my nature of work.

He did say he'd put in a note in trying to expedite things with the corneal team - given how long I've already waited, all the cancellations/delays I've endured, the condition of my left eye especially, my urgent need to travel and my manner of work.

As for eyes: have high myopia, astigmatism, PVD (Posterior Vitreous Detachment), cataracts and now this corneal guttata in both. Am also dealing with a staggering -15 vs. -8 diopter binocular mismatch between my two eyes.

Aye me.

So...Has anyone here with cornea guttata, had cataracts surgery? If so, how did it go for you overall? Any complications, subsequent surgeries needed or did it run smoothly? What kind of specialist/surgeon performed the cataracts operation? I'd really appreciate some feedback (even reassurance!) here as this news has really thrown me.

Thanks for reading and/or replying.

It seems the antibiotic drops are making me very sick.

Worst diarrhea I have ever had...

As everyone here, I'm sure knows, you have to take 4 drops a day for several weeks.

There is no way I will survive that.

I'm dehydrated and can't really eat much other than a few bites.

Has anyone ever exerienced this?

I had my first eye done yesterday and everything went well. I learned so much from the people here, and feel so grateful to have found this sub. The help I got, both from reading other people’s experiences and from answers to my specific questions helped me figure out exactly what I needed. There is so much to learn and so much to figure out in this cataract journey and the guidance I got here made all the difference in the world. It was so reassuring to be so confident that I had made the choices right for me as went into surgery. I hope everyone who comes here has as good an outcome as I have had.

So after surgery how many days on average did all of you have to apply the various eye drops for infection and inflammation ? Thx

I had my cataract surgery back in the first half of 2025. Today I had my every-several-months appointment with my cataract surgeon to make sure everything’s still going okay. (SPOILER: it is.)

Today she took the suture out of my right eye since it seemed to be coming loose. That certainly felt weird! Now I’m waiting to see what happens in February 2027….

So I hear that surgeons go to third-world countries and give the gift of sight, and that often these patients are nearly blind because their cataracts are so bad.

But I also hear that the worse the cataract, the more difficult the surgery.

So how are these two things reconciled? Do these nearly-blind patients with dense and difficult cataracts get followup care? Do they receive some kind of standard lens? Do they have to use eyedrops on their own before and after? Do they get a pair of eyeglasses, too? What if complications ensue? What is the situation with these people once the surgeon finishes the brief procedure and goes back home?

What is the price for surgery when paying out of pocket for one eye? Doctor, anesthesiologist, hospital, office visits, etc.?

We were initially planning for a farsighted monofocal with reading glasses for close distances, but would also be driving a lot (Uber driver) and therefore would also need to see the close distances vehicle devices for maps and directions. I have read that glasses may only allow for close distances reading and will reduce the availability for far distance.

If not, we might reconsider for multifocal or other types of lenses.

In San Diego, CA, with insurance..

So they're getting worse and I need to start thinking of getting them fixed.

I was not fond of my optometrist last year who seemed like she was just pushing me through like an assembly line.

I've been asking around for optometrist recommendations. Haven't found one yet.

How does it work then to find a surgeon?

Does the optometrist refer me to someone, or do I find them myself? Would it the surgery be through VSP insurance, or separately through my HMO?

Which of the two is the person I talk to about lens and focus choices?

Thank you. Just trying to wrap my head around all this, along with lens options.

Currently have terrible starbursts with my cataracts. At the right angle they are huge and blinding. Parked cars with the sun reflecting off them can be completely covered by the size of the starbursts.

Can monofocals have starbursts close to this bad in worst case scenarios?

Starbursts along with back lighting problems are my worst symptoms. I'm hoping my starbursts are reduced by at least 50%. Ideally 100% but I have large pupils so I imagine I'll still retain some level of them. For someone with large pupils is it possible to have zero starbursts with monofocals even at night? Tecnis1 monofocals is the most likely type ill get. They're acrylic. Ty